Inspection on 17/03/09 for Forestview

This inspection was carried out on 17th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Forestview 21/03/07

Forestview 09/03/06

Forestview 09/11/05

Forestview 02/02/05

Forestview 10/11/04

Forestview 10/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Forestview 60 Cherry Orchard Marlborough Wiltshire SN8 4AS     The quality rating for this care home is:   three star excellent 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: Pauline Lintern     Date: 1 7 0 3 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. that people have said are important to them: They reflect the things 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 34 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Forestview 60 Cherry Orchard Marlborough Wiltshire SN8 4AS 01672512464 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): White Horse Care Trust Name of registered manager (if applicable) Mrs Allyson Kim Read Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: No more than 2 service users with a learning disability, aged 65 years and over may be acommodated at any one time The difference in age between the youngest and oldest service users must not exceed 45 years The maximum number of service users that can be accommodated at any one time is 8 Date of last inspection Brief description of the care home Forest View is a spacious bungalow situated in a residential area of Marlborough. The home is registered to provide care to eight people who have a learning disability. The home is managed by the White Horse Care Trust and is one of a number of care homes run by the Trust. The house is furnished in relation to service users needs and offers a number of communal areas in the form of a spacious lounge, separate dining room and breakfast area within the kitchen. Service users access various outreach services and day Care Homes for Adults (18-65 years) Page 4 of 34 8 Over 65 2 care home 8 Brief description of the care home sessions and the home has its own transport. Fees for this service range between 978 pounds and 1,410 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 34 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: three star excellent 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: This service was last inspected on 21/3/07. People using the service are referred to as clients at Forestview and may be referred to as such throughout this report. The unannounced key inspection took place on 17/03/09 between the hours of 10.00am and 4.30pm. The manager Mrs Read was available throughout the day to assist us. The area manager was also available when we gave our feedback at the end of the day. When we arrived at the service, two of the people living at the home were at day Care Homes for Adults (18-65 years) Page 6 of 34 services and the remaining five were at home. The home currently has one vacancy. During the day we were able to meet with three staff members in private to obtain their views. We also met with the people using the service. As part of the inspection process, we sent surveys to the home for people to complete, if they wanted to. We also sent surveys; to be distributed by the home to peoples using the service and staff members, care managers, GPs and other health care professionals. Five staff members, one person using the service and one health care professional responded. The feedback received, is reported upon within this report. We sent Mrs Read an Annual Quality Assurance Assessment (AQAA) to complete. This was their own assessment of how well they are performing and it gave us information about their future plans. Information from the AQAA is detailed within this report. We reviewed the information that we had received about the home since the last inspection. We looked around the home and saw a number of records, including care plans, risk assessments, health and safety procedures, staff files and medication records. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Adults (18-65 years) Page 8 of 34 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 34 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 34 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. While there have been no new people to the service, the organisations admission policies would be adhered to, to ensure appropriate placements. This judgement has been made using available evidence including a visit to the service. Evidence: The home has a Statement of Purpose, which provides information about the service. This enables people considering seeking a place there to decide if they feel the service will meet their needs. One person commented within our survey I was asked if I wanted to move into the home and received enough information to decide if the home was right for me. Each person living at the home has a copy of the service user guide, which includes Care Homes for Adults (18-65 years) Page 11 of 34 Evidence: information, on how to raise any concerns or complaints. This is now provided in alternative formats such as pictorial as recommended at our previous inspection, however, the guide did not have up to date information about how to contact the Commission. All people who live at the home have lived at Forestview for a number of years. It is therefore not possible to look at the admission process in practices. At the last inspection, this outcome was judged as good. There has been no information to conflict with this view. Based on this, we have made a judgement, that the admission process would ensure the service could meet the needs of any person admitted. Care Homes for Adults (18-65 years) Page 12 of 34 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. Individual care plans reflect the persons assessed needs and are kept under review. People are offered choices and make decisions where possible. Assessments are completed to minimise any potential risk, whilst promoting the persons independence. This judgement has been made using available evidence including a visit