Inspection on 21/10/08 for The Cedars

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Cedars 18/12/06

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cedars, The 4 Chequer Street Bulkington Warwickshire CV12 9NH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie McGarry     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Cedars, The 4 Chequer Street Bulkington Warwickshire CV12 9NH 02476310974 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Yearby Type of registration: Number of places registered: Coventry and Warwickshire Partnership Trust care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The home can provide care and accommodation for 4 service users under 65 for reasons of learning disability. Date of last inspection Brief description of the care home The Cedars is a joint venture between Leicester Housing Association, which owns the property and Coventry and Warwickshire Partnership Trust, which provides the services and care. The Cedars provides 24-hour care to 4 people with a learning disability. The Trust also provides Day Services for each individual. The Cedars is a domestic-style bungalow in the village of Bulkington. The bungalow has a communal living/dining area and four single bedrooms. There are no en-suite facilities. The home has been adapted to meet the service users needs including a good range of equipment to assist with daily routines. There is a large communal garden with flowerbeds. The property has secure fencing around the perimeter. There is a large minibus driven by staff members to enable people who live here to access the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 4 Brief description of the care home community. The current scale of charging is £273.00. Additional costs that have to be met by service users include toiletries, holidays and social expenses. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service two star. This means the people who use this service experience good quality outcomes. This was a Key unannounced inspection; it was undertaken on the 21st October 2008. This inspection was carried out to establish the outcomes for people living in the home, and to confirm whether they are protected from harm. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff, people living in the home and the manager were spoken with. The inspection focused on assessing the main Key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us Care Homes for Adults (18-65 years) Page 6 of 30 such as notifications of accidents allegations and incidents. The manager completed and returned an annual quality assurance questionnaire containing helpful information about the home in time for the inspection. Questionnaires were completed and returned by four people at the home. As the people who live at this home have communication needs these questionnaires were completed by the staff who work there. Three staff members also completed staff questionnaires giving their views of the service. The inspection included meeting everyone living at the home and case tracking the needs of two people. This involves looking at two peoples care plans and health records in detail and checking how their needs are met in practice. Information was also sampled from two other peoples files to check that information is available to support good care practices. Due to the high communication support needs of the people at the home it was not possible to gain peoples personal comments on the service. Discussions were held with staff on duty and the manager. A number of records such as care plans, complaints record, staff training certificates and fire safety records were also sampled for information as part of this inspection. The inspector would like to thank the people who live at The Cedars, the staff and the manager. What the care home does well: What has improved since the last inspection? What they could do better: Most of the information in support plans and risk assessments contain the information needed for staff to be clear about the help that people need and the way they like care Care Homes for Adults (18-65 years) Page 8 of 30 provided, however further work needs to be undertaken to ensure all aspects of peoples care needs are recorded. Homely remedy medication is not accounted for properly. Daily checks should be carried out to make sure the medication records tallies with the stock record. The hallway and lounge is sparsely decorated. Effort has been made by staff to draw murals on the walls to add some colour, however further work needs to be undertaken to make the home nicer for people and offer greater visual stimulation. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their representatives have the information needed to decide if the home can meet their needs. They have their needs assessed and a contract that tells them about the service they will receive. Evidence: At the last inspection, the home demonstrated that it has an acceptable procedure for admitting new people to the home. The current group of people living at the home has remained unchanged since the home opened. There are currently no vacancies. The home has an admission procedure in place and the manager expressed a commitment to assessing peoples needs before they move in and providing opportunities for people to visit beforehand so that they can decide if the home is the right place for them to live in. Detailed assessment information and resettlement plans are on the files of people living at the home, verifying the homes commitment to assessing peoples needs. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Four peoples files were checked. Three people have been issued with contracts detailing the terms and conditions of their stay at the home so they and their representatives are clear about what they are entitled to and what they have to pay for. One contract could not be located. The manager said that a copy of the Service User Guide, Statement of Purpose and contract are given to people who may be considering moving to the home. Each are avialble in easy read formats. