Inspection on 13/01/09 for Hart View

This inspection was carried out on 13th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hart View 26/03/08

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: Hart View 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU     The quality rating for this care home is:   one star adequate 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: Carolyn Delaney     Date: 1 3 0 1 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 30 Information about the care home Name of care home: Address: Hart View 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU 01702433330 01702433330 hatview@sky.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : R Hart Care Ltd care home 8 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 8 The registered person may provide the following categories of service: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disabiliies, or dementia - code MD Date of last inspection Brief description of the care home Hart View is a residential care home, which provides personal care only for up to a maximum of eight younger adults who have a diagnosed mental disorder. The aim of the home is to provide care and support so as to rehabilitate people so that they can live independently within the community. The usual period a person will stay in the home is two years however the period depends upon the needs of each individual. The home is an older style property, which is situated in Westcliff on Sea, close to local shops and amenities and the seafront. The fees for a place at the home range from 870 pounds to 1170 pounds per week. Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 was a routine unannounced inspection, which included a visit made to the home between the hours of 11.00 and 18.00 on 13th January 2009. The last inspection was carried out on 26th March 2008. As part of the inspection process we reviewed information we had received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they do well, how they evidence this and the improvements made within the previous twelve months. Care Homes for Adults (18-65 years) Page 5 of 30 We sent surveys each to the home to distribute to residents, staff and health care professionals to complete and tell us what they think about the home. At the time of writing this report we had received three surveys from residents, one from staff and two from a visiting health care professional. During the inspection we spoke with five residents and three members of staff. The views and comments expressed by these people were reflected in the report. As part of the inspection we employed the use of an expert by experience to visit the home with us. An expert by experience is a person who has an experience of receiving a social care service and we use these people to help us look at a service from a users perspective. The expert spent time talking with residents and observing how staff supported residents. They also viewed residents bedrooms and communal areas. They completed a report of their finding and we used this information where relevant within the report. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. During the site visit, records including residents care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. 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 7 of 30 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 –03000 616161. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move into the home cannot be assured that their assessed needs will be met as they are not assessed before they move in. Evidence: We were told in the Annual Quality Assurance Assessment that there is an admission procedure which starts when a social worker or care coordinator contacts the home to enquire about a place. The manager told us that at this stage information was obtained so as to ensure that the person would not be unsuitable (for example someone who would not be ready for rehabilitation). We were told that following on from this escorted visits to the home will be arranged and an assessment of the individuals needs will be carried out. Residents who completed surveys we sent out as part of the inspection process told us that they had been asked if they wanted to move into the home and they had been provided with enough information about the home to help them decide if it would be suitable for them. When we visited the home we spoke with and looked at records for Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: two people, one who had been admitted to the home since the last inspection and another person who was visiting the home for an overnight stay as part of the admission process. This person told us that they had visited Hart View and a number of other homes in the area to help them decide which place would be more suitable for them. This person told told us that they had visited the home on a number of occasions and this would be their first overnight stay. They said This place is better for me, it is more homely and closer to Southend. We looked at the way in which information about both persons needs had been obtained and recorded. We saw that there had been a number of meetings with the care teams who supported both individuals. There was some information available in the form of minutes from meetings and information provided by social workers and health care professionals. However there was no evidence that an assessment of both individuals needs had been carried out by the manager to determine whether, taking into account the needs of the people already living in the home and the resources such as staff knowledge and experience, that the home would be suitable. There was very limited information recorded about the visits made by both people to the home in respect of how they had settled and interacted with other residents and staff. Eight people had moved into the home within the past twelve months. The manager told us in the Annual Quality Assurance Assessment that there had been two placement breakdowns during this time. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident cannot always make decisions about their daily lives. Evidence: The manager told us in the Annual Quality Assurance Assessment that the care planning process begins at the assessment stage and that care plans are developed with the manager, service users and their key worker. When we visited the home we looked in depth at the care plans for two people. Each person had a plan of care in place, which provided information about their physical and mental health care needs. The plan included information about how each person was to be supported. Although the care plans were detailed they did not include details of each individuals perception of their illness or their individual goals, but rather reflected the outcomes that staff wanted. We saw that staff reviewed care plans regularly and recorded details of any improvements made since the last review. However they did not include the views of each person in these reviews so as to ensure that the care plan accurately reflects the needs and wishes of individual. