Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 17/11/08 for Harry Chamberlain Court Residential Home (12)

Also see our care home review for Harry Chamberlain Court Residential Home (12) for more information

This inspection was carried out on 17th November 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Harry Chamberlain Court Residential Home (12) 12 Harry Chamberlain Court Hollingsworth Road Lowestoft Suffolk NR32 4UG The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Small Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 37 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: Harry Chamberlain Court Residential Home (12) 12 Harry Chamberlain Court Hollingsworth Road Lowestoft Suffolk NR32 4UG 01502582561 01502582561 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Christine June Loades Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 1 5 0 0 care home 5 dementia learning disability Additional conditions: 12 Harry Chamberlain Court may also care for one service user who has both a learning disability and dementia, falling in the registration categories of LD, DE as detailed in the correspondence with the Commission for Social Care Inspection. Date of last inspection 2 9 0 1 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home 12, Harry Chamberlain Court is part of a large block of flats owned by Waveney District Council and located to the north of Lowestoft. The main town is a bus ride away but there are local shops and facilities within easy reach. The home provides accommodation for up to five residents with a learning disability between the ages of 18 and 65 and the Royal Mencap Society provides personal support. The accommodation is all on the ground floor and consists of five single bedrooms, a lounge, a kitchen and dining area and open plan garden to the rear of the property. There are adequate bathroom and toilet facilities and there is also a laundry and office space for the staff. At the time of the inspection the manager stated that the current scale of charge was £65.80 to £108.00. Care Homes for Adults (18-65 years) Page 5 of 37 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 37 How we did our inspection: This is what the inspector did when they were at the care home The inspection was undertaken Monday 17th November 2008 from 11:20 to 15:50. The inspection was a key inspection which focused on the core standards relating to adults and was undertaken by regulation inspector Julie Small. The report has been written using accumulated evidence prior to and during the inspection. Tim Brown is an expert by experience. ‘Experts by Experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use social care services. The term ‘Experts by Experience’ is used to describe people whose knowledge about social care services comes directly from using them. The Expert by Experience joined the inspector on this site visit, spoke with two people that used the service and one staff member. Care Homes for Adults (18-65 years) Page 7 of 37 His comments and observations are added to this report. The Expert by Experience stated there were three residents at the care home when Expert by Experience arrived. The home has 4 residents at the moment which are all women and one of the residents was out at a day centre and another of the resident was non verbal so Expert by Experience did not speak to her. We viewed the care plans of three people that lived at the home. Care Homes for Adults (18-65 years) Page 8 of 37 We looked at records, which included the homes procedures and health and safety records. The other records that were viewed are identified in this report. The AQAA (Annual Quality Assurance Assessment) was forwarded to the home prior to the inspection and was returned to us when we asked for it. Care Homes for Adults (18-65 years) Page 9 of 37 What the care home does well The Expert by Experience stated upon arrival the Expert by Experience and support worker was asked to sign in a signing in book that also had pictures on it. This the Expert by Experience was very impressed with. There was also a notice board in the main room that detailed all of the up and coming activities. There was another board that has all staff names and pictures on it. Expert by Experience thought that the home felt very homely, Expert by Experience thought that there was no issues at the home and was one of the happiest homes he had seen, and they even had birthday cards up for one of the residents. Care Homes for Adults (18-65 years) Page 10 of 37 It was noted that peoples choices and preferences were listened to, such as what activities they wished to take part in. Peoples care plans included their choices and preferences, which showed that they were consulted with about the support that they were provided with. Staff treated the people who lived at the home with respect. Care Homes for Adults (18-65 years) Page 11 of 37 What has got better from the last inspection The home had a new Registered Manager, who was present during the inspection and provided us with the requested information promptly and in an open manner. Staff were provided with training, which supported them to meet the needs of people that lived at the home. Staff recruitment records showed that checks had been done before they started working at the home to ensure that the homes recruitment procedures were followed and that people were safeguarded. Care Homes for Adults (18-65 years) Page 12 of 37 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 13 of 37 If you want to speak to the inspector please contact Julie Small CSCI Capital Park Fulbourn Cambridge CB1 5XE 01223771300 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 14 of 37 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 15 of 37 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 . People can expect to be provided with the information that they need to enable them to make an informed choice about if they want to live at the home, to be provided with a detailed needs assessment and to have their assessed needs met. Evidence: People were provided with the information that they needed which enabled them to make informed decisions about if they wanted to move into the home in the Statement of Purpose and the Service Users Guide. The Statement of Purpose was viewed and included information such as the care provided by the home, the aims and objectives of the home, the application and assessment processes, trial visits, the accommodation