Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Orton Mere 547 Oundle Road Orton Longueville Peterborough PE2 7DH 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: Don Traylen
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. the things that people have said are important to them: They reflect 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 29 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home
Name of care home: Address: Orton Mere 547 Oundle Road Orton Longueville Peterborough PE2 7DH 01733392900 01733392901 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Charlene Gwidza Type of registration: Number of places registered: Ermine Care Ltd care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Orton Mere was first registered as a care home on 27th September 2007. The home is registerd to provide care with nursing for thirteen people with Learning Disability and Mental Health Disorders. The building has been purposely extended and converted and is on three levels as a result of these alterations. There are thirten rooms that each have full ensuite facilities, apart from one room that has an adjacent dedicated bathroom. Peoples rooms are located on each floor. There is a mangement/administration office on the ground floor and a dedicated office for the manager and a small staff changing room in the attic area. There is a large garden to the side and rear of the property and a driveway with parking. Fees range from £1950 per week. Copies of CSCI reports are available at the home or from the CSCI website. 13 13 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 29 Care Homes for Adults (18-65 years) Page 5 of 29 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
peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was carried out on the 13/01/2009. A visit to the home started at 10:30 and ended at 19:30. During the inspection the manager and six staff were present at different periods. At different times of the day the six people living at the home were present and were spoken to both individually and as a group. Time was spent with them at various periods throughout the inspection. A lunchtime light meal was observed when we sat and ate with people. Observations of staff interaction with people living at the home and with each other were observed. Staff were spoken to throughout the inspection and two care staff whose recruitment and induction processes were tracked, were asked about their roles and recruitment and training. Records relating to these two staff were assessed. Records were also assessed for two peoples care plans; their admission arrangements and process; the storage and Care Homes for Adults (18-65 years)
Page 6 of 29 administration of medication, policies and guidances and fire safety precautions. A discussion with the Psychiatrist, who is employed by the organisation, about medication and the reviews of peoples care took place. A tour of the building included the main kitchen and a smaler anciliary kitchen used solely by people when assistance with their daily living activities include tasks related to the use of this room. The cook informed us about his role, the training he had received and peoples diets and choices of food. An Annual Quality Assurance Assessment was adequately completed and returned to the Commission prior to the inspection. Four Surveys were received from relatives and seven from staff. What the care home does well: The collective result of what the service does well ensures peoples best interests are promoted. The service is intended to provide care for people who have learning disabilities that include challenging and behavioural difficulties. To meet these needs the service employs a psychiatrist and a psychologist and seven registered nurses trained in either mental health, learning disabilities, or general nursing. The admission process is carefully planned and takes place over an extended time frame and this is to ensure people are familiar with and agree to live at the home and their particular care needs can be met. People are only admitted when there are sufficient trained staff to meet their needs and if the proposed new person is willing to live at the home and the people already living at the home are compatible to that person moving in. There were six people living at the home at the time of this inspection. Care is individually planned to meet each persons specific needs. The organisation provides well planned care that is outcome focused and person-centred. Care plans are especially well recorded and detailed and include a range of pragmatic risk assessments based upon each persons Activities of Daily Living and developmental needs. Much of the care is one care worker for each person and this is generally planned so that peoples scheduled daily activities can be achieved. Freedoms and choices are anticipated to be made and the service demonstrated these are expressed and form the basis of peoples daily lives. Social development is continuously encouraged and facilitated. Safeguarding and protection is promoted and the local authoritys guidelines are adhered to. The building is well maintained, clean and was comfortably warm. The gardens were safe well kept and accessible. Staff are recruited in a safe manner and all appropriate checks and carried out before any new care worker commences employment. Induction training is especially good because it is based on the Skills for Care Common Induction Standards, is implemented immediately and staff are rigorously assessed by the manager for their achievement. Training is thorough. Annual refresher training in a core group of mandatory topics are expected to be attended. Training in specific topics relating to the type of care such as MAYBO training must be received by all staff before they commence employment. Further training is strongly encouraged and is facilitated wherever there is a valid case for staff to be trained in any subject. For instance, one Registered Nurse has been funded to train in Mental Health nursing. Daily conduct and approach is set by the good practise demonstrated by the manager. Staff considered her to be approachable, open and fair. The manager facilitates staff to consider decision making based on the best interests of people and to