to the service. Evidence: As part of the inspection process we sampled two case files in detail. We found that each plan reflected the persons initial assessment. Plans are kept under regular review. Monthly reports are completed by the key worker, which provides an overview of any health issues/ changes, social participation and appointments attended during the previous month. Any relevant information is added to the care plan. Staff members told us that information is shared at handovers and team meetings. Care Homes for Adults (18-65 years) Page 13 of 34 Evidence: When review meetings take place, evidence shows that the person using the service attend, if they wish to do so. One staff member told us I believe that even if the client cannot fully understand the discussion, at least they know the meeting is for them, if they attend. The home is continuing to develop Person Centred Planning, in a way that makes sense to the person receiving the service. A recent development has been new Person Centred, Choice and Communication passports Mrs Read explained that they are to be used to aid peoples communication. Each folder details how the person communicates and makes decisions within their life. Mrs Read reported that she feels it is important that each person is considered as an individual and that they are valued as such. We discussed the difficulties experienced when the home tried to have client meetings. Mrs Read commented that they found it was not a true reflection of the persons views but often staff members interpretation of a situation, which could potentially mean not truly respecting the persons values. On-going training in Person Centred Planning continues within the Trust. Each person using the service has a Life book, which includes photographs and pictures of family members, friends, day trips, events and holidays. Staff members we spoke to, told us how they support people to make decisions about their lives. One member of staff told us that they offer a couple of choices, when supporting people to decide what they wish to wear. They explained that by offering too many choices, it could make it more difficult for the client. Many people using the service will use gestures and body language to confirm if they wish to do something or not. During the day of our visit staff were observed offering choices to the people they support. One staff member told us that one client may change their mind a number of times and therefore staff need to ask the question a couple of times to be sure that they really want to do the activity. Within our surveys one staff member commented, we are very good at meeting the needs of all clients, providing regular training for all staff, passing on information, good working environment and by providing choice /opportunities and treating all residents as individuals. At the time of our visit no one living at the home had an advocate. However, details on a local advocacy service were available on the notice board in the hallway. Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: Peoples spiritual needs are addressed and documented within their care plan. Both plans sampled record that the person does not wish to attend church services, however they enjoy participating in Christmas Carols. Mrs Read reported that the Trust organised a cultural day last year for people using the services, which was held at Legg House. She added that staff members from different ethnic backgrounds talked about their cultures and their feelings. Foods from different countries were prepared and sampled. The event was a success. Evidence demonstrates that risk assessments are kept under review and all staff sign up to the assessment. Mrs Read and her deputies have recently attended a training workshop on the Mental Capacity Act deprivation of liberties safeguards. Mrs Read reported that as a result of this training they are developing a new form, which would link with risk assessments and provide a detailed explanation as to why a decision had been arrived at. Care Homes for Adults (18-65 years) Page 15 of 34 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. People using the service have the opportunity to participate in appropriate activities, if they choose to do so. If a person living at the home wishes to maintain links with family and friends, staff support and encourage them to so. Peoples rights are respected and responsibilities recognised in their daily lives. Meals appear well balanced and varied. This judgement has been made using available evidence including a visit to the service. Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: Since the reduction of local day services available to the people using the service, the home have been pro-active in ensuring that the clients are still involved in regular activities. Within the AQAA it states, We are slowly replacing all day services with meaningful and individual activities chosen by the resident or, best guessed by the staff and family. Each person has an activities plan for the week. Every day they hold an opportunities plan when everyone gets together (if they choose to do so) and certain activities are carried out or plans made. On the day of our visit, it was noted that everyone attended the session. The staff member responsible for the sessions, spent time discussing plans they had for further developing the sessions. We discussed the benefits of developing a recording system, which would allow her to evaluate how successful or not the session/activity had been for each person, as currently this is not in place. An evaluation record would enable staff to identify any trends or emerging patterns, which may take place. In the afternoon a game of bingo took place, again everyone participated in the activity. The manager reported that some clients enjoy activities such as washing and cleaning out the homes vehicle. It was noted in the diary that some people had helped to clear away the recent snow from the pathways. Regular music and movement sessions