Inspection on 09/02/09 for East Fields (Royal Mencap Society)

This inspection was carried out on 9th February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

East Fields (Royal Mencap... 15/02/07

East Fields (Royal Mencap... 09/01/06

East Fields (Royal Mencap... 31/08/05

East Fields (Royal Mencap... 21/02/05

East Fields (Royal Mencap... 11/11/04

East Fields (Royal Mencap... 15/01/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: East Fields (Royal Mencap Society) 24a East Crescent Duckmanton Chesterfield Derbyshire S44 5ET 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: Angela Kennedy Date: 0 9 0 2 2 0 0 9 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 33 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 33 Information about the care home Name of care home: Address: East Fields (Royal Mencap Society) 24a East Crescent Duckmanton Chesterfield Derbyshire S44 5ET 01246824511 01246824511 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Miss Claire Marie Thompson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Eastfields offers planned short breaks for adults with a learning disability aged between 18 to 65 that live with their family or carers. This service enables parents or carers to have a rest or go on holiday. Eastfields has 2 lounges, a games room, a conservatory a kitchen and laundry. There is one bathroom, shower and toilet upstairs and a bathroom, walk in shower and toilet downstairs. There are 3 downstairs bedrooms and 5 upstairs bedrooms.There is a garden at the front and back of the house. The cost to stay at Eastfields depends on your age and your savings if they are over £22,250. At the time of this visit the cost for each night ranged from £7.53 to £53.03. Information on how costs are worked out for each person was included in the service guide. Items not included in this fee are: Personal items, like clothes and toiletries. Money for meals, drinks and snacks at individuals day centres, college or workplace and money for activities and outings during your stay at Eastfields. Care Homes for Adults (18-65 years) Page 5 of 33 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 Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home This key inspection took place over one day. The last Key Inspection undertaken at this service was on the 15th February 2007. The inspection was focused on assessing that the service met the key National Minimum Standards The commission had requested the service to complete an Annual Quality Assurance Assessment and the information provided within this document is included within this report. Surveys were sent out to some of the people that used the service and their carers and some of the staff team. The information provided within these surveys is included within this report. There was one person that had come to Eastfields for a short stay at the time of this visit. This person was spoken with and confirmed they were happy with the support and care they received when they stayed at Eastfields. They said that they enjoyed coming to Eastfields and was able to tell the inspector some of things that they enjoyed doing whilst at Eastfields. Two other people were coming to stay at Eastfields on the day of this visit but had not arrived before the inspection ended. Care Homes for Adults (18-65 years) Page 7 of 33 The manager was on duty on the day of this inspection visit and provided all of the required information. What the care home does well Prior to accessing the service individuals needs are thoroughly assessed through an admissions short break panel. This ensures that the panel can be sure that Eastfields is able to meet individuals support needs before the service is offered.MENCAP work in partnership with Social services and work closely with other short break providers in the area who have the same referral system, some which are health resources. Positive comments were received from people using the service and their parents and carers. Such as, they make everyone feel at home both service users and relatives, they let people choose what they want to do or not do and they have plenty of outings to different places . Staff confirmed that the training provided to them was to a good standard, comments included Training is continuously update and resource information is readily available. Care Homes for Adults (18-65 years) Page 8 of 33 What has got better from the last inspection What the care home could do better Overall the documentation seen such as the care plans and risk assessments were very detailed and addressed all areas of health, personal and social care support needs. However the risk assessments seen within one persons file had not been reviewed since September 2007, this has the potential for any changes in risk to go unidentified which could mean that the correct measures to minimise risk are not in place. Care Homes for Adults (18-65 years) Page 9 of 33 It was stated by the manager that these risk assessments would be reviewed with the individual during their present respite visit. This led to the manager identifying a number service users risk assessments that had not been reviewed within the last 12 months. The manager confirmed that these assessments would be reviewed with individuals at their next respite stay. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Angela Kennedy Cambridge Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE Tel: 01223 771300 Care Homes for Adults (18-65 years) Page 10 of 33 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 11 of 33 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 12 of 33 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 . A robust referral and assessment process is in place to ensure individuals needs can be met by the service. Sufficient information is available for individuals to decide if the service is right for them. Evidence: At the time of this inspection visit, one person was accessing the service for respite, there were two other people due to access the service later that day but they did not arrive before the visit ended. The records held for the person accessing the service were looked at and this person was spoken with regarding the service provided to them at Eastfields. Although this person was not able to articulate their views on the service they were able to confirm that they enjoyed their respite stays at Eastfields and indicated that they got on well with the staff and felt they were supported well. This persons records showed that a thorough assessment of their needs had been undertaken before they had started to use the service. As stated in the pre-inspection information received, prior to accessing the service each persons needs are thoroughly Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: assessed through an admissions short break panel. This panel consist of representatives from social services, the primary care team and other short break providers in the area who have the same referral system, some which are health resources. This ensures that the panel can be sure that Eastfields is able to meet individuals support needs before the service is offered and if not refer individuals to a more appropriate service. The manager confirmed that there was detailed information available to prospective users of the service and their families. This information was seen and included the service user guide and short break agreement information pack. Both were provided in an easy read format that was appropriate for people with learning difficulties. Discussion with the manager and records seen demonstrated that following assessment at the panel meeting, if accepted, individuals induction into the service was undertaken at a pace that was appropriate for each person. This commenced with a visit to look around the home and was followed with tea visits and overnight stays that lead to planned respite. Comments received from people that used the service and their carers demonstrated that they were happy with the service and had been given an opportunity to visit before they decided if it was right for them. One parent said, ... visited Eastfields and met some of the staff before opting to have respite care there. One person that accessed the service said, My sister told me all about Eastfields. When I was asked if I wanted to go to Eastfields I said yes and I’m glad I did. Care Homes for Adults (18-65 years) Page 14 of 33 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individual’s needs and goals are met through the support plans in place and are supported to take risks and make choices to enable them to stay independent. Evidence: From the records seen it was apparent that individuals support needs were identified within their support plans. The records seen addressed all areas of personal, health and social care. These support plans covered details of morning and night time routines, support with personal care, food and drink preferences, day placement information and transport, social and recreational interest and important people in that persons life. As stated in the pre inspection information each person had a designated key worker. The key workers role was to ensure that the information within individuals support plans was current and workable. Information recorded in the personal file seen confirmed the level and type of support that was required for that person’s needs to be Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: met. This included a support plan regarding making choices and decisions. This plan addressed the person’s vulnerability and included detailed information for staff on how this person was to be supported to enable them to make choices and decisions. For example methods of communication that were to be used was identified to enable this person to make informed decisions. Written evidence was seen to demonstrate that this persons main carer had been involved in and agreed with support plans in place and that these support plans had been reviewed and updated on a regular basis. As stated in the pre inspection information the staff at the service were involved in individuals circle of support reviews to ensure that they were up to date on any significant changes or developments in individuals support needs. Parent and carer reviews were also held to enable carers to have their say on the service provided and any changes they felt would be beneficial. The manager confirmed that these reviews were undertaken on an annual basis and prior to the allocation of respite for each person. This enabled carers to confirm their preferences regarding respite dates available. Risk assessments were in place within the persons file looked at. These assessments were detailed and provided staff with clear instruction as to how each person was to be supported within their daily lives in a safe way, whilst promoting their independence and choice. The risk assessments seen covered all areas of daily life and corresponded with the support plans in place. Risk assessments seen had not been reviewed since September 2007. Staff signatures were in place to demonstrate that they had read these risk assessments in December 2008. On reporting this to the manager it was then identified that several other peoples risk assessment had also not been reviewed within the last twelve months. The manager stated that these risk assessments would be reviewed and updated as required at the next respite stays of all individuals concerned. This will ensure that the information provided remains relevant and that people are kept safe. One carer had commented that their relative was unable to access public transport independently when in respite and had stated that when at home they were able to access their local