and facilities provided by the home, consultation, duty of care, staffing levels, management, confidentiality, fire safety, quality assurance, complaints and CSCI (Commission for Social Care) details, which needed updating to show the current address should a person wish to contact us. The Service Users Guide was viewed and included information such as photographs of Care Homes for Adults (18-65 years) Page 16 of 37 Evidence: the home and the manager, the aims and objectives of the home, complaints, choice, respect and the support that people could expect when living at the home. The AQAA stated we have policies and processes that guide staff in ensuring that people receive good and reliable information before they move and are supported in making a successful transition. The records of three people that lived at the home were viewed and each contained a detailed needs assessment, which were updated regularly to reflect their changing needs and preferences. The records held detailed care plans which detailed the support that people required and preferred to meet their assessed needs. The AQAA stated we have an assessment process that involves gathering information from the person we are supporting, their circle of support people who are important to them and other professionals involved in their support. Care Homes for Adults (18-65 years) Page 17 of 37 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 . People can expect to be provided with a care plan which identifies how their assessed needs are to be met, to be consulted with about the care that they are provided with and to be supported to minimise the risks in their daily living. Evidence: Details of the step by step support that people required and preferred to meet their assessed needs, such as with their personal care, were identified in three care plans that were viewed. The care plans were regularly updated to reflect peoples changing needs and preferences. There were records of regular care reviews, which provided people and their representatives the opportunity to express their views and preferences about the service that they were provided with. People were further consulted with regarding the support that they were provided with in monthly key worker meetings and any changes in their preferences were clearly recorded in their care plans. The manager was spoken with and explained that one persons needs had recently changed and continued to change due to a deterioration in their condition. Their care Care Homes for Adults (18-65 years) Page 18 of 37 Evidence: plan was viewed and clearly reflected the changes in their care provision. The AQAA stated we support people to take a lead in their support planning and help to arrange individual meetings on a regular basis to review these plans. We ensure key people are invited enabling the people we support in the development of their plans. The Expert by Experience spoke with a staff member and reported that they told them residents have a key worker that sit down with residents and go through their care plan with them and a person that lived at the home told them she has access to her own care plan. The records of two people showed that they had used the support from a local befriending service. Three peoples daily diary was viewed, which identified their well being each day and where they had made choices in their daily living, such as if they went out or if they had participated in activities. The Expert by Experience report stated that a person told them there is house meetings once a month that she takes part in. The minutes for house meetings were viewed and showed that people were consulted with about what happened in the home. The minutes from a recent meeting showed that people had made decisions about what they wanted to do for Christmas and they discussed the arrangements for household chores in the home. A person told us that they helped to keep the home clean and tidy. The Expert by Experience stated that a person told them she helps out around the house by cleaning the toilets and bathroom as well as the shower room and another person told them helps around the house by working the dishwasher, also enjoys washing up. A person was spoken with and reported that they made their own decisions about what they wanted to do in their lives and that the staff listened to what they said. The Expert by Experience stated that a person told them she buys what she likes with her own money, she said that she likes to buy tops and another person told them she buys want she wants with her money she loves spending. A person that was spoken with explained that they kept their bank card and that they had memorised their pin number, which they would not tell anyone. They said that the staff helped them to look after their money. Peoples records that were viewed clearly identified the support that people required and preferred with their finances. Their records included financial risk assessments and detailed records of their incoming money and spending, which included receipts. Further risk assessments included in peoples records included how the risks should be minimised on issues such as making hot drinks, using the oven, road safety and challenging behaviour. Care Homes for Adults (18-65 years) Page 19 of 37 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can expect to be supported to participate in activities that are of interest to them, to be supported to maintain contacts, be treated with respect and to be provided with a nutritious diet. Evidence: The manager was spoken with and explained that one person that lived at the home attended a day centre. The other three people had attended day centres but had recently decided they they no longer wished to. Their records were viewed and held clear details of the consultation that had taken place with the people about their choices. One persons records identified that the person had decided to cut their attendance to two days a week and then had decided that they no longer wished to attend, due to getting older. Another person had ceased their attendance due to their deteriorating condition. A person was spoken with and confirmed that they had decided that they did not wish to attend a day centre, they said Im getting old. They reported that they enjoyed their time at the home and that there was always Care Homes for Adults (18-65 years) Page 20 of 37 Evidence: something to keep them busy and that they had planned to go