are held at the home. Mrs Read reported that everyone enjoys the sessions and becomes really involved in them. Massage sessions are available to the people using the service, which again are a great success. Local colleges and day services are accessed by some of the people living at the home, such as Wyvern College and Harlequins. Staff from Forestview support one person who regularly attends Harlequins. Staff members told us that a holiday has been arranged for May 2009, when a number of clients will be going to Centre Parcs. Within our surveys one member of staff commented in an ideal world, with a bigger budget more could be done with activities and day trips for clients. If a person living at the home wishes to maintain links with family and friends, staff support and encourage them to so. Individual life books demonstrate that friends and family contact is encouraged and supported. Staff members told us that the people using the service often visit other Trust homes for events or celebrations, which provides people with the opportunity to keep in contact with their friends. Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: Peoples rights and responsibilities are respected within the home. People can choose whether they wish to be involved in small tasks around the home such as vacuuming and dusting. The manager told us that currently no one holds a key to their own room. She added that one people used to hold their own key but they kept loosing it so it became a slight security risk. During the day of our visit, staff members were observed including clients into their conversations and spending time chatting to individuals on a one to one basis. When people chose to spend time in their room alone, the staff on duty respected this. The weekly menu was sampled and showed that food served at the home is varied and well balanced. The main meal of the day is generally served in the evening, except on a Sunday, when everyone enjoys a roast dinner mid-day. Plenty of refreshments are available throughout the day. Fridge and freezer temperatures are recorded daily and hot food is probed to ensure it has reached a safe temperature. Care Homes for Adults (18-65 years) Page 18 of 34 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. Guidelines are within each persons care plan, which inform the reader on how the person wishes to be supported. People have access to healthcare professionals to ensure that their physical and emotional health needs are met. Medication administration records are well maintained, however the storage of controlled medication does not meet current legislation. This judgement has been made using available evidence including a visit to the service. Evidence: Within each persons care plan clear guidance is provided on how they wish to have their personal care delivered. Preferred routines are documented for the morning, evening and bathing or showering. One persons file records that they prefer to wear Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: pyjamas rather than a nightdress and that they like to have their hair cut and styled regularly. Another persons support plan states X is able to dress himself with minimum support and verbal prompts; X should be encouraged to maintain his independence. One healthcare professional commented within our survey, I believe individuals privacy and dignity are respected at all times. The home has a Parker bath, which means that some people no longer have to be hoisted into the bath. Within the AQAA it states, we know our resident group very well and can recognise almost immediately when someone is off colour. We have a good GP surgery who respond quickly and commence treatments. We also carry out OK healthchecks and/or Health Action Plans on each individual. All records of GP, optician, dental, hospital visits are kept in the individuals notes so follow ups are not overlooked. If a resident is admitted to hospital the home will arrange staff cover to assist where required (waking hours only). The home are very good at identifying when a clients healthcare needs are changing and contacting the appropriate people for support. Mrs Read reported that recently the home had noticed that there was significant changes in one persons health needs. The Consultant physchiatrist is now offering support and guideance to the staff team. Within our surveys one healthcare professional stated, when X is well, management by staff is very good, however when mental health needs change , staff are requesting additional outside services. The service are good at highlighting the changing needs of the individuals. All staff are trained in physical intervention and guidance is recorded within care plans. Staff members explained when this may be used. They confirmed that they receive regular refresher training in the use of physical intervention. Behaviour management plans are in place for the people who might need them. Records demonstrate that health care professionals, family and care managers are involved in any decisions reached. We looked at the arrangements for managing medication. Medication administration records (MAR) were found to be completed properly, with no unexplained gaps. Each individuals medication record now has a photograph of the person on the front. Each individuals medication is reviewed regularly. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: All staff must complete training in the administration of medication and successfully pass an in house competency test before they are allowed to administer medication. Mrs Read told us that she is very aware of the importance of managing medication correctly. One recently appointed staff member told us that they had attended medication training, but had not yet passed the in house training so was not yet allowed at administer medication. Storage of general medication was satisfactory, however we are requiring that the controlled medication must be stored in a cabinet, which meets the current legislation for safe storage. Care Homes for Adults (18-65 years) Page 21 of 34 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 know how to make a complaint and raise any concerns. Arrangements for protecting people from abuse are suitably in place, with staff being aware of the procedures to be followed. This judgement has been made using available evidence including a visit to the service. Evidence: The home has a complaints policy and procedure, which is available in a pictorial format, if required. People living at the home have a copy of the procedure, within their service user guide. As mentioned earlier in this report, the contact details for CSCI need to be updated. Within our surveys, people told us they know how to raise concerns and who to talk to. Comments we received included I know who to speak to if I am not happy and I know how to make a complaint, carers always listen and act on what I say, I believe they ask for support from the Community Support Team if the person using the service has raised concerns about their care and any issues or problems are dealt with straight away. Within the AQAA it states, All residents have a personal postcard to post to the Trust if Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: anything happens that they do not like. The Trust will investigate every complaint and alert through the Vulnerable Adults policy whenever necessary. All staff receive abuse training annually and have read No Secrets and the VA policy. Staff members we spoke to, confirmed that they knew the procedure to follow for reporting any suspected abuse. One person told us I have a copy of No Secrets and I would consult this , in the first instance, to be sure I followed the correct procedure. The home has a whistle blowing policy, which enables staff to feel confident to raise concerns without incrimination. As part of the inspection process, we looked at the arrangements for holding personal money on behalf of the people using the service. Mrs Read explained that the maximum held for each person at the home is 50 pounds. The records sampled balanced with the cash held in the home. It was noted that some clients choose to purchase birthday gifts for the other people using the service. We asked Mrs Read to ensure that clear protocols are in place for this and that it be documented within the Statement of Purpose. We asked that a ceiling be placed on the amount spent and that people have the option to opt out if they wish to do so. The home has a policy not to use restraint. Instead all staff receive practical and awareness training in non-violent physical intervention. One member of staff reported that training is tailored to each Trust home and the individual needs of the people living there. Care Homes for Adults (18-65 years) Page 23 of 34 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 home provides a homely, safe and comfortable environment for the people who live there. The home is clean and hygienic throughout. This judgement has been made using available evidence including a visit to the service. Evidence: When we arrived at the home, it was clean and tidy with no offensve odours. The bungalow is spacious, bright and airy. There is a large communal lounge and a separate dining room. The kitchen is a good size and has a kitchen table at one end, which overlooks the garden. We toured the building and noted that all bedrooms had been personalised with photographs, ornaments and pictures. Some rooms have sensory lights and other equipment. Mrs Read reported that one person likes to have soft music playing while they take a rest after lunch. Rooms are decorated and furnished to a high standard. Bathrooms and toilets were found to be clean and hygienic. Supplies of protective clothing were available for staff members. The laundry has two washing machines and Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: there are two driers in the garage. All toxic materials are also stored securely in the garage. The waking night staff have a cleaning programme, to ensure that all areas are regularly deep cleaned. Staff members receive training on infection control and the home has a copy of Wiltshires guidance on infection control. Care Homes for Adults (18-65 years) Page 25 of 34 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. Staff demonstrate overall competency and appear to be sufficient in numbers, properly recruited, inducted, supervised and trained. This judgement has been made using available evidence including a visit to the service. Evidence: Mrs Read told us that the home currently is almost fully staffed, having just one staff vacancy. Generally there are three staff members plus Mrs Read on duty for all shifts. During the night there is one sleeping in staff and one waking night staff. One member of staff commented in their survey there is usually enough staff on duty, although we are now fully staffed. As part of the inspection process we sampled three staff files. Two being the most recently appointed staff. We also had the opportunity to discuss their recruitment, induction and training with them in person. Recruitment records demonstrate that staff are recruited, inducted and trained Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: properly. All relevant safeguarding checks are carried out prior to the person being offered a position. We spoke to three members of staff in private to obtain their views of the service provision. They spoke positively about working at Forestview and the care being provided to the people living there. Their comments included I think it is a really nice home, I love the client group, all of the staff here really care about the clients, I have never seen a lack of care and I think its brilliant, the team works well, Within our surveys one staff member commented, usually we have the right support, experience and knowledge to meet the needs of the people using the service. We always have this from the Trust and the manager but not always from other professionals. The Trust have