community independently. This was discussed with the manager and it was confirmed that this persons risk assessments had been reviewed and they were now being supported to access the local community independently whilst in respite. Comments from the people that used the service and their carers indicated that the support they received from the staff team met their needs and empowered them to make choices and decisions in their daily lives. Comments included, they make everyone feel at home, they let people choose what they want to do or not and staff respect his choices such as to spend time alone in his room or sit with others and join in... and On Saturday mornings ...takes me to town and then to tesco. Information about local advocacy services was available at the home. The manager confirmed that advocacy services have been used for people accessing the service and that the staff team had received advocacy training to enable them to support Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: individuals in expressing their needs. In the pre inspection information the manager stated that where there are highlighted difficulties with consent and making decisions, the service accesses support from the Independent Mental Capacity Act service, Derbyshire advocacy services and would arrange a circle of support meeting to address these issues. Care Homes for Adults (18-65 years) Page 17 of 33 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service is responsive to each persons different needs and supports them to maintain contact with the local community, family and friends during their stay. A variety of leisure activities enable individuals to choose how they spend their spare time. Dietary needs and choices are catered for and meals are enjoyed. Evidence: It was confirmed in the pre inspection information that individuals were able to attend their usual day placements when accessing respite. This was also confirmed by the records seen in the persons file looked at. This person had support plans and risk assessments in place regarding accessing the day service when at Eastfields and this included information regarding their transport arrangements. One member of the staff care team was allocated the role of the activities coordinator and this person discussed how they planned structured activities such as trips out. It Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: was stated this was done through monthly meetings that were held with people that accessed the service and through monthly staff meetings. One person accessing the service confirmed that they went out regularly with the staff and on the day of this visit went shopping with staff support. In place was an activities diary, where activities were planned. An album of photographs showing the activities and outings that had been undertaken was also seen. Written information was also included with these photos regarding each activity. The manager confirmed that this album was used as part of the review process with families as they were then are able to see the types of activities that the people using the service had been part of. Eastfields has a variety of leisure equipment in place for the people accessing the service, all of the bedrooms had a TV. There was a games room with pool table and a football table. Within this games room artwork was on display that had been done by people using the service. There was two lounges, one lounge had an audio descriptive service on the television for people with sensory impairments. Games equipment such as a Games console and a Wii were provided in one lounge and the other lounge had a Play Station 2. There was also a conservatory that had a computer with internet access. A variety of music cds and videos was also available to use along with a karaoke machine. The service user guide provided information on the types of activities available both within the building and in the local community, such as bowling, the cinema, meals out, shopping trips, local walks, pubs and the local nightclub. The manager confirmed that the local nightclub organised a night for adults with learning difficulties every three months and this was accessed by people using the service. The person in respite at the time of this visit confirmed that they enjoyed going to the nightclub. As stated in the pre inspection information there is also additional equipment such as DVD players and stereos for people to use in their rooms. Each person was offered a key to lock their bedroom when in respite, written evidence of this was seen in the personal file looked at. The comments received by the people using the service indicated that they enjoyed the activities available to them and confirmed they were able to decide what they wanted to do. One person said, if others decide on watching TV, I go to my room and do a puzzle or two. Carers comments also confirmed this saying, ...is happy and content when visiting Eastfields. He looks forward to going and has lots to tell us when he gets home. The manager confirmed that there is an open visiting policy but said that visitors are asked to ring before hand to make sure that there will be someone at home. It was confirmed that although some people did have visitors, the nature of the service, which gave main carers a break meant that this was not a daily occurrence. However it was confirmed that individuals were able to invite friends to visit when they accessed Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: the service. As stated in the pre inspection information family and friends also made contact by phone during respite stays. Comments from one relative confirmed this, On occasions ... has rang for a chat when at Eastfields, sometimes he forgets and we ring him. The manager confirmed that the bulk of food shopping was undertaken through internet shopping. She did state that people