for a meal and to see a show in the near future. They said that they changed the staffing notice board every three days, which showed the staff photographs that were working on each shift. The AQAA stated we encourage residents to take a lead regarding what they would like to do. During the inspection a person chose to go out shopping with a staff member and a person was observed to play with a large set of cards, which had been purchased when their sight had started to deteriorate and a person played dominoes with a staff member. Peoples daily diaries which were viewed identified the activities that people participated in which included going to the cinema, eating out, going to the theatre, going to the seaside and holidays. Peoples care plans identified their interests and hobbies. The Expert by Experience talked with two people and they reported that one person told them that the resident can go on public transport down town, and also to the shopping centre, she goes there with the support of the staff not by herself. She has her own TV in her room but doesnt really use it as she prefers to watch the TV set in the main room where she watches soaps. Does not attend any clubs because she does not like it, she prefers to stay in the home to upset the staff she said that in a joking tone. She goes out to eat socially with staff. The Expert by Experience reported that another person told them does go out on public transport and also gets a taxi into Lowestoft but she cannot go out by herself she always goes with a member of staff. Has a TV set in her room. She cannot go out by herself but does gets time by herself in the home. She used to go to clubs up the road, but doesnt go any longer as she found it to be to loud. A person told us that they had planned their Christmas activities, which included a meal out and a meal at the home. This was confirmed in the minutes of a house meeting which were viewed, which showed that the people that lived at the home had made decisions about their Christmas celebrations. The person said that the people that lived at the home had recently hosted a Halloween party and that their families and friends attended. They showed us photographs of the people that lived at the home and their guests in Halloween fancy dress costumes. The manager said that people had decorated the home and made Halloween lanterns for the party. The AQAA stated residents arrange parties on a regular basis, choose their own holidays, group or individual and the service has tried to facilitate available resources in the area, local clubs and bingo sessions have been sourced. Taster days have been held. A person that lived at the home that was spoken with said that they maintained contact with their friends and relatives and that staff supported them to do so. Peoples records that were viewed clearly identified the contact that people had Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: maintained with their relatives. During the inspection a staff member was observed to support a person to make a telephone call to their relative. The AQAA stated our families charter encourages and guides our staff in supporting people to maintain and strengthen family connections that are important to them and we encourage families and friends to visit. The Expert by Experience talked with people at the home and reported she does not have friends to visit much but is allowed visitors if she wanted to, she has access to two house phones in the home one in the quiet room and one in the main room and she also has her own mobile and also has friends in to visit. The Expert by Experience observed the resident received a postcard from her (relative) in Canada that a member of staff read out to her. The manager reported that people were provided with keys for their home and bedroom. A person that lived at the home wanted to participate in the inspection process and they were supported to do so by the manager of the home. The person was very helpful during the inspection and they showed us around the home and told us about the routines of the home. Interaction between staff and people that lived at the home was observed to be friendly and professional. The Expert by Experience reported she gets to spend time by herself in the home if she wants to, she picks her own clothes that she wants to wear, felt that staff treat her with respect and she chooses her own clothes. People were provided with a healthy diet and were supported to make choices about what they wanted to eat. A person told us that the evening meal was beef risotto, that they had eaten it before and that the meal was lovely. Lunch was a choice of sandwiches. People were offered drinks throughout the day and a person that lived at the home made drinks for us. The manager said that people chose what they wanted to eat from a menu book. The Expert by Experience reported she likes to bake and even baked a cake last week, she chooses what to eat from the menu in the kitchen and said food is lovely here. They reported Resident 2 also seemed generally happy and was just sitting down to a healthy lunch that she had made herself. Care Homes for Adults (18-65 years) Page 22 of 37 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 . People can expect to be supported in the way that they prefer and require, to have their health needs met and to be safeguarded by the homes medication procedures and processes. Evidence: Three peoples care plans that were viewed clearly identified details of the personal care that they required and preferred to meet their assessed needs. The care plans identified areas of personal care that people could attend to independently and how staff should support them to be as independent as possible. One persons records that were viewed showed that the person had told their key worker that they wanted to take more care with their personal appearance and the care plan was updated to ensure that they were supported to do this. It was noted by the Expert by Experience that peoples choices and dignity was respected at the home. The Expert by Experience spoke with two people who told him she gets up early at 7am by her own choice and goes to bed at 11pm by her own choice, she goes to bed at 10pm by her own choice, she makes the choice of having a bath there is also a shower room there, which are located in separate rooms, she picks her own clothes that she wants to wear and she does not exercise, but uses a Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: walking aid. Peoples records that were viewed clearly identified their health care needs and how they were to be met. The records showed where people had attended health care appointments such as breast screening and doctors, dental and optical appointments. One persons records showed that they had been referred to their doctor following unexplained falls and the actions that had been taken. Another persons records showed how the home had referred them for assessments for a chair and manual handling. The manager explained that a persons health needs had recently changed and their records were updated to show their changing needs, the records were viewed and confirmed this. Staff training records that were viewed showed that they were provided with training to enable them to support the peoples changing needs, such as manual handling and dementia. The AQAA stated as part of person centred planning we aim to support people in being more aware of their health needs and use health action plans to support people in doing this. During the inspection a person was observed to return from a dental appointment, on their return the manager discussed with them the outcomes of their treatment and how they felt about the support that they had been provided with. The Expert by Experience talked with people that lived at the home and reported if she needed a doctor he would come to the home, she also previously went to the dentist to have dentures fitted and she goes out to the doctors and dentist when needed. People were protected by the homes medication procedures and processes. Peoples care plans that were viewed clearly explained the arrangements for the administration and storage of their medication, such as if they self medicated and if they chose to store their medication in their bedrooms. There were risk assessments which identified how risks should be minimised if people administered their medication themselves. The manager explained that one person kept their medication in a locked cupboard in their bedroom and administered their own medication. Their records were viewed and they clearly explained how the person had wanted to be more independent with their medication and how they were supported to achieve their goal. The manager stated that another person preferred to store their medication in the office and took their medication from the packaging to administer it themselves. The Expert by Experience stated the staff help her with her medication and when the Expert by Experience went to view her room Expert by Experience was shown a box on the wall that had a lock, that holds all resident one medication which she has a key to and the staff help her with her medication. The AQAA stated our policies and procedures regarding medication actively encourages staff to demonstrate safe working practices and to fully involve the individual in taking as much control as possible over their medication. Care Homes for Adults (18-65 years) Page 24 of 37 Evidence: The care plans that were viewed included a medication profile, which identified the prescribed medication for each person, the reasons for the medication and the possible side effects. A copy of the document was included in the MAR (medication administration records) charts. The MAR charts were viewed and included a photograph of the person and it was noted that there were no unexplained gaps. Records were present which identified when a person had taken their medication with them when they were staying overnight with their relatives. Three peoples medication was stored in a secured cabinet and secured refrigerator in the office. Records of daily temperature checks if the cabinet and the refrigerator were viewed. The manager explained that they had been provided with a medication inspection from a local pharmacist and that it was noted that the cabinet had got too warm. The manager explained that to remedy the issue they had placed ice packs in the cabinet twice a day and this had maintained a safe temperature. Staff training records that were viewed showed that they had been provided with training on the safe handling of medication. Care Homes for Adults (18-65 years) Page 25 of 37 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 can expect to have their complaints listened to and acted upon and to be protected from abuse. Evidence: People were advised of how they could raise concerns and complaints about the support that they were provided with in the Statement of Purpose, Service Users Guide and the Mencap complaints procedure, which were available in the entrance hall to the home. There was also a notice board in the dining area, which provided a document which explained how to make complaints that was in a format which could be understood by the people that lived at the home. The Expert by Experience talked with two people and reported she knows how to make a complaint, but said she is happy with the home and she knows how to make a complaint, she said she also speaks to staff if she is upset. The AQAA stated that there had been no complaints made in the past twelve months, which was confirmed by the complaints and compliments book which was viewed. There were several thank you cards and letters regarding the support that people had been provided with. The AQAA stated it is our belief that those who use our services should be able to comment or complain if any aspect of our services or activities do not meet the high standards that they have a right to expect. Care Homes for Adults (18-65 years) Page 26 of 37 Evidence: Staff were provided with the information that they needed to ensure that the people that lived at the home were safeguarded in the homes detailed safeguarding procedures, the local authority safeguarding guidelines and safeguarding training. The AQAA stated our policies and procedures require staff to actively engage with local vulnerable adults processes to ensure that any threat to people with a learning disability is identified and reported. There had been one safeguarding referral made in the last twelve months. The persons records were viewed and showed that the home had acted appropriately following concerns raised by the person. We were notified at the time of the incident by the homes manager. The manager was spoken with and it was noted that they had a good understanding of their roles and responsibilities regarding safeguarding people. The Expert by Experience reported that they