Inspection on 18/11/08 for May Terrace

This inspection was carried out on 18th 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.

Other inspections for this house

May Terrace 30/11/06

May Terrace 13/01/06

May Terrace 22/06/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: May Terrace 24 May Terrace Lipson Plymouth Devon PL4 8PP 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: Antonia Reynolds Date: 1 9 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: May Terrace 24 May Terrace Lipson Plymouth Devon PL4 8PP 01752668139 01752668139 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): May Terrace Limited Name of registered manager (if applicable) Mr John Leslie Jobling Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: Age Range 18 - 60 years Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home 24 May Terrace is privately owned by May Terrace Limited although the same owners have been operating the home for several years. The service is aimed at people with a mild to moderate learning disability who wish to develop their skills and confidence, usually prior to living independently. The home was opened in 1992 and is a two-storey midterraced house situated in the residential area of Lipson, Plymouth. There is no dedicated parking for the home, although on street parking is available nearby. The fee levels are between 343 Pounds and 381 Pounds per week although these may vary depending on the individual needs of the people who live in the home. Information about the home and copies of inspection reports can be obtained from the Registered Manager, Mr John Jobling. Five people with learning disabilities live at the home. The house is close to shops and the city centre. Care Homes for Adults (18-65 years) Page 5 of 37 There is a bus stop near the home where people can take buses into the city centre or other places. People can use trains and taxis to go to other places. There are lounge and dining rooms on the ground floor as well as a kitchen. Each person has their own bedroom. No-one has to share a bedroom. Care Homes for Adults (18-65 years) Page 6 of 37 The bathroom and toilets are on the 1st floor. The home has a courtyard at the back of the house and there is a park nearby. Care Homes for Adults (18-65 years) Page 7 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 8 of 37 How we did our inspection: This is what the inspector did when they were at the care home This inspection consisted of two announced visits to the home between 11am and 2pm on Tuesday, 18th November 2008 and between 1.15pm and 3.15pm on Wednesday, 19th November 2008. The inspection was announced because we were accompanied by an Expert by Experience on the first day. Throughout this report the term we will be used as the report is written on behalf of the Commission for Social Care Inspection. An Annual Quality Assurance Assessment (AQAA) was completed by the home prior to the inspection. The AQAA is a self-assessment that focusses on how well outcomes are met for the people who live in the home. The last inspection of this home took place on 30th November 2006. We talked to four people who live in the home. Care Homes for Adults (18-65 years) Page 9 of 37 One person sent us a survey form. Three surveys for relatives were left in the home and one was returned to us. Four surveys for staff were left in the home but none were returned. A survey was sent to one social care professional but was not returned. We looked all round the home. We talked to the Registered Manager, John Jobling. The care records of three people who live in the home were inspected. Care Homes for Adults (18-65 years) Page 10 of 37 Other records about how the home is run were also inspected. This included staff records. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. What the care home does well The Registered Manager has an open and positive management style, and the ethos of the home promotes peoples well being by recognising their rights to independence and individuality. Most people in the home have paid jobs during the day. Care Homes for Adults (18-65 years) Page 11 of 37 People also go to college if they want to more education or do a training course. People take part in various activities in the community. Everyone chooses what they want to do each day. People go out on their own and independence is promoted. Everyone has their own front door key and a key to their bedroom door. Care Homes for Adults (18-65 years) Page 12 of 37 The use of public transport is encouraged and promoted. It is easy to get into the city centre. People’s rights, diverse interests and individual lifestyles are supported and respected. The home has a small, consistent staff team who have worked in the home for several years. This provides consistency and continuity of care and support to the people who live there. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 13 of 37 The refurbishment of the kitchen has been completed, including a cooker with a double oven, which was provided at the request of the people who live in the home. The lounge room has been redecorated. What the care home could do better People should be actively involved in all aspects of the running of the home, such as going shopping for food. This is so that people learn practical life skills and feel that they have control over what happens in the home. Care Homes for Adults (18-65 years) Page 14 of 37 House meetings should take place if people want them. People who live in the home should be involved in any plans for redecoration. People should be consulted about whether they want the house rule, where visitors have to leave by 10pm, kept as it is or changed. Each person in the home should have the option of a minimum seven-day annual holiday outside the home, which they help choose and plan. Care Homes for Adults (18-65 years) Page 15 of 37 People should be supported to budget their money properly so that they can go on holiday or save for more expensive items. Support/care plans need to be more person centred and include personal goals, wishes and aspirations and detail how these will be achieved. This is so that the people who live in the home and the staff team are aware of what needs to happen for each person to achieve their goals and to monitor progress towards those goals. The Registered Manager needs to keep up-to-date with legislative and social care changes to improve his knowledge, skills and competence while managing the home. The Registered Manager should put an effective quality assurance and monitoring system into place. This system needs to seek the views of the people who live in the home, their relatives and representatives and other professionals involved in peoples care. An annual internal audit of all the services and facilities in the home should be carried out. A report should be written with the results of the survey. This is to ensure that the home is being run in the best interests of the people who live there and Care Homes for Adults (18-65 years) Page 16 of 37 they know their views are taken into account in the development of the home. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Antonia Reynolds 33 Greycoat Street London SW1P 2QF 02079792000 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 Care Homes for Adults (18-65 years) Page 17 of 37 our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 18 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 19 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 who choose to live in the home can be confident that their support needs are assessed prior to admission. They will have opportunities to visit the home to meet the other people who live there and the staff team. Evidence: No-one has been admitted to this home since the last inspection. However the four people spoken to said that they had opportunities to visit the home before they came to live there. The Registered Manager confirmed that people were consulted and involved in the decision to move into this home. There are procedures in place to ensure that detailed pre-admission assessments are carried out before anyone starts living in the home. Discussion with the Registered Manager confirmed that this includes meeting and consulting with the person concerned, their relatives or representatives and any other professionals involved in the persons care, such as social and learning disability services. This assessment is so that people coming to live in the home can be confident that their needs will be met and helps the Registered Manager make an informed decision about whether the home is suitable. Care Homes for Adults (18-65 years) Page 20 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 . The people who live in the home can be confident that they will be encouraged and supported to make choices and decisions about their lifestyles. Evidence: Each person who lives in the home is encouraged, enabled and supported to make their own decisions, choices and be as independent as possible. Discussions with the people who live in the home, and observation of discussions between the people who live in the home and the Registered Manager, showed that the running of the home, and all routines and activities, are organised around the wishes, choices and needs of the people who live there. Each person has a written plan that says what type of support and help they need on a day to day basis. Each person has signed these documents and people spoken to knew what they contained and that they could see what was written in them whenever they liked. However these plans were not particularly detailed and did not include information about peoples wishes, aspirations and short and long term goals, and how these would be achieved. For example, some people wished to move out of residential care and into a less supported environment, but there was limited information about how this will be achieved. Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: Activities that people participate in are assessed for possible risks, to make sure that they are kept safe from harm. The people who live in the home said that the staff team are aware of the way in which their learning disability affects them and takes this into account when supporting them to make decisions and choices. Discussion with the Registered Manager confirmed that staff are fully aware of the needs of each person. The people who live in the home said that they participate in most aspects of the day to day running of the home such as cleaning, cooking and laundry, and staff support and assist where required. However people are not involved in the shopping for the home because the Registered Manager said they did not wish to participate. Also people said that the lounge room had been redecorated and they were not consulted about it at all. The people who live in the home said that the staff help them to make decisions about their lifestyle and with choosing activities, some of which may be in the home and some in the wider community, such as going shopping or out with friends. The people who live in the home and the Registered Manager confirmed that each person has their own bank account and manages their own money. However there was no information in peoples support plans about how they are assisted with budgeting and discussion with the Registered Manager indicated that this is an area that needs addressing. This is because people have built up debts occasionally and have no money to go on holidays or save for more expensive items. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live in the home can be confident that individual lifestyles are respected and independence and choice are promoted. Evidence: Discussions with the people who live in the home and the Registered Manager, as well as documentation, showed that people are enabled to live as full a life as they wish to. All the people living in the home attend a range of regular work, education and leisure opportunities. The people who live in the home said that the staff actively support them to obtain and keep paid employment which is excellent practice as people feel valued and fulfilled in their lives. If they decide that they want to change jobs, they are provided with whatever support is required to achieve this. One person works in a post office, another in the Co-op and a third person works in a shop selling clothes or working on the till. Peoples links with the community are further enhanced because they all use public transport and travel regularly by bus around the city and further afield. One person had never used a bus before coming to live at the home but now Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: does so with confidence. The home is located in a residential area of Plymouth with a few shops and amenities nearby, including doctors and the dentist, that people can walk to. People have their own interests including socialising with friends, shopping, visiting family or staying in and relaxing in front of the television. People who live in the home said they could go to church if they wish to but they choose not to. Everybody who lives in the home said they are free to come and go as they please, and do not feel that there are any restrictions on this. So that people know what is going on locally, the home buys the local Evening Herald every day for people to read. Two people said they were rather fearful of going out at night as they thought it might be dangerous. However they did have plans to go late night shopping and to the theatre to see the pantomime. Discussion with the Registered Manager confirmed that peoples sexual orientations were respected and specialist support and advice was sought if required. Each person had their own key to the front door and to their own bedrooms. Three of the people who live in the home said that they had not been away on holiday, although one person did say she had been on several day trips when she had a week off work. Discussion with the Registered Manager indicated that people went to families for holidays or away with friends but nothing was facilitated by staff in the home. Three people spoken with said that, whilst they