using the service were able to food shop with staff support for daily purchases. This took place on the day of this visit, when the person in respite went food shopping with a member of staff. Menus were on display on the fridge in the kitchen area. It was confirmed by the manager that menus were planned in consultation with the people using the service when they accessed respite and at service user and staff meetings. This was seen in the minutes of meetings looked at. People were encouraged to be health aware and this included healthy eating, this was noted on the menus seen. The manager confirmed that specific dietary needs could be catered for, such as gluten/wheat free diets, diabetic diets, cultural and religious requirements, food allergies and diets for individuals that had chosen to join a weight loss programme. Evidence was seen to demonstrate that specific dietary needs were catered for as required. Information to support that the service was able to meet the different needs of people was also provided in a staff survey returned. This member of staff stated that they had researched information regarding a particular faith to enable them to support a person that used the service. The person in respite at the time of this visit said that they enjoyed the meals at Eastfields and confirmed that there was lots of choice available. This person had a support plan in place regarding meal preparation. This identified their preferred meal choices and identified what this person was able to do for themselves and what they required support and assistance with. Care Homes for Adults (18-65 years) Page 20 of 33 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 . Personal care support is provided to individuals in the way they prefer and they are supported to access health care and specialist services. The practices in place ensure people using the service are supported to take their medication in a safe way. Evidence: In the file looked at Support plans and risk assessments were in place regarding personal care support. These plans also linked with support plans for making choices and decisions and the communication methods that were to be used. This demonstrated that personal care support was given in a way that was preferred by this person. Comments from people that used the service indicated that staff supported them in their preferred way, the staff always listen to what I have to say and the staff are very nice to me and they have been rather helpful as well. As stated in the pre inspection information aids and adaptations were in place at Eastfields to assist people with their personal and health care needs. One profiling bed was in place to support one individual that accessed the service. A bed monitor with a Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: radio pager was also available for another person.This ensured that staff were alerted during the night if this person required support. A call system was available throughout the building. This enabled the people using the service to alert staff if they needed support or help. Privacy curtains in bathrooms ensured individuals dignity and privacy was maintained for those, who due to health care reasons could not be left unsupervised when bathing. As stated in the pre inspection information health and medical profiles were in place for individuals that identified any health and medical needs and any medication prescribed. This ensured that staff had the relevant information to enable them to support individuals and access the relevant health care teams for advice and guidance as required. The manager confirmed that the service had a lot of involvement with the Community Learning Disabilities Team. She discussed referrals that had been made to the Speech and Language Therapist and Epilepsy profiles that had been completed by the Community Learning Disabilities Team, to support individuals in their health care needs. Staff comments confirmed this, The service also works well as a team, liaising with outside agencies such as day services, health professionals and families. The manager confirmed that during each persons initial assessment, confirmation was sought to ascertain if individuals G.P.s were willing to visit them at Eastfields if they were unwell. If this was not possible, agreements had been made with local surgeries that were able to provide medical attention for people using the service. This information along with the contact details of these surgeries was made available to the staff team within the emergency medical procedures at the home. Other documents seen that related to emergencies included the Emergency medication procedure which provided staff with the actions to take in different situations. This ensured the staff team had clear instructions to ensure that people received their prescribed medication in a safe way. At the time of this visit there was no one using the service that was prescribed any medication. The manager confirmed that out of all the people that accessed the service there was one person that self-administered their medication. The practices in place ensured they took their medication in a safe way. Metal wall cabinets were provided in each bedroom for people to store their medication safely. Staff medication training was provided by a suitably qualified person. The staff were also provided with medication training through MENCAP, this included work based observations and a detailed training pack. The manager confirmed that she had done medication awareness training, this training enabled her to update the staff in their medication practices. Records of staffs medication training was seen in the staff training and development files looked at. Care Homes for Adults (18-65 years) Page 22 of 33 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 . The practices in place protected people using the