had spoken with two people that lived at the home and that they both reported that they felt safe at the home. The Expert by Experience reported upon arrival the Expert by Experience and support worker was asked to sign in a signing in book that also had pictures on it. This the Expert by Experience was very impressed with. This showed that visitors to the home were monitored to ensure that people were safeguarded. The arrangements for the safeguarding of peoples finances were clearly identified in the peoples records that were viewed, which included risk assessment that showed how the assessed risks were to be minimised. Care Homes for Adults (18-65 years) Page 27 of 37 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can expect to be provided with a comfortable, clean and well maintained environment to live in. Evidence: People were provided with a clean, well maintained and comfortable home to live in. The manager explained that there had been improvements in the home, which were identified in the AQAA, which stated this year all the communal areas have been decorated, carpets replaced, some individual bedrooms with specialist flooring, curtains replaced which are now fire retardant, new tumble dryer. The Expert by Experience reported Expert by Experience thought that the home felt very homely. A person that lived at the home and the manager gave us a guided tour of the premises and the person stated that they liked their home. It was noted that the home was fresh and clean and there were no unpleasant odours. There were fresh flowers in the entrance hall. The lounge was comfortable and homely and it was noted that there were sufficient comfortable seating for people who lived at the home. The manager and the person explained that the people that lived at the home were in the process of choosing new Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: seating. There were several birthday cards displayed in the lounge and the person explained that another person who lived at the home had recently celebrated their birthday. The person said that they could go into any room in the house as it was their home, but they could not go into other peoples bedrooms without their permission. The garden was spacious and well maintained and there was seating provided if people wished to enjoy the garden in better weather. The kitchen and dining area was clean and provided sufficient seating and tables for people to enjoy their meals. During the inspection a person was observed to play cards and dominoes at one of the dining tables and people helped themselves to drinks in the kitchen. The home provided a toilet, a shower room and an assisted bathroom, which enabled people to make choices of how they wished to bathe. The Expert by Experience spoke with a person who lived at the home and stated she makes the choice of having a bath there is also a shower room there, which are located in separate rooms. The communal bathrooms and toilets each held hand wash liquid and disposable towels which minimised the risks of cross infection. A person showed us their bedroom and it was clean, tidy and reflected their individuality and choice. There were several personal items of memorabilia and photographs in their room. The Expert by Experience reported when Expert by Experience was shown her room it was very spacious and had nice furniture. It also has family pictures up. Resident one said that she picked her own colour scheme for the room and shes going to have her room colour changed, she has chosen the colour scheme herself. A person told us that they helped to keep the home clean and tidy and that they dusted and vacuumed. The Expert by Experience spoke with people that lived at the home and reported she helps out around the house by cleaning the toilets and bathroom as well as the shower room and helps around the house by working the dishwasher, also enjoys washing up. The AQAA stated we aim to encourage and support people to be involved in the upkeep of their home and take pride in where they live. The maintenance book was viewed and it was noted that reported areas for repair had been made good in a timely manner. The AQAA stated we aim to work constructively with the housing provider to ensure that the environment is properly maintained, decorated, equipped and furnished to a comfortable safe standard. The laundry was viewed, which held a washing machine and drying machine. The manager and a person reported that they had recently purchased a new washing machine, which was easier to use which enabled people to undertake their laundry independently. The laundry provided hand washing facilities which minimised the risks of cross infection. Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: During the inspection staff and people were observed to use good infection control procedures, which included washing their hands before they handled food. Staff training records which were viewed showed that staff were provided with infection control training. Care Homes for Adults (18-65 years) Page 30 of 37 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 can expect to be supported by staff who are trained and qualified to meet their needs and to be safeguarded by the homes recruitment procedures. Evidence: The recruitment records of three staff members were viewed and it was noted that the appropriate checks were undertaken prior to people starting work to ensure that people were safeguarded by the homes recruitment procedures. The records held a CRB (Criminal Records Bureau) check, two written references, their work history which was included in their application form and identification, such as a copy of their birth certificate, driving license or passport. Staff training records were viewed which included training certificates and an individual training profile. The records showed that staff were provided with the training that they required to meet peoples needs. Training included manual handling, epilepsy, fire safety, safeguarding, challenging behaviour, equal opportunities, dementia, food hygiene, first aid and medication. One persons training record included a certificate of achievement for an infection control distance learning course. The manager explained that they were in the process of identifying staff to undertake further distance learning courses on medication and food and nutrition. The staff training records that were viewed showed that newly appointed staff were Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: provided with an appropriate induction course, such as the Skills for Care Common Induction Standards. The AQAA stated staff receive a 12 week induction and ongoing training to ensure that staff fully understand their responsibilities and how to effectively support people with a learning disability. The manager explained that the induction process included two training study days and the completion of an induction work book. The home had met the target of 50 staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 by 2005 as identified in the National Minimum Standards relating to adults. The manager stated that there were three staff members who had achieved their NVQ level 2 that had recently started working on their NVQ level 3 award. The minutes of regular staff meetings were viewed and they showed that staff were advised of any changes in the requirements of their role and in the needs of the people that lived at the home. They were provided with the opportunity to discuss issues that they had in their work role and in supporting people. The manager reported that the home was fully staffed, there had been two staff members on leave and during this time regular relief staff and existing staff covered their hours. The manager said that there were two staff on duty throughout the day and that there was one waking night staff during the night. They said that they had recently reviewed the staffing at the home to ensure that the people who had chosen not to attend day centres were appropriately supported. The Expert by Experience talked with a staff member and reported 10 members of staff work at the home. There two working at all times. All staff do different shifts but the night care workers only work nights. (the staff member) really enjoys (the staff members) work. Residents have a key worker that sit down with residents and go through their care plan with them. They spoke with two people that lived at the home and reported felt that staff treat her with respect and she has two key workers who she feels are very good. During the inspection it was noted that staff interacted well with the people that lived at the home and they were respectful, friendly and professional. Care Homes for Adults (18-65 years) Page 32 of 37 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 . People can expect to live in a home with is managed by a person who is fit to be in charge and that is run in their best interests and that their health and safety is promoted and protected. Evidence: Since the last inspection the organisation had employed a new manager in January 2008. The manager was assessed as fit to be in charge in the CSCI registered manager application process. The manager was spoken with and stated that they had achieved the NVQ level 4 in care and that they were currently working on their RMA (registered manager award). The manager was receptive to the inspection process and provided the requested information promptly and in an open manner. They had a good knowledge of their role and responsibilities. The manager stated that the organisation had proposed to deregister the home and to provide people with a supported living service. They stated that the manager and staff had been provided with supported living awareness training. Staff meeting records which were viewed showed that they had been informed of the proposals. We had not yet received an application to deregister the service. Care Homes for Adults (18-65 years) Page 33 of 37 Evidence: The manager stated that they had not undertaken quality assurance satisfaction surveys this year. However, people were provided with the opportunity to state their views about the service that they were provided with in monthly key worker meetings, care reviews and regular house meetings, the records of which were viewed and confirmed what the manager had told us. The records of monthly manager compliance reports were viewed and showed that the manager audited the records in the home and monitored the health and safety in the home. The incident and accident reports were viewed and showed that they were checked regularly by the manager. The reports included comments from the manager where further action was required, such as the referral of an issue to the persons doctor or for staff to observe a person and clearly record any changes in their condition. The Regulation 26 visit reports were viewed, which were the visits made by the organisation to ensure that the home is running appropriately. It was noted that the visits had been undertaken by the area manager on a monthly basis until June 2008 and there had been one visit October 2008 completed by a manager in another Mencap home. A person that lived at the home told us that they participated in weekly fire drills and they explained the procedure for evacuating the home if there was a fire. The fire safety records were viewed and it was noted that the home provided a fire risk assessment and that fire safety checks were undertaken regularly to ensure that people were safeguarded. Records of health and safety checks were viewed and it was noted that peoples health and safety was promoted and protected. The records showed that regular safety checks were undertaken which included dorguard checks, first aid box contents and temperature checks of water, refrigerator and freezer. There were monthly health and safety reports, which showed that risks and hazards were identified and remedied. A certificate was viewed which showed that the electrical appliances had been tested February 2008 and the landlords gas safety certificate was viewed, which had been completed March 2008. The environmental risk assessments were viewed and it was noted that they identified possible risks in the home and actions that should be taken to minimise the risks, such as with leaks, heating and cleaning windows. Staff training records that were viewed showed that they were provided with training to ensure that people were safeguarded, which included health and safety, first aid, manual handling, medication, infection control, fire safety and food hygiene. Care Homes for Adults (18-65 years) Page 34 of 37 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 35 of 37 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 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 36 of 37 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 37 of 37 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!