can have friends and family visiting them in the home, they have to leave by 10pm and no-one is allowed to stay overnight. Discussion with the Registered Manager confirmed that this is a house rule introduced some years ago, because of a particular situation at the time. However this rule has remained, despite a change of people who live in the home. The people who live in the home said they have a choice of meals and can eat whenever and wherever they like, however three people said they were not involved in shopping for food. The Registered Manager confirmed that he did the food shopping for the home, although everyone contributes to the shopping list, because no-one wants to go with him. One person who lives in the home said that the Registered Manager gives him money to do his own shopping and each person has their own cupboard in the dining room to keep food items. Care Homes for Adults (18-65 years) Page 24 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 who live in the home can be confident that personal support is provided in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. Evidence: Discussions with the people who live in the home confirmed that each person receives personal support in the way they prefer and require. Each person has a support plan that provides information about personal, emotional and health care needs. Staff involvement in personal care is minimal because the people who live in the home do not need this assistance. People said that they have contact with representatives from Social Services, Learning Disability Services, doctors and various other healthcare professionals. Any visits to the doctor, dentist and other health checks were recorded in individual files. Information contained within personal files, as well as discussion with the Registered Manager confirmed that external professional advice and guidance is sought when necessary from local health care professionals or social services. The people who live in the home said that they decide what time they get up and go to bed, have meals, have a shower or bath, and go out during the day or evening. Through discussion and observation it was clear that timings are flexible and the Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: choice of the people who live in the home. Each person has a designated key worker and people said they could discuss any personal issues with their key worker or other member of staff. Medication was locked away safely and regular medication reviews with health professionals take place. Records pertaining to the administration of medication were up to date and the practice of administering medication, described by the Registered Manager, was found to be safe. The Registered Manager knew what to do in the event of someone refusing their medication and that unused or contaminated medication needs to be returned to the pharmacy for safe disposal. The Registered Manager confirmed that all staff have received training to safely administer medication. Care Homes for Adults (18-65 years) Page 26 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 who live in the home are protected from abuse, neglect and self-harm. People can be confident that any concerns or complaints will be listened to, taken seriously and acted upon immediately. Evidence: The people who live in the home said that they feel safe there, they trust the staff, and would tell the manager if they had a problem or concern. These discussions, as well as discussion with the Registered Manager, demonstrated that the open culture of the home and the recognition of peoples rights, ensure that people are protected from harm. Observation showed that they felt very free to raise any issues or concerns with the Registered Manager. All staff have undertaken training in safeguarding adults and the Registered Manager knew what action to take should he suspect that any person in the home was being abused or not treated respectfully. There was also written guidance in the home for the staff to follow should they need to. The home has a complaints procedure and discussions with the people who live there showed that they know how, and to whom, to make a complaint if they wish to. House meetings used to be held but three of the people who live in the home said these had not taken place for some time and they would like them to be reinstated. 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 live in a clean, safe, comfortable and well-furnished home. Evidence: May Terrace is an older property in a residential street in Plymouth. It is indistinguishable from the neighbouring properties. The home is spacious, comfortable, safe and clean with a good standard of decor and furnishings. Since the last inspection the kitchen has been refurbished and the lounge room redecorated. The people who live in the home said they are responsible for cleaning their own bedrooms and the staff clean the shared rooms. Each person has a single bedroom, none of which have en suite facilities, but all have wash hand basins. One bedroom is on the ground floor and four are on the 1st floor. Bedrooms are individually furnished and contain many personal possessions. All bedroom doors are fitted with locks that people could lock from the outside but staff could gain access in an emergency. Each person has a key for their own bedroom door and the front door. The home has a pay phone in the dining room that people may use privately and each person has their own mobile phone. The home has a bathroom on the 1st floor consisting of a bath with over bath shower, wash hand basin and a toilet and there is a separate toilet beside it. There are shared rooms on the ground floor consisting of a kitchen, dining room and lounge room. Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: Laundry facilities are in an outhouse at the rear of the property. People who live in the home said they do their own washing. There is an office on the 1st floor with sleeping facilities for staff, although they also have the option of sleeping on the settee in the lounge room should they wish to. Care Homes for Adults (18-65 years) Page 29 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 . Recruitment procedures are robust and people who live in the home benefit from a consistent, well supported and supervised staff team. Evidence: May Terrace has a small staff team who have worked in the home for several years. The most recently appointed member of support staff originally joined the team in 2004 but she is related to the owners and already knew the people who lived in the home. The people who live in the home said that they liked the staff and liked the consistency they receive from having the same staff team for several years. The information contained in staff files showed that the recruitment procedure is robust and all checks and references are obtained before a new member of staff starts work. This procedure had not been strictly adhered to for the most recently appointed staff member but the Registered Manager explained that this was because she is a close family