introduced a new induction pack, which links to the Learning Disability Qualification (LDQ) and National Vocational Qualification (NVQ). Staff told us that they mostly felt that their induction covered most aspects of their role. One person told us that they shadowed a more qualified member of staff until they were deemed competent to work alone. Within our surveys staff told us my induction did very well covering everything I needed to know. Anything I forgot at the induction, I have learnt working on a day to day basis and training is good for new staff, its good to have a probation period as if the job is not for you, you can explain why and when training, its not hard to learn, it is made easy for you. Another person added my induction was very good, manager and staff were very helpful and approachable. Another comment was the basic induction was ok, but I did think the manual handling and first aid should have been completed sooner. We looked at staff training records and saw that all staff complete their mandatory training such as, first aid, health and safety, basic food hygiene, safeguarding people, manual handling and basic food hygiene. Staff members told us that there is a new two day course, which relates to person centred plannning, called Making it Real. There are also opportunities to complete workbooks in subjects such as equality and divesrity and health and safety. Records demonstrate that staff are properly supervised. One member of staff commented I am happy with how often I have support sessions. Its good to voice any problems I have. We also have unannounced sessions if any problems or you have Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: done something well. Another person told us I have regular supervision sessions. Kim (Mrs Read) is always available if you have any worries or concerns. Mrs Read and her deputies carry out one to one supervision with the staff team. Regular team meetings take place, which enables staff to share ideas and discuss issues relating to the home and the people who live there. One newer member of staff told us that at first they didnt feel confident to share their views in the team meetings, however their confidence has now grown and they feel able to confront issues and speak their mind, within that environment. Care Homes for Adults (18-65 years) Page 28 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run by a competent and qualified manager. The views of the people living at the home and their representatives are canvassed. The health, safety and welfare of people using the service is promoted and protected. This judgement has been made using available evidence including a visit to the service. Evidence: Mrs Read is a competent and experienced manager, strives to run the home in the supportive and approachable. One member of staff told us I have never had a manager who gives me praise before. Within our surveys one staff member commented, The White Horse Care Trust is the best company I have ever worked for. The manager is approachable and listens and values people, I will be working for them until I retire! Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: Another person commented there are too many chiefs and not enough Indians Quality assurance is taken very seriously and conscientiously. As mentioned earlier within this report it has been difficult to canvas the true veiws of the people using the service. Mrs Read has ensured that any external stakeholders, visiting the home are asked to complete a satisfaction questionnaire, which enables her to evaluate the service provision. We sampled questionnaires completed by trainers, physio and massage therapist, health and safety consultant, the GP and the community nurse. All comments received were positive. One comment was there is a pleasant odour when the clients evening meal is being prepared, it always smells very appetizing. Next of Kin surveys were sent out to all relatives by the Trust in 2008. During October 2008 an Investors in People (IIP) review was completed. The outcome of the review stated White Horse Care Trust continues to meet the requirements of IIP recognition is maintained. Regular audits are completed by senior managers of the Trust. These include care, administration, health and safety and and finances. Unannounced secret squirrel spot checks are also regularly carried out by a senior manager. The home has a staff training and development plan in place and there is a business plan for the period of 2008-2011. During February 2008 Kennet Distrct Council completed a health and safety audit and the home were awarded five stars for the basic food hygeine scheme. All radiators in the home are guarded and hot water is regulated close to 43 c to reduce the risk of injury to the people using the service. Examination of the fire safety book demonstrates that staff are receiving fire safety training and regular checks are carried out on fire fighting equipment. The health and safety policies and procedures that are in place underpin safe working practices. Care Homes for Adults (18-65 years) Page 30 of 34 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 31 of 34 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 20 13 A controlled drug cupboard 25/04/2009 that meets the current storage regulations (The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007) must be appropriately secured to the wall. To meet current legislation. 2 23 13 You must ensure clear 25/04/2009 protocols are in place for the purchasing of gifts for people living at the home. This must be documented within the Statement of Purpose. To safeguard people using the service. 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 34 1 2 1 14 The Service User Guide should include the current contact details for CSCI within the complaints procedure. To develop a format, which enables an evaluation of activities participated in. Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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