service from abuse and enabled the views and concerns to be listened to and acted upon. Evidence: As stated in the pre inspection information that the organisation has reviewed its complaints and feedback systems in place and introduced an updated policy. This is called Mencap feedback complaints and compliments management system and was introduced in September 2008. Accessible documentation was in place. The manager confirmed in her pre inspection information that this new system had reduced waiting times for outcomes. These new management systems included feedback forms to enable all minor complaints to be recorded. As stated in pre inspection information all people accessing the service and their carers have a copy of the complaints procedure. This was seen within the Service Guide and Eastfields Short Break Agreement Information pack and was provided in an easy read format and included contact information for the Commission for Social Care Inspection. Various documents were available to enable people using the service to express their views and any concerns they have. These were used at service user meetings and lay visits. These were visits that were undertaken by a person that visited the service every three months and asked the people using the service about their stay, such as what they were and werent happy with. This information was then used by the manager to enable any necessary changes to be made to improve the service. The Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: manager confirmed that the lay visitor was a person with a learning difficulty that lived independently within the community and did not access Eastfields. Since the last inspection the service had received four complaints. The records held regarding these complaints was looked at and demonstrated that all of these complaints had been dealt with appropriately and within the required timescale. These records demonstrated that the service liaised with other agencies when required to address any concerns raised. Comments from people using the service indicated that any concerns they had would be listened to, such as the carers always listen to what I have to say, I enjoy having a chat with them and I know who to speak to if I’m not happy and I know how to make a complaint by letting staff know, but so far I’ve not had to make one. Records showed that safeguarding training had been provided to staff. Policies were not looked at during this visit. The pre inspection information confirmed that policies were in place at the home, such the local guidelines for reporting abuse along with the safeguarding adults and prevention of abuse policy and the disclosure of abuse and bad practice policy, known as the Whistle Blowing Policy. Staff spoken with and comments in surveys demonstrated a good understanding of the procedures to follow and the need to be aware and vigilant to ensure individuals were protected from abuse and harm. Care Homes for Adults (18-65 years) Page 24 of 33 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 . The service is maintained to a high standard which enhances the quality of life for the people using it. Evidence: The service was purpose built. The maintenance of the building was clearly maintained to a very high standard. Information provided in the pre inspection document demonstrated that the refurbishment and redecoration of the home was maintained. The building had been redecorated throughout since the last inspection visit and several items of equipment and new furniture purchased. Information provided in the pre inspection document confirmed that that further plans for redecoration and refurbishment and purchases was planned. The environment met the needs of the people using the service. Facilities and equipment were in place to ensure the safe moving and handling of people who required support was in place. Fire safety and security was in place, records were seen to demonstrate that fire fighting equipment and intruder alarms were serviced as required and weekly fire alarm tests were undertaken. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: The facilities and equipment provided a range of leisure and relaxation opportunities for the people that used the service, as confirmed earlier in this report (see standards 11-17). Following requests made by some individuals, the service has purchased a Wii games console, pool table and football table, a computer and free view boxes for both lounges. This demonstrates that the service strives to meet the preferences and interests of the people that use the service. The environment also benefited from lots of storage space, which enabled the building to be clutter free which enhanced its appearance. The manager confirmed that cleaning schedules were in place to ensure the home was well maintained. This consisted of a housekeeper that was employed for twelve hours a week and a contract with a cleaning agency that cleaned the home on a monthly basis. Evidence was in place within the support plans seen to demonstrate that people using the service were supported to keep the building kept clean and tidy. There was a garden area to the front and rear of the building and the manager confirmed that seating was available for people to sit out in the warmer months. This information was also provided in the service guide. Comments received from the people using the service confirmed that the building was maintained to a high standard, comments included When I have been to Eastfields the home itself has always been clean and tidy. Care Homes for Adults (18-65 years) Page 26 of 33 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 . People using the service have safe and appropriate support from a competent, trained staff team. Evidence: Discussions with staff demonstrated they were clear regarding their roles and responsibilities. Comments from staff