member who has been involved in the home for many years and knows the people who live there very well. Therefore there were no risks to the safety and wellbeing of the people who live in the home. There is usually at least one staff member on duty at all times with one person sleeping in the home at night, although this is flexible depending on what activities are happening. Discussion with the Registered Manager, as well as documentation, confirmed that each member of staff attends individual supervision meetings with him Care Homes for Adults (18-65 years) Page 30 of 37 Evidence: every two months and annual appraisals take place. This is so that the performance of staff is monitored and any training needs identified. When the Registered Manager is not working in the home, he is always available on call should there be a problem which the staff on duty feel they cannot manage. New staff are expected to complete a comprehensive induction programme and then complete training in safeguarding vulnerable adults, first aid, health and safety, fire safety, the administration of medication, food hygiene and National Vocational Qualifications (NVQs). One staff member has completed training in person centred planning and managing challenging behaviour. Discussion with the Registered Manager indicated that he was not aware of new legislation that may affect the people who live in the home such as the Mental Capacity Act and the deprivation of liberty safeguards. Due to only having one staff member on duty, the Registered Manager said there may be times when the people who live in the home arrive back at the home when the staff member is out with other people, or doing other tasks. This means there are short periods of time when the people who live in the home may be there without a staff member but the Registered Manager said each situation is subject to an assessment of each persons abilities and they all have their own door keys so can come and go as they choose. Care Homes for Adults (18-65 years) Page 31 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 . The management approach is open and positive, providing clear leadership and guidance. Peoples rights, health, safety and welfare are protected and promoted. Evidence: The Registered Manager, who also owns the home, is experienced, qualified and competent in his role. He has many years experience of working with people with learning disabilities and has been managing this home since it opened in 1992. He has attained relevant qualifications to manage the home namely a level 4 National Vocational Qualification (NVQ) in Care and the Registered Managers Award which is a management qualification. Discussion with the Registered Manager indicated that he has not been keeping himself up to date with new legislation, such as the Mental Capacity Act and the deprivation of liberty safeguards, or practices in social care, such as person centred planning. He was not aware that the Local Authority had organised specific training for Registered Managers related to safeguarding vulnerable adults. The people who live in the home said that they liked the manager and observation showed that they talked to him very openly about most issues. The quality of care provided is continually being monitored and reviewed by the Registered Manager as he spends a great deal of time at the home talking with the people who live there, their Care Homes for Adults (18-65 years) Page 32 of 37 Evidence: relatives and representatives, and staff. However discussion with the people who live in the home indicated that they feel they are not always consulted or involved in all decisions regarding the running of the home, for example, redecorating without any consultation and the ceasing of house meetings. Health and safety checks, including fire equipment, gas safety and portable electrical appliances are carried out regularly. Fire safety training is carried out with staff and the people who live in the home are involved in fire drills. The people who live in the home described what they would do in the event of a fire, that is, leave the home as quickly as possible. The Registered Manager, as well as staff training records, confirmed that all staff complete training in emergency first aid, health and safety and food hygiene. One person has completed training in the control of infection. The Registered Manager said that staff do not complete training in moving and handling because they are not expected to do any manual lifting of either people or objects. The use of hot water has been risk assessed and the Registered Manager does not consider that thermostatically controlled valves, to regulate the temperature, need to be installed. Radiators are not guarded as this is not considered necessary for the safety of the people who live in the home. Care Homes for Adults (18-65 years) Page 33 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 34 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 1 6 Each person should have a detailed and comprehensive care and support plan that is devised with them in a person-centred way. This plan should include personal goals, wishes and aspirations and detail how these will be achieved. This is so that the staff team are aware of what needs to happen for the person to achieve their goals and to monitor progress towards those goals. People should be provided with support, advice and guidance to help them budget their money properly. This is so that they have opportunities to go on holiday or buy bigger items should they wish to. People who live in the home should be consulted on, and participate in, all aspects of life in the home. This is so that people feel it is their home and that they have control over what happens within it. The Registered Manager should encourage and support people to develop independent living skills, such as shopping for food. This is so that people have opportunities for personal development and learn practical life skills to Page 35 of 37 2 7 3 8 4 11 Care Homes for Adults (18-65 years) prepare them for more independent living. 5 14 Each person in the home should have the option of a minimum seven-day annual holiday outside the home, which they help choose and plan. The Registered Manager, in consultation with the people who live in the home home, should review the house rule where visitors have to leave by 10pm and are not allowed to stay overnight. The Registered Manager should undertake periodic training and development, including legislative and social care changes, to maintain and update his knowledge, skills and competence while managing the home. The Registered Manager should put an effective quality assurance and quality monitoring system in place. This should include seeking the views of the people who live in the home, their relatives and representatives, other professionals involved in peoples care and carrying out an annual internal audit of all the services and facilities in the home. 6 15 7 37 8 39 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. 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