take responsibility for offering and encouraging personal development. The manager is currently undertaking further training in National Vocational Qualification (NVQ) level 5 in management. Records expected under the Care Homes Regulations 2001 are Care Homes for Adults (18-65 years) Page 8 of 29 accurately and well maintained. All incidents affecting people have been promptly reported to the Commission and to the local Safeguarding Officer at the PCT, whenever this has been necessary. What has improved since the last inspection? What they could do better: Care staff should be encouraged to strengthen their practise by being prepared to respond quickly to personal requests for support, when a person is asking for individual social support and their care plan has indicated a need to facilitate greater independence. Consideration should be given to the use of one of the two eating areas that is located immediately outside of the kitchen. This area has four doors leading to other parts of the home and has become a busy passageway to these four exits. Consideration should also be given to reducing the noise level in this room by ensuring that the noise created by three of these self closing doors do not bang shut and are not a continual interuption and disturbance to people living at the home. The home should continue to ensure the environment does not become a catalyst for Care Homes for Adults (18-65 years) Page 9 of 29 aggravated or challenging behaviours by constantly reconsidering the numbers of people living at 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 29 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 11 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured the home has carefully planned their admission and has their assessment information and are given multiple opportunities to visit the home before deciding to move there. Evidence: The Statement of Purpose had been reviewed and adequately reflected the service being offered. The Statement included a clear and precise staffing arrangement to indicate how many trained staff would be working when if and when a certain number of people were living at the home. The manager stated the home will continue to admit more people only when they are confident the placement is suitable for all people living at the home and that all their current processes of determining complex are carried out. At the time of this inspection there were six people living at the home and their admissions had been carefully planned and their needs and aspirations had been thoroughly assessed. The home has a policy of not admitting a person until they have been clinically assessed for their learning disability and psychological needs as well as developmental aspirations. People are assured they are assessed in a multidisciplinary
Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: discipline that includes social workers and care managers employed by local authorities or Learning Disability Partnerships, psychologists and psychiatrists already involved in their care, therapists skilled in speech and language and communication and are also assessed by the home with the inclusion of their psychiatrist or psychologist. One person had moved into the home as an an urgent need and in this instance the usual lengthy process of admission was avoided. The home had received adequate information relating to his needs and this urgent referral was an appropriately managed admission. Contracts are made with the different commissioning authority who funded each person care. Care Homes for Adults (18-65 years) Page 13 of 29 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured their assessed needs are well planned and are promoted and they are supported to increase their independence and take risks within a carefully assessed approach. Evidence: All six people living at the home had a written plan of their weekly schedule that included their daily activities for educational, physical and personal aspirations. Two peoples care plans were assessed. Each persons needs differed significantly. The plans were indexed and neatly presented in hard plastic folders and contained the specific needs, aims and tasks and risk assessments. The plans were mostly written as Word documents. Hand written records were maintained for handover notes daily diary notes and records of interventions and decisions by different Doctors. There was a large photograph of the person and their personal contacts. There was evidence of the history of care and the current needs and the strategies used to manage challenging behaviours. Each persons social and personal development had been planned and
Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: recorded. One persons care plan showed he had been admitted in an emergency. As a result the home had been expected to rapidly gather and determine his assessment information and formulate a care plan that suited him. His circumstances and his care plan were discussed with him and the manager during the inspection He told us that he wishes to realise certain ambitions and move away from the home soon to a more independent lifestyle. This was shown in his care plan as a need that was being planned and included the support of a social worker and an advocate. There were extensive risk assessments in both person files and each risk had been included in the elements of the care plans. One persons plan included a job opportunities strategy. Risks had been assessed for going out of the home for each person. Each plan include continuous clinical records and a record of psychiatric input and visits by either the psychiatrist psychologist or GP. Observation records were kept where this activity was a necessary aspect of the care. An Adaptive Behavioural Assessment System (ABAS) had been recorded for each person who had needs to support them manage their behaviour. The home had a developed a risk assessment approach. This was shown in the risk assessments for each risk and in the summary of these risks and in a Risk Assessment Form showing the high and low measurements of risks when actions to prevent risks are put into place. One persons care plans showed a Typical Assault Cycle that was being used to as a strategy to deter some behavioural issues. A measurement