were very positive about the support they provided to the people using the service. Comments included, the service promotes respect, dignity and inclusion for all and the support is very much person centred and I enjoy working at Eastfields. I find it a caring home to work in. One member of staff confirmed that the staff team made positive efforts to build relationships with carers. This included annual visits to discuss respite allocations and generally confirm that carers were happy with the service provided. Staff training records showed that staff are kept up to date with training, both mandatory and training that was specific to the needs of the people using the service. Training and development plans were in place. In house induction records were seen and demonstrated that staff received the appropriate induction and ongoing training to ensure they were aware of their responsibilities and were able to support individuals effectively. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: Supervision contracts and records were in place in the records seen. Staff comments confirmed that the training provided was to a high standard, comments included training is very good, we get regular supervision from the manager that works on our aims and objectives and we work well as a staff team. The manager stated in the pre inspection information that eight out of the nine staff employed had completed their NVQ 2 and the other member of staff was in the process of completing this training. This ensures that the people using the service are supported by a competent and qualified staff team. It was also confirmed that a number of staff have been given the opportunity to progress to NVQ 3. Minutes were seen to show that staff meetings were held on a regular basis, to ensure that staff were kept up date with any changes or decisions regarding the service and to discuss any matters relating to individuals that used the service. One member of staff confirmed, we have regular staff meetings . Staff recruitment policies and procedures were in place. As stated in the pre inspection information the recruitment practises in place were robust, to ensure staff employed were safe to work with the people using the service. All recruitment documents that are required by law were in place within the two staff files seen. Other records in place demonstrated that robust staff management practises were in place. Care Homes for Adults (18-65 years) Page 28 of 33 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 managed appropriately with the interests of those using the service being central to its development. Health and Safety practices maintained individuals welfare. Evidence: There is an established and experienced manager in post. She confirmed that she achieved the Registered Managers Award. This is a management qualification for managers working within the social care sector. From discussions with the manager and staff it was confirmed that there was a strong and committed staff team in place to support the people using the service. All of the staff team had delegated responsibilities from managing the rota to ordering stationary. The opinions of the people using the service were central to the service development. This was reflected in the quality assurance systems that were in place. Records were seen of laypersons visit as mentioned earlier in this report. Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: Monthly meetings were held for people using the service and minutes were in place to demonstrate this and the actions that had been taken as a result of the suggestions made at these meetings. As stated earlier in this report these meetings also provided people using the service with an opportunity to discuss any concerns they had. Questionnaires were sent out to relatives/ carers on an annual basis and these were audited at the organisations head office, reports where then sent to the service for any issues to be addressed. These were then audited as part of the monthly proprietor visits. Records of these visits were held at the service. As stated in the pre inspection information the service has a continuous improvement plan, which enabled them to record things that have been actioned to complete. For individuals who were unable to manage their own personal monies the service had robust practices in place for the safe keeping of individual’s monies. These practices were looked at and demonstrated that monies were securely stored and separate records were in place for each individual. These records demonstrated that all transactions were recorded and signed by staff and the individual whenever possible. The manager confirmed that if an individual did not have the capacity to understand or sign their transaction records two staff signed whenever possible. If staff were working alone then this was recorded. The manager confirmed in the pre inspection information that all equipment within the home was serviced or tested as recommended by the manufacturer or other regulatory body. A sample of service certificates and records were looked at and confirmed that safe working practices were maintained to ensure the safety and welfare of the people using the service, staff and visitors. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 33 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 Description 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 Description Timescale for action 1 9 13 Risk assessment for 09/04/2009 individuals must be reviewed regularly To ensure that the information provided remains relevant and that people are kept safe. 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 Care Homes for Adults (18-65 years) Page 32 of 33 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 © (2009) Commission for Social Care Inspection (CSCI). 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