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The outcomes for people who use this service are good and people are supported to make everyday choices so that they can exercise some control over their daily lives. Care plans and risk assessments are completed to describe peoples individual needs to ensure that they receive the care and support that they require in a consistent manner. Evidence: As at the previous inspection, care plans looked at continued to evidence that people are supported by staff in a person centred aproach to care. Each person living at The Cedars has a care plan in place which has detailed guidelines on the relevant aspects of care, such as morning and evening routines and access to the community. These are regularly reviewed. Guidelines include the assessment and management of risks, such as behaviour management, support to individuals with epilepsy, and those who required help with eating and drinking. Good, clear, detailed guidelines were noted for Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: key areas such as bathing and mealtimes. However the risk assessment plans for one person needs to be updated to identify the associated risks to themselves and others when they choose to lie on the hallway floor. Comments by staff and the manager demonstrated a detailed knowledge of peoples care needs. Staff were able to illustrate examples of good care practices. For instance, staff were able to discuss the safe practices they follow to ensure that two people who try to eat various objects and are at risk of choking are supported with minimal risk to their wellbeing. Similarly staff were able to explain the approaches they would follow to support a person who presents occasional challenging behaviour to reduce the possibility of it escalating. The manager has been proactive in trying to identify the triggers to these behaviours and has responded by reviewing their approaches to the care for this individual. There is a designated key worker system to promote continuity of care and support to the people who live there. The people who live at the home are involved in the planning of their care through key worker meetings. Staff hold meetings with the people who live there regularly to make decisions about menu choices and activities preferences. Care plans and daily records also detailed information on promoting peoples independent living skills through such activities as cooking sessions. The people who live here have communication difficulties and rely on staff recognising signs to understand their needs and wishes. Staff were observed communicating effectively and respectfully. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here benefit from a wide variety of activities to meet individual needs, and are supported in contacts with relatives. Mealtimes are made a positive experience by good staff support and service user involvement in planning and preparation. Evidence: The people who live here continue to access a variety of activities, some through local colleges and day services, others through activities provided by the service itself. Records detail activities that people enjoy, for example, swimming, horse riding, shopping, going out for meals and college courses. The service has developed individual life story books, which have a clear, illustrated record of activities for of what each person has done in the past year and what they had enjoyed. The life story books contain numerous photographs of the various activities people are involved in, so they can look back on what they have done and achieved in the past year. The Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: service achieved a Dignity in Care award in response to the person centred care work staff provide to the people who live there. This award was presented to the staff from the Department of Health and Institute for Innovation and Improvement. On the day of the inspection, one person at the home was unwell. During the inspection this person remained seated in the lounge area where staff could monitor their wellbeing whilst enabling them to watch their choice of DVDs. From a discussion with the manager, we were told that this is this persons preference as how care should be provided when they are unwell. Two other people were supported to go out shopping by staff. Planned activities for one person had to be changed from swimming to one to one interaction and relaxation, as there were not enough staff on duty to support this person to go swimming. Staff responded well to this situation and made alternative arrangements with this person to participate in a relaxation activity, and have one to one time with a member of staff. We observed one member of staff using relaxation techniques, as devised by this persons physiotherapist, to interact and engage with this person. When we spoken to the member of staff they demonstarted their knowledge about the aims and purpose of the activity. People who live here maintain links with their family and staff provide support where possible. One person who lives at the Cedars has no family however, the manager informs us that staff have carried out work with this person in relation to their life history. There was evidence in daily records that peoples needs with regard to keeping in touch with friends and relatives are being recorded. The menu showed a variety of wholesome food available, and picture menus are used when people decided what meals they would like to have each day. We are told by care staff that the money available to them each week for food and drink shopping has not increased in recent years. Staff tell us that this does not impact upon the provision of meals for the people who live there, however, there is little money left over from shopping to buy any treats for the home. The manager confirmed that this was the case and is liaising with senior management about this issue. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live here benefit from a service that meets their personal care needs in a way they require, and is prompt in identifying specific needs and getting in additional outside support as needed. Evidence: Staff were observed in supporting residents in a sensitive, calm, and warm manner that enhanced their personal dignity. Interactions between staff and the people who live there are easy going and good natured, with requests for help being heeded in a timely manner, particular behaviours being interpreted and acted upon. As at previous inspections, care plans looked at continued to evidence that people have ready access to a GP and other health professionals locally including, consultants, dentists, speech and language therapists, opticians and chiropodists. On the day of the inspection, staff supported one person to visit their GP following their concerns about that persons health needs as they have been displaying symptoms of diabetes. The information in the care plans are well organised and guide staff about how Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: peoples care support is to be provided. For example, one person has challenging