of one person activity of behaviours had been collated and showed as a Bar chart. Indicators of how many care staff should be present to meet particular needs are shown in each person care plans. For instance, when individual support is necessary and one-to-one care has been assessed as necessary. One person was aware the home had kept this care record, but he had not seen it. Both people were asked by the manager if these details could be shared with us. One person exercised his right to personally request a copy of the information that was assessed and then gave this to us during the inspection when we discussed it with him. Each persons circumstances are regularly reviewed at the fortnightly meetings of the homes multi-disciplinary team. Contribution to the meetings can be made by all staff. Reviews are recorded in the care plans when alterations to care are put into place. Care Homes for Adults (18-65 years) Page 15 of 29 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 are assured they are supported and encouraged to achieve personal development. However further assurance is needed to ensure they can realise their aspirations. Evidence: The care plans show a medical model of care. Personal care and social and leisure development is encouraged and recorded. Activities of Daily Living (ADL) as social development was also recorded and measured in the skill shown and the willingness to participate in the daily tasks that people had agreed to be involved in. Each person has a chart for structured activities that included personal domestic tasks, going out for a walk attending a Day Centre, Gardening, going to Mc Donalds restaurant, making own breakfast, shopping, going to a pub,going to a bookshop, going to named parks. There is a strong emphasis on encouraging each person to be responsible for their personal
Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: hygiene and for specific domestic tasks that are designed to develop their independence. Individual progress as achievement and willingness is discussed at the fortnightly multi-disciplinary clinical reviews. Much of the progress made by people in terms of their mood, or behaviour, or their goals and aspirations was not shown in the care plan, although the reviews did reflect part of any progress made. Care is planned so that there are opportunities to access the wider community. The amount type and frequency of community access varies with each persons needs and risks. There are occasionally times when access to the community cannot be assured and this is when there are not sufficient numbers of staff to provide the level of support that is needed. For this reason, access to the community is planned and structured so that staff support can be assured. It was observed during the inspection that one person expressed his wish to a member of staff to purchase a personal item. He had informed us of his intentions and wishes to become independent, but it appeared that staff had not understood the urgency of his intentions and feelings. This matter was discussed with the manager during the inspection and it was acknowledged that staff should be prepared to make decisions about a persons request for support. Family contacts are maintained and one person spoke to us and informed us that he sees his mother and father every other weekend. The visits to his parents are facilitated by the home. Trips into the community or visits to families are supported by the home who have a suitable vehicle specifically for this purpose. The recorded menu for meals was the choices of food asked for by people living at the home. Two people confirmed they chose the meal and requested food they wanted. A lunchtime meal was observed that catered for the busy lifestyle people were enjoying. Lunch was a choice of spaghetti and toast, or sandwiches, or soup and rolls. This was what the two people said they wanted as the activities that each person enjoyed determined they ate their main meal in the evening. Care Homes for Adults (18-65 years) Page 17 of 29 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 are assured they will receive appropriate psychological and health care and that the control of their medication is safely managed. Evidence: Three people spoken to confirmed that staff support them. Comments made included, this place is excellent.. they are helping me and its the best place I have lived in. Another person told us the staff he liked and sat down and discussed this with us. Observations showed that staff clearly offer help that suits each person. People express their preferences about food and what they wanted to plan. Emotional support was clearly demonstrated and is recorded as an element of care planning. Physical health is included in the general care plan. One person was waiting to attend the dentist and had an appointment made for the following week. No person self medicates. People are encouraged to be responsible for remembering the times when they should take their medication. This responsibility is a structured element of the support plan to enable independence. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Records of medication were assessed; they had been accurately maintained. Amounts of medication were checked and these were compatible with the records maintained. The storage of medication was safe and was kept at a suitable temperature which had been recorded each day. Medication prescribed PRN (Pro Re Nata), or, as required had been recorded in the care plans with the reasons and considerations for offering and administering. Care Homes for Adults (18-65 years) Page 19 of 29 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 are assured the home protects them from harm. Evidence: The home has a satisfactory complaints policy and a suitable safeguarding policy. The manager has collected a useful resource file about safeguarding, although this was not known by staff. Two staff said they knew where they could independently report any suspicion of abuse should they wish, or need to. The home has consistently reported all suspicions and incident to the local safeguarding team within Peterborough Primary Care Trust. They are familiar with the manner in which these incidents are investigated. The home is part of the