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: We looked at how the manager and staff supported residents in making decisions and taking risks as part of living their lives independently and preparing people to move out of the home. Two of the three residents who completed surveys told us that they could usually make decisions about what they want to do and one person said that they always could. We saw that residents were encouraged to participate in daily domestic chores and to take responsibility for cleaning, shopping and preparing meals according to their abilities. During the inspection the inspector and the expert by experience spoke with residents and from these conversations we found that there were times where individuals were restricted in making decisions and that residents were not always fully supported in ensuring that they could make choices about their lives. The expert by experience viewed some residents bedrooms and observed that for the most part these were identically decorated and furnished and that residents had limited personal items. Where residents had purchased items for their rooms such as pictures etc these had not been hung or displayed. Residents who spoke with the expert by experience said that they would like the opportunity to personalise and characterise their bedrooms. One resident told us that they did not like the colour of their bedroom. They told us that they had not been involved in choosing the colour scheme. We saw that some restrictions were imposed on residents such as being able to eat snacks or fruit where they wished. Residents were told by staff to do this at the dining table. We observed that between 9am and 5pm residents were not allowed to watch television. We were told by the manager that this time was allocated for rehab. However there were no planned activities or rehabilitation exercises provided or promoted during this time and no evidence of any planned for other days so it was unclear as to the effectiveness or reason for these restrictions. During the inspection we observed staff assisting one resident to move from their bedroom to another room. This was being done so as to accommodate a person who was spending the night at the home as part of the admission process. The resident appeared to be unhappy with the proposed move and we heard some other residents remind them that they had agreed to the move. However when we spoke with the resident they said I dont want to move. It appeared that little consultation had taken place regarding this and while the person clearly appeared unhappy that staff carried on with the move regardless. There was a system in place for identifying risks to residents health and safety and there were plans in place to minimise these risks. However it was not evident from looking at these plans that residents had been involved in this process or that they were enabled to make decisions or take risks as part of their rehabilitation programme. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home do not always enjoy a lifestyle which suits their needs and wishes. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents are free to participate in activities of their choosing and to maintain contacts with family and friends. Residents are supported and encouraged to access various day care centres and other activities within the community and to participate in adult education. Residents previous pursuits and interests are taken into account when planning any activities for residents. When we visited the home we looked at how staff supported residents to participate in activities and social pursuits, which suit their needs and wishes. We saw that there Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: were daily activity plans for each person and we looked at plans for two people. These indicated that the majority of activities were centred around household chores and some limited outdoor activities such as shopping. However there was no evidence of any other occupational or social activities. These issues were highlighted at the previous inspection. It was recorded that this person lacked motivation and that they needed a lot of support. However there was no evidence as to how staff motivated or supported this resident to participate in activities and to experience a more fulfilling lifestyle. We saw evidence that some residents enjoyed activities outside of the home. Some residents attended a local growing together initiative where they learnt gardening skills. Two residents attended a local gym and one resident was completing a cookery course one day per week. Two residents go out occasionally to play pool. However these activities were quite limited and on the day of the inspection five of the residents spent the day in the home with little activity or stimulation. Staff played card games with some residents for a short period in the afternoon. Residents were supported to make and retain friendships and relationships with people outside of the home and could invite friends and family to visit if they chose to. At the time of the inspection none of the residents were participating in any form of paid employment and there was no evidence that this had been explored with each person to see if it was something they would be interested in doing. There are planned schedules in the home for shopping, cooking and laundry. These seemed quite rigid and appeared to have been planned by staff rather than through an open discussion. Residents were allocated days where they could wash their clothing and it was felt that chores such as this could be planned in a less institutionalised way through agreements between residents. Residents who are capable are supported in purchasing food and preparing their meals. These residents are provided with twenty-four pounds per week to buy food. Two residents told us that they take turns in cooking for each other and this increases the choices and variety of meals. It was less clear how other residents made choices about their meals. One member of staff said that they make a list of items needed each week and it was not clear why residents were not encouraged to complete this task, which would allow them more control and choice. We saw that residents were encouraged to eat a healthy diet with fresh fruits and vegetables. Residents told us that they enjoy their meals and that they have take away meals and go out to local restaurants regularly. On the day of the inspection some residents went out for their evening meal to a local pizza restaurant. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their assessed mental and health care needs met. Evidence: We were told in the Annual Quality Assurance Assessment that the home respects residents privacy at all times and that personal care is carried out in complete privacy in a location of the persons choice. At the time of this inspection all residents living in the home were capable of maintaining their own personal care needs with little or no input from staff. Some residents required some prompting and encouragement and this was recorded and monitored in their care plans. We looked at how residents were supported for their physical and mental health care needs. Each resident had a detailed care plan in respect of their health care needs. Residents were supported and encouraged to take responsibility for attending various medical and health related appointments such as regular blood tests. Staff monitored residents weight where issues had been identified. We looked at the arrangements in place for supporting residents with their medication. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: There was a policy and procedure in place, which emphasised the ethos for supporting residents to be as independent as possible in managing their medicines. There was a staged process which residents commenced soon after they moved into the home. Stage one of this process involved staff supervising residents when taking medicines and according to each persons abilities and assessed risks involved residents then moved to stage two where they can take responsibilities for picking up prescriptions and administering their medicines independently. Staff monitored the process so as to ensure that residents received the support they needed. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are usually treated well. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents, their families and advocates are provided with information about how to complain if they were unhappy or raise concerns. He told us that all complaints were investigated thoroughly. Residents who completed surveys for this inspection told us that they knew who to speak with if they were unhappy. Two of the three residents told us that staff always treat them well and one said thats staff usually did. When we visited the home each of the four residents we spoke with told us that they had no complaints about the home. One person said if I had any complaints I would speak with Tony (manager) or Semone (senior support worker) and they would do their best to put things right. There was a detailed complaints policy and procedure, which described how a person may complain and how complaints and concerns would be dealt with and responded to. The manager told us that there had been no complaints made and we had received no complaints, concerns or allegations about the home within the past twelve months. While it appeared that residents were generally treated well by staff the expert by experience observed on two occasions some staff to speak to residents in a tone, which was somewhat patronising. We spoke with residents and asked them if they Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: were aware of their rights and how they could expect to be treated and three residents told us that they were unaware. We looked at the arrangements in place for safeguarding residents from abuse. We saw that there was a policy and procedure in place for staff to adhere to. This policy instructed staff on how to act and report any incidents of ill treatment or abuse of residents. However it did not include details of how the manager was to deal with any allegations brought to their attention. When we spoke with the manager they were unaware of their responsibilities in reporting any allegations to the local safeguarding team or how these issues were to be managed. This means that allegations may not be dealt with appropriately. We saw that not all staff had received training in respect of safeguarding people from abuse and dealing with challenging or aggressive behaviour. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean, comfortable and well maintained home. However the environment does not meet all residents needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home is decorated and maintained to a very high standard and meets the needs of residents. He told us that residents could be more involved in choosing furniture and items for the home. He said that many of the residents are interested in music and they have been involved in purchasing music systems and mp3 players. Residents who completed surveys told us that the home is fresh and clean. When we visited the home we looked at the accommodation and how it was maintained. The expert by experience viewed some residents bedrooms with their permission. They observed that bedrooms were decorated and furnished similarly with little evidence of residents personal choices. Where residents had purchased items for their bedrooms such as pictures these had not been hung or displayed. Residents who spoke with the expert by experience said that they had not been involved in choosing the colour scheme or furniture for their bedrooms. There was little evidence that residents felt they had any ownership over their bedrooms and this was highlighted by Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: the fact that one resident moved out of their bedroom when they did not wish to do so. We observed that there were limited facilities for residents to dry their clothing. There were two tumble dryers available, however residents were observed to dry clothing on clothes racks in their bedrooms. This could restrict movement within bedrooms and impact on residents use of their personal space. The manager said that this was due to poor weather conditions, which made it difficult for residents to dry clothing outside. Communal spaces including kitchen, bathrooms and lounge areas were decorated to a high standard and were clean and well maintained. Residents had access to a dedicated external covered smoking area. There was a quiet room located in a shed type building at the rear of the garden. However this area housed fridge and freezers for residents food and the computer had no internet access. This room therefore was not suitable for its intended use and so did not benefit residents. Care Homes for Adults (18-65 years) Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are not consistently recruited thoroughly or trained to safeguard residents or meet their mental health needs. Evidence: We were told in the Annual Quality Assurance Assessment that the recruitment process met with current regulations and that all the required checks including references and satisfactory PoVA First checks and Criminal Records Bureau disclosures were obtained before a person commenced work at the home. We were also told that all new staff would be introduced to staff when they come for interview. When we visited the home we looked at how people were recruited and the checks carried out before a person was employed. We looked at the recruitment file for the person who had been employed since the last inspection. This person had completed an application form but had only given details of their most recent employer and not details covering the past ten years, as requested on the application form. While the person had provided contact details for two referees only one reference had been obtained. A satisfactory Criminal Records Bureau disclosure and PoVA First check had been obtained before the person was employed. These checks helped to ensure that only people who were suited are employed in the home. There was no evidence that this person had been interviewed or that residents had been involved in this process. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Residents told us that they meet staff when they start work at the home. We discussed these issues with the manager and he said that he knew the candidate personally but acknowledged that all of the required checks and information about the person should have been obtained and recorded in line with the recruitment policy and procedure. We looked at the arrangements in place for inducting staff to the home and for ongoing training and development. We saw that new staff completed a basic induction which helped them familiarise themselves with policies and procedures and the needs of residents in the home. Some but not all staff had commenced or completed the recognised skills for Care Common Induction standards. This training helps to promote consistency in the delivery of care to people who receive social care. The manager said more could be done to help staff understand mental illness as many of them are new to caring for this client group. We looked at training for staff and while some staff had received training in safeguarding people from abuse, medication, care planning, moving and handling and controlling infection, some people only had minimal training and no staff had received training in respect of caring for people who have a mental illness. Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 managed and maintained. However it is not always run in the best interests of residents. Evidence: The manager who had been employed at the home shortly after the last inspection completed a detailed Annual Quality Assurance Assessment, which highlighted where improvements were needed and a plan to address these issues within the next twelve months. The manager told us that he had over 18 years experience of supporting people who have mental health problems. The manager told us in the Annual Quality Assurance Assessment that since the home opened improvements had been made and that they had achieved a good reputation with commissioners (teams who purchase social care placements) which had led to an increase in referrals and enquiries to admit people. We sent surveys to health and social care professionals who were involved in placing and supporting residents in the home. Two people responded and these told us that residents needs were generally well met. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: When we visited the home we saw that the home was well maintained and that checks were carried out regularly on the equipment including heating and hot water systems, electrical installations and fire detecting and containing equipment to ensure that they remained in good safe working order. There was a system of policies and procedures in place which underpinned the running of the home. Staff and residents had regular meetings where issues could be discussed, however as indicated throughout this report routines and house rules could be discussed and made more flexible and include residents more in the day to day running of the home. The manager told us that they had not yet obtained the views of residents and other stakeholders so as to monitor and make improvements to the service where necessary. This would further help to include residents in influencing how the home is run and how they were supported. Care Homes for Adults (18-65 years) Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R 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 1 2 14(1) A full assessment of each persons needs must be carried out before they are offered a place at the home so as to ensure that the home will be suited to the individual. Staff working at the home must receive training in respect of the roles they are to perform and the needs of the residents. 30/05/2008 2 35 18 (10 (c) (i) 30/05/2008 Care Homes for Adults (18-65 years) Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 A detailed assessment of each persons mental and physical health needs must be carried out before they are offered a place in the home. This will help to ensure that the home will be suitable and that the persons needs will be met. 13/03/2009 2 23 13 Arrangements must be implemented to ensure that all staff are aware of their responsibilities in respect of safeguarding people from abuse and how to deal with any allegations appropriately. This will help to ensure that residents safeguarded. 26/03/2009 3 24 16 Suitable arrangements must be provided for residents to dry their clothing. This will ensure that residents do not need to use 31/03/2009 Care Homes for Adults (18-65 years) Page 27 of 30 their personal spaces for the purposes of drying their clothing. 4 32 19 All of the necessary checks and information including employment and references must be sought before a person is employed in the home. This will help to ensure that only people who are suited are employed and residents are safeguarded. 5 35 18 Staff must receive training, which is relevant to their roles and the needs of residents. This will help to ensure that staff have the skills and understanding to support people living in the home. 6 39 24 The views of residents, their 30/04/2009 representatives (where appropriate) must be obtained as part of a system for monitoring and improving the quality of the services provided by the home. This will ensure that the home is operated in the best interests of people who live there. 30/04/2009 31/03/2009 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 28 of 30 1 6 Care plans should be developed and reviewed where possible with the input of residents so as to ensure that they are individual to each person and reflect their goals and views. Residents should be supported and enabled to make decisions about their daily lives so as to promote their independence and choice. Residents should be supported to make decisions and take risks as part of their rehabilitation to help prepare them for moving out of the home. The manager and staff could do more to support and encourage residents to find suitable occupational courses or employment which would benefit them as part of their rehabilitation and preparation for living a more independent life. The manager and staff could do more to support residents in accessing amenities and activities in the local community so as to provide a more active and stimulating lifestyle. The routines of the home and house rules could be more flexible and based around residents choices. Staff including the manager should receive training so that they are aware of their responsibilities including reporting any Residents should be supported in choosing decorating and personalising their bedrooms according to their tastes so as to promote individuality. The homes quite room should be available and equipped so that it can be used by residents as intended. 2 7 3 9 4 12 5 13 6 7 16 23 8 26 9 28 Care Homes for Adults (18-65 years) Page 29 of 30 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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