Key inspection report
Care homes for adults (18-65 years)
Name: Address: Ingleby Care 66 Plough Hill Road Warks CV109NY The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Brenda Smart
Date: 0 9 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years)
Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Ingleby Care 66 Plough Hill Road Warks CV109NY 01827370202 01827370201 gavin.miller@inglebyltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ingleby Care Limited Name of registered manager (if applicable) Mr Gary Ratcliffe Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum numbers of service users who can be accommodated is 3 The registered person may provide the following categories of service only Care Home only PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories Learning Disability LD Date of last inspection Brief description of the care home Ingleby Care is a respite unit for up to 3 people with a learning disability. People can stay for a weekend or for a maximum of two weeks at a time. The home opened in April 2009, most referals come through Warwickshire Social Services but they also take referals from private clients. People who use the service are supported with their daily routines and are encouraged to do things for themselves. The respite unit is a three bedroom bungalow, situated in Galley Common, Nuneaton. Care Homes for Adults (18-65 years)
Page 4 of 30 Over 65 0 3 Brief description of the care home People staying in the unit use all the local amenities for shopping and leisure activities. While in respite clients are able to pursue their usual hobbies and interests, but this may need support from families for transport. Care Homes for Adults (18-65 years) Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 the first inspection of the service since it was registered in April 2009. The visit to this home took place from 2.30 pm until 7.30pm on a Wednesday. During our visit we case tracked two people. Case tracking means that we meet and talk to people and the staff that support them, look at records about their care, the way their medicines are looked after and look at the home they live in to make sure that it meets their needs. Case tracking helps us understand the experiences of people who live in the home. We also talked to the owner, the team leader and other staff about the support they give to people and looked at records that explain how to help people stay safe and well. We looked around the home to make sure that it was clean, warm and a pleasant place Care Homes for Adults (18-65 years)
Page 6 of 30 for people to live. Ingelby Care refer to people staying in the unit as guests, or clients. We have chosen to use clients within this report. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The service has only been operating since April 2009 and is developing well. However, there are several things the home needs to do to make sure people who use the respite unit remain safe and well, and to make sure their best interests are promoted. The home should appoint a manager who is qualified and experienced to manage the unit. The successful candidate must apply to be registered with the Commission. Individual support plans should be more user friendly and include pictures and photographs as people we spoke to said these were helpful in understanding what was written. Care Homes for Adults (18-65 years)
Page 8 of 30 Most people who use the service need support to make decisions about how they live their lives. How people make decisions should be recorded in their care plan, this is to make sure people make as many decisions for themselves as possible There is only one member of staff on duty during the evenings and weekends. This means if someone wants to go to the cinema, or to the pub then the other people staying in the home are persuaded to join them, otherwise the person couldnt go. There should be sufficient staff available to support individual activities, clients should be able to remain in the home if they prefer without stopping other peoples outings. The medication procedures should be improved. Prescriptions must be seen on assessments and the medication should be recorded from this rather than from boxes, this should ensure no medication is missed. As support staff usually work on their own it is recommended that a medication competency assessment is completed to ensure staff work in line with policies and procedures A record of complaints is required to show all concerns and complaints are taken seriously and properly looked into. The heated towel rail in the shared bathroom must be regulated to a safe temperature to ensure clients are not placed at risk of scalding. All recruitment files must be audited to ensure all the relevant documentation is available. When requesting employer references these are returned with a company stamp or headed paper to make sure these are genuine. There must be evidence available to show that staff have been fully trained to carry out their roles safely. It is recommended that training certificates are retained, and an individual training record is kept on each staff file. Staff records must be available for inspections and should be kept in a confidential locked facility in the home. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings
Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is available, and people have opportunities to visit the home before their first respite stay, so that they can decide if they want to stay there. Peoples support needs are assessed before their first stay, to ensure that individual needs can be met. Evidence: The unit offers a respite service and has a procedure for assessing the needs of people before they come to stay, so they can make sure their needs will be met. Ingleby Care call the respite unit a hotel, as it takes bookings from individuals for differing periods of time, to meet the needs of the individual, or their family and carers. People who use the service can stay for up to two weeks at a time, but the usual stay is either during the week, Monday to Friday or over a weekend, Friday to Monday. Clients funded by social services are allocated their amount of respite on a yearly basis. The unit discusses preferred dates with clients and tries to accommodate preferences. We looked at two client files, both had assessments of need completed by the unit
Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: before their first visit. Files also contained copies of the Social Services assessment of need. All clients are visited before their first stay to assess and confirm care needs, and clients are able to visit the unit before deciding to stay. Information gathered during the assessment process is used to develop personal support plans. Plans are reviewed regularly and since the service opened they have implemented an outcome focused support planning system. The plans seen were of good quality and included all elements of the persons social, health, communication and personal care needs. Plans are person centred which means based on the individuals strengths, needs, preferences and choices. The support staff we spoke to had a good understanding of the clients individual needs, and said that they had enough information to meet peoples needs. There is a statement of purpose and service user guide that describes the services and facilities provided in the home. We received three completed surveys from people who use the service and three from relatives and carers. Surveys show that the unit provides written information before peoples first respite stay, and the information provided is easy to understand and tells them what the service offers. The service user guide contains photographs, pictures and plain language so its easy for people who cant read to understand the content. There is also a copy on audio tape. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems of care planning to make sure that peoples needs are understood and met. Risks to peoples health and well being are managed effectively to ensure that they are protected from possible harm. Evidence: We looked at two peoples care plans. Care plans describe the support that people need to manage their day to day lives. The plans had information about individual likes and dislikes, for example, if people would rather have a bath than a shower. This should make sure that people receive care in a way that they prefer. Care plans were mainly in written format and these could be more client friendly by including photos and pictures. One client we asked said, as he couldnt read he preferred information with pictures. The staff we spoke to demonstrated a good knowledge of peoples needs, and
Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: understood individuals care plans. The unit completes risk assessments so that people are protected from taking unreasonable risks which may cause them harm. There is a positive approach to risk management and people are encouraged and supported to do things for themselves where possible. The staff we talked to were enthusiastic and motivated to empower people to make their own decisions and live their lives as they choose, and were positive about the strengths and skills of the people they support As most people who use the respite service need support with daily living tasks, it is recommended that how the person makes decisions is recorded in their care plan. This is to make sure people make as many decisions for themselves as possible. When we visited, there was no one staying in the unit who couldnt make their own decisions with support. There is a safe procedure for supporting clients to manage their personal money. Support plans told us that people staying in the unit needed support with this. We looked at the financial records for the two people we case tracked, and found that the amount of cash held on their behalf matched the records of their expenditure, receipts were obtained and all outgoings were recorded. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who stay in the unit experience a meaningful lifestyle that promotes their independence and is reflective of their individual needs. Evidence: The team leader has responsibility for organising peoples respite stay, she told us, that she tries to match people with similar needs to come in for short stays together. Clients are encouraged to participate in all daily living activities, and people we spoke to said they are supported to choose and make meals and to wash up. The respite unit is situated in Galley Common, which is a village area, and people staying in the unit use all the local amenities for shopping and leisure activities including the local pubs. While in respite clients are able to pursue their usual hobbies and interests, but this may need support from families for transport. We looked at support plans for two people and spoke to people in the unit about the
Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: opportunities they have to go out and do things they enjoy. They told us that regular activities are often organised in advance or arranged at short notice. During our visit two people in the unit decided to go to the cinema that evening and to eat out, and were waiting for the third person to arrive back to discuss this with him. Staffing does not allow flexibility to follow individual activities as there is only one member of staff on duty during the evenings and weekends. This means if someone wants to go to the cinema, or to the pub then the other people staying in the home are persuaded to join them otherwise the person couldnt go. There should be sufficient staff available to support clients individual activities while staying in the unit, clients should be able to remain in the home if they prefer without stopping other peoples outings. This is a recommendation and is discussed in the staffing area of this report. Comments from people who use the service included, The staff make sure I do the things I like to do. I like it that the hotel has sky satellite TV. People also said I would like to do more day trips. I would like there to be more staff on the weekends, so we can go on day trips. The home supports people to keep in touch with their friends and relatives a client told us that they make and receive telephone calls from their relatives while in respite. We looked at menus and records of food that people had eaten to make sure that a range of healthy and nutritious meals are offered. We also spoke to people about meals and they told us they were fully involved in menu planning, shopping and help with the cooking if they are able to. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to make sure that peoples personal and health care needs are identified, understood and met. Evidence: The team leader told us that each person has a plan that describes clients personal and health care needs. We looked at the plans for two people. Both plans included a description of peoples preferred personal care routines. One person told us that the staff were kind and always helped him when he needed support. The preferred gender of carer for intimate personal care routines is discussed at the initial assessment visit. The respite unit employs both male and female carers. If clients state a preference, personal care routines are arranged when the preferred staff are on duty. Although health needs are assessed and recorded in the support plan, due to the short term nature of the respite placements, routine health appointments are not usually arranged when the person is in respite. The member of staff we spoke to demonstrated good knowledge of peoples personal and health care needs, which indicates they had read and understood written plans of
Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: care. We looked at the storage and management of peoples medicines to make sure that it was being looked after safely. Medicines were stored securely and the records that we looked at cross referenced with the medication kept in the home, which indicates that medicines had been given as prescribed. We discussed the procedure for obtaining information about clients medication before they come to stay in the unit. The team leader who completes all the assessments said they ask to see the boxes of medication and records details from these. It is recommended that prescriptions are seen on assessments and medication recorded from this rather than from boxes, to ensure no medication is missed. Records show that staff complete medication training before assisting with this. The owner said that they are in the process of sourcing further training through Boots. As support staff usually work on their own it is recommended that a medication competency assessment is completed to ensure staff work in line with policies and procedures. This should contribute to a safer system of handling and managing medicines for the benefit of people who live in the home. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to listen to and act upon complaints and to safeguard people from possible harm. Evidence: The complaints procedure is included in the homes statement of purpose and service user guide so that it is accessible to people who stay there and their families. All three people staying in the home said that they would tell staff if they were unhappy and were confident that they would sort out any problems they had. There have been no complaints or safeguarding issues raised since the respite unit opened in April 2009. The team leader said there had only been one concern raised since the unit opened and this had been satisfactorily resolved. However, the unit does not have a log for recording concerns and complaints. A record of complaints is required to show all concerns and complaints are taken seriously and properly looked into. Recording concerns and complaints also allows any trends and patterns to be quickly identified. The staff we spoke to stated that they would not hesitate to report safeguarding incidents so that people were protected. From discussion with two members of staff and from looking at their records, it was evident that training in safeguarding had been completed in 2009. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Comments received from service users relatives said they like the service because it keeps people safe. Care Homes for Adults (18-65 years) Page 20 of 30 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well furnished, comfortable and clean. Evidence: Ingelby Care respite unit is situated in Galley Common, Nuneaton. The home looks no different to others in the area. There is good access to local facilities such as pubs, shops, and public transport links. This is important to the people who live there as they make regular use of community resources. We looked around the home to make sure that it was clean, comfortable and that the facilities met peoples needs. The respite unit is a three bedroom bungalow, which has been decorated and furnished to a very good standard. There is a comfortable lounge, which had new sofas, easy chairs and a wall mounted flat screen television. There is a large well equipped dining kitchen where people are supported to cook and eat their meals. We were invited to look at all three bedrooms, which were spacious, well furnished and equipped with individual televisions. Due to the short term nature of the respite placements the rooms were not personalised by people staying there. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home was clean throughout, with no indication of poor cleansing routines. There is a laundry area off the kitchen, this has domestic washing machines which are appropriate for the people who stay there. The lighting throughout the communal areas has been sympathetically installed. The kitchen, dining area and lounge had several different lighting systems in place including overhead lighting and coloured muted spot lights. One bedroom has an en suite facility the other two bedrooms share a bathroom. Both bathrooms have showers and were clean and airy. The heated towel rail in the shared bathroom was hot to touch. We were told that this was due to a problem with the central heating/hot water system which had been repaired once but is still leaking, the engineer was due to call on Friday, two days after our visit, we agreed it was acceptable to wait till then. All three clients were told not to touch the towel rail and one client helped write a sign to say hot do not touch. The towel rail must be made safe to touch so the clients are not at risk of being injured. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment and training procedures contribute to making sure that people are supported by a well trained and competent team of staff. but all documents required to evidence this were not available. Evidence: We spoke to the three people currently staying in the home about the qualities of the staff team and we were told that they are all, nice, kind people. We observed staff working with clients and it was evident that people liked spending time in the respite unit and enjoyed the company of the staff on duty. We looked at the staff rota to make sure that there were enough staff on duty each day to meet peoples needs and promote their day to day living. The rota showed that there is usually only one staff member on duty after 4.30pm and at weekends. This does not provide enough staff support for clients in respite to undertake separate activities. Staff spoken to said if a client wants to go to the cinema, or to the pub then the other people staying in the home are persuaded to join them otherwise the person couldnt go. There should be sufficient staff available to support clients, individual activities while staying in the unit, clients should be able to remain in the home if they prefer without stopping other peoples outings.
Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The unit employs four permanent support staff. We looked at the recruitment records for two members of staff, which showed that a range of checks had been made to ensure that people had been protected from the risk of having unsuitable staff working with them. These included receiving written references, Criminal Records Bureau checks and a completed application form. However one staff file had only one written reference instead of two, the owner said that this staff member had worked for Ingelby Care for several years and had recently transfered to the respite unit and not all documents had been transfered to the respite file. The other staff file had the CRB information recorded on a post it note stuck into the file, which is not robust. It is recommended that all recruitment files are audited to ensure all the relevant documentation is available. It is also recommended that when requesting employer references these are returned with a company stamp or headed paper to make sure these are genuine. Staff files are currently stored at the Domiciliary Care office, and were bought to the unit for the inspection. If this inspection had been unannounced the staff files would not have been available. It is recommended that staff records are kept in a confidential locked facility in the home. Ingelby Care, uses several agencies, including Workforce Development through Social Services, and the Warwickshire Quality Partnership to provide a rolling programme of staff training. This showed staff have the opportunity to complete new training and refresher courses. They also source Learning Disability training from a local college, The training records we were shown did not have all the mandatory training recorded. There were no individual training records in the two staff files we looked at, and not all certificates were in place. We spoke to staff on duty who confirmed they had completed all mandatory training and also said they felt well trained and equipped to do their job. There must be evidence available to show that staff have been fully trained to carry out their roles safely. It is recommended that training certificates are retained, and an individual training record is kept on each staff file. Staff files show that support staff receive regular supervision from the team leader. This process will include an annual appraisal. It is recommended that staff also have their practise observed to ensure they work in line with policies and procedures. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ingleby Care should appoint a manager who is qualified and experienced to ensure the unit is well managed and peoples health and safety is promoted and protected. Evidence: The manager post is currently vacant, the previous registered manager having moved to a different role with in the organisation. The mangers post has been advertised but there were no suitable applicants. The home has an experienced team leader, who is responsible for the day to day running of the service in the managers absence. This person has completed a range of training (called National Vocational Qualifications) that are relevant to her managerial role, and is considering applying for the managers post. To ensure Ingelby Care operates in the best interests of clients, the unit should appoint a manager who is qualified and experienced to manage the unit. The successful candidate must apply to be registered with the Commission. All three clients staying in the unit at the time of our visit needed support to manage finances. The personal monies for two clients were seen and checked, all outgoings are recorded and receipts obtained. Both amounts checked were seen to be correct.
Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The recruitment and training procedures should be more robust, this is discusssed in the staffing section of this report. Quality assurance systems are in place. All clients are asked to complete a satisfaction questionnaire at the end of their respite stay. we looked at completed surveys and these show that people who use the service are very happy and one person said I cant wait to come again. The home have completed a quality audit for commissioners of Warwickshire Social Services, which identifies and evidences how the service promotes positive outcomes for the people who use the service. We looked at a range of records to make sure that the health and safety of people living in the home was being promoted and protected. Maintenance checks are being carried out regularly, and maintenance records seen corresponded with the information supplied in the AQAA. The home must make sure that the heated towel rail in the shared bathroom is regulated to ensure clients are not at risk of scalding. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 6 Individual support plans should be more user friendly and include pictures, photographs etc if people are unable to read. How people make decisions should be recorded in their care plan. This is to make sure people make as many decisions for themselves as possible As support staff usually work on their own it is recommended that a medication competency assessment is completed to ensure staff work in line with policies and procedures Prescriptions should be seen on assessments and medication recorded from this rather than from boxes to ensure no medication is missed A record of complaints is required to show all concerns and complaints are taken seriously and properly looked into. The heated towel rail in the shared bathroom must be regulated to a safe temperature to ensure clients are not placed at risk of scalding. There should be sufficient staff available to support clients,
Page 28 of 30 2 8 3 20 4 20 5 6 22 27 7 33 Care Homes for Adults (18-65 years) 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 individual activities while staying in the unit, clients should be able to remain in the home if they prefer without stopping other peoples outings. 8 9 34 34 Staff records must be available for inspections and should be kept in a confidential locked facility in the home. When requesting employer references these are returned with a company stamp or headed paper to make sure these are genuine. All recruitment files must be audited to ensure all the relevant documentation is available. There must be evidence available to show that staff have been fully trained to carry out their roles safely. It is recommended that training certificates are retained, and an individual training record is kept on each staff file. The unit should appoint a manager who is qualified and experienced to manage the unit. The successful candidate must apply to be registered with the Commission. 10 11 34 35 12 37 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!