behaviour and can occasionally hit out at staff. As this is a recent change in their behaviour, staff are documenting all incidents, regularly reviewing the information and liaising with professionals to understand the triggers to this change in behaviour. Guidelines inform staff that this person needs to be closely monitored to minimize risk to themselves, other people who live there and staff. It is evident from observations, speaking to staff and reviewing records that these guidelines are being followed. Discussions with staff and the manager illustrate that staff are providing good care and sensitive support and have a good understanding of peoples needs. Care plans are being regularly reviewed and updated to reflect any changing needs of the people who live there. Further work must however be undertaken to ensure documents are completed in full, for example, one person has an under active thyroid and is currently putting on weight. Weight records are not being maintained to monitor weight increase, and guidelines need to be in place to advise staff what action needs to be taken in response to weight gain that could impact upon the persons health and wellbeing. Records do however demonstare that this person is being supported by their GP with this health need through regualr blood tests. A suitable lockable cabinet is in place for the safe storage of medication at the home. The cabinet was well ordered and not overstocked. Medication looked at was correct and audits could be easily made. The service does need to ensure that that homely remedies like paracetamol are also auditable. The home currently carries no controlled drugs that would necessitate any special storage and recording arrangements. There are no drugs that need to be stored in the fridge. There are a range of policies and procedures in place relating to administration, training and disposal of medication in each individuals medication folder. The home keeps a float of peoples monies, this is held securely in the homes safe. Two individuals financial records and money were checked. The money held matched the records. Receipts were evident to show items that were purchased. Peoples bank statements for their personal accounts were also seen. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here can be confident that the service listens to and acts upon their views. They are protected by the services policies and procedures, and by the close involvement of relatives and outside professionals. Evidence: Staff were seen to be attentive to service users needs, using communication aids or knowledge gained from experience, where communication was not clear. The service has appropriate policies and procedures in place concerning abuse, and staff receive training relating to protection of vulnerable adults. Staff spoken to were able to explain appropriate actions in the event of abuse being witnessed or suspected. Development records showed that the majority of staff had completed National Vocational Qualifications (NVQ), which includes sessions in safeguarding vulnerable adults. There is an accessible complaints procedure Letting us know in place at the home with pictures to help people to understand the contents. The complaints procedure is contained in peoples files and Service User Guide. The annual quality assurance assessment and records seen during this visit showed that there had been no complaints made about the home since the last inspection. No complaints have been received to us about the home since the last inspection. Care Homes for Adults (18-65 years) Page 19 of 30 Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe and comfortable environment that meets their individual needs. Continued redecoration work is needed to make the service homely and more stimulating. Evidence: The home was warm, tidy, and in a generally good state of repair. Some of the communal areas appeared rather bare. Staff and management advised that one person had can be destructive with objects, and items e.g. pictures had consequently been removed. The manager is currently drawing murals on the walls in the lounge and the bathroom to make the walls less bare and create more visual stimulation. Three bedrooms visited were personalised to a high degree, displaying a number of individual possessions including pictures and photographs. One persons room is sparsely decorated and their belongings are in a locked cupboard outside of their room. Staff explained that this was necessary due to the behaviour of the individual and this persons individual preference to have very little in their room. We were told that this person would remove items left in their room, so staff store this persons belongings in a locked cupboard to keep them safe. Records maintained by staff reflect the need for this action. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Since the last inspection redecoration of one persons room has been undertaken. The service has also provided new dining furniture. The house is clean and there were no unpleasant odours, which indicate that effective cleaning and infection control procedures are in place. Staff need to ensure that foodstuff is labelled once opened so people know when the food needs to be consumed by. Since the last inspection, the service has responded to the requirement made. The service new provides sufficient bathing and showering facilities to meet the personal and healthcare needs of those who live there. Staff spoken to state that two of the people in particular who live there are benefiting from this, and should there be any problems with the bath hoist, staff are able to continue to meet the personal care needs of all four people who live there. Comments by a member of staff indicate that staff follow safe hygiene practices when carrying and disposing of continence products. Clinical waste bins are in place at the home. The kitchen was clean and well organised. Records were kept of the fridge and freezer temperatures showing appropriate temperatures to maintain good food safety. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and competent team of established staff who have a good understanding of each persons individual needs support them. The home operates a robust system of recruiting staff for the protection of the people who live there. Evidence: On the day of the inspection there were three members of care staff on duty and the manager. The manager informs us that there are usually six staff each day to support people in their day services and personal interest. Staffing rotas confirmed that there are usually more than three staff on each day during the week. As previously noted, lower staffing levels on the day of the inspection resulted in the need for a change to peoples planned activities for the day, for example, plans were in place for one person to go swimming, however two members of staff are needed for this to happen. Alternative in-house arrangements were made for this person. Three staff files were looked at to ascertain whether recruitment policies were robust. Two of the recruitment records sampled showed that appropriate checks had been made to make sure that staff were suitably experienced and qualified to work with Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: vulnerable adults. Criminal Records Bureau (CRB) checks had been made and written references received before the employees began work so that people were protected from the risk of having unsuitable staff work in the home with them. One person however has had the Protection of Vulnerable Adults First check and references are in place, however the full CRB has not been completed despite this person having started work in July. The manager states that this member of staff is still working under the supervision of other staff, and the manager will ensure that this staff member does not work alone until the CRB check has been received. Existing staff welcomed the additional staff support, and commented on how this has enabled the people who live here to do more varied activities of personal interest and have frequent one to one interaction with staff. Records of supervision notes were evident. Information from supervision records demonstrates peoples personal development as well as information on changing needs of people who use the service and how care needs to changed to meet changing needs. The total number of staff within the home is nineteen, this includes a full time manager whose hours are supernumerary, and a team leader. The majority of staff work full time. Information supplied by the manager state that 14 members of care staff are qualified to National Vocational Qualification in Care Level 2. This is above the national Minimum Standard for 50 per cent of staff to be qualified. This should mean that people living here benefit from having their needs met by staff that are appropriately experienced and qualified. The training records of staff working at the home were seen and demonstrate that staff receive mandatory training. It was evident that staff have opportunities to attend various training programs. Staff present during this visit were able to answer our questions about meeting the needs of people who live in the home and have clearly got to know them well. The home does not have any domestic or catering staff. Care staff take on these duties during their shifts. Most of the care staff are trained in food hygiene. At night time, there is one sleeping staff member and one waking member of staff to respond to peoples needs. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed in a way that listens to and acts upon the views of the people who live there. The management of areas of health and safety practice is sufficient to ensure people are protected from potential risk of harm. Evidence: During conversations with the manager, she demonstrated a clear understanding of the way the service should continue to ensure ongoing development so that people who use this service can continue to live ordinary and meaningful lives. Staff spoke highly of the manager and the support that they receive from her. The Annual Quality Assurance Assessment (AQQA) completed by the manager was completed to a good standard. Information provided was supported by a range of evidence, and the Annual Quality Assurance Assessment (AQAA) fully informed us about changes the home has made and where improvements still need to be made. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: There are clear lines of accountability within the home with the team leader reporting to the manager who in turn is supported by her organisational line manager. A representative of the registered provider visits the house on a regular basis to report on the standard of care provided, from which reports are made available within the home. From looking at the most recent report and discussion with the staff team, it was evident that the views of people who live in the home had been actively sought with regard to the way in which the service is being run. We were told that there are regular house meetings so that people have an opportunity to be involved making decisions about what is important to them, such as planning activities and menus. The home manager completes an organisational audit system for monitoring working practices and the quality of care delivered to people living in the home on a monthly basis. Evidence was available to demonstrate that an action plan is developed to address areas requiring improvement. A number of checks are made by staff to make sure that peoples health and safety is maintained. For example, records showed that the fire alarm system had been regularly tested and serviced to make sure that it was working properly. Peoples money held for safekeeping is deposited into their bank account and a float is held in the home so that people can access their money when they want it. Individual account sheets are available for each person detailing income and expenditure along with receipts accounting for any expenditure. We examined a sample of account sheets, which we found to be accurate. Evidence throughout this report demonstrates there are good outcomes for people living in the home. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 There must be risk 18/11/2008 assessments in place for all people living at the home. Plans must be available for all identifiable risks, specifically in relation to the monitoring of weight for one individual. This is to ensure staff can monitor any changes to peoples health needs and take timely and appropriate action to maintain peoples health and wellbeing. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Set up a daily check of the homely remedies medications to ensure that the record on the medication sheets and stock sheets tallies with the number of tablets in the boxes. This is necessary so that medication can be properly accounted for and any errors are traced swiftly and resolved. Continue with plans to improve the decor in the hallway and lounge to create a more homely and stimulating 2 24 Care Homes for Adults (18-65 years) Page 28 of 30 environment. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!