Peterborough forum for Care Providers for Safeguarding that meets every three months. It was discussed with the manager that that home could further promote the actual reporting of incidents, so that staff or any person living at the home, or any visitor to the home is informed how they might report a concern or suspicion of harm should they chose to. Care Homes for Adults (18-65 years) Page 20 of 29 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 are assured the home is safe and comfortable. Evidence: The home was well maintained. It was clean and free of any offensive odours was bright and had adequate natural light. There is a system for informing the maintenance worker employed by the home to correct any defects or make repairs. All rooms, bar one has full en suite facilities the one room that hasnt has sole use of the adjacent bathroom. Bedrooms are adequately spacious and furnished with good quality fittings and had been recently decorated. There are two dining or eating areas and the one that is located next to the kitchen has four doors leading off it.The doors lead to the administration office the kitchen a corridor to bedrooms and the garden and side door and the other door leads to the main entrance and the upper floor. It was noticed that three of these self closing fire doors closed with a loud noise. This noise was a disturbance and was remarked on by two people as being noisy. One person said he did not like this noise and wanted to go into another room to talk to us. This was discussed with the manager as a potential source of annoyance and agitation and an likely intrusion of privacy because it was
Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: used a through-corridor by all staff and all people living at the home. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured staff are rigorously recruited and inducted and are suitably trained to meet their needs. Evidence: The recruitment details for two care staff were assessed. They had each been satisfactorily checked for POVA First clearance and for a Criminal Record Bureau disclosure, before they commenced employment and this was in accordance with the homes policy. They each had two suitable references and an application showing their work history. They had each received regular supervision, as well as an appraisal of their three month probationary period. Their induction training consisted of a three day training in mandatory skills before they worked. After they had commenced employment they immediately started the Skills for Care Common Induction Standards programme. Each persons woorkbook for this training was read and showed they had been carefully assessed for their competencies by the manager. The induction was discussed with both members of staff and they explained their training was thorough and they felt they benefited from this thorough induction. On the day of the inspection there were four registered nurses, plus three care support staff working to provide support for the six people resident at the home. The home
Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: also employ a cook, an administrator, a maintenance worker. They have a number of clinical specialists including a psychiatrist and psychologist employed by organization to support this service. Most people were in and out of the home during the day participating in various activities and interests. One or two staff accompanied people to do this. One persons care plan showed he needed one staff to support him at all times. The staff roster showed there are usually five staff plus the manager working at all times during the day and after 10pm there are three staff, including one or two nurses. It has already been indicated in this report that staff effectiveness is risk orientated and this is reflective of needs. The recommendations made in this report are that some instances of staff listening to peoples requests should be responded to at an earlier stage, before they become a growing issue for that person. The example of this was the person who wanted to purchase a bed and was requesting for somebody to sanction this and to agree when he could do this. Staff training is carefully planned. There was evidence of a range of appropriate training and refresher training in mandatory and further subjects. One registered general nurse has commenced training in mental health nursing. All staff are taught techniques to deal with physical and verbally challenging behaviours. Training in Epilepsy, Administering Medication, Infection Control, Fire Safety, Health & Safety, First Aid, Food Hygiene, Moving and Handling, Adult Protection are arranged for all staff. All staff have had training in these topics during the last 12 months. Training in Autism, Aspergers syndrome are also provided for all staff. The training matrix showed how this training had been planned for 2009, as well as the training that had been provided in 2008. Staff confirmed they received the necessary training and stated they felt they were given plenty of training opportunities and could request additional training,should they want to be trained in further topics. All staff had received supervision every two months which had been planned and recorded as a one-to-one process with either the manager, or deputy manager. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured the service is well run and is managed so their best interests are promoted. Evidence: The home is well run. The manager is a registered nurse who has continued to develop her practice and has undertaken an NVQ level 5 award in management. She demonstrated that the example she sets is focused on individual care and that the service is provided in the best interests of people who live there. Two people told us that they liked the manager and it was clear through their conversations with her that they could express their views and were listened to . Two staff said they felt the manager was approachable and promoted an open door policy. Staff stated they had received regular one-to-one supervision and there were records kept to show that all staff, including the cook, were receiving regular supervision. There were records of regular and routine fire alarm tests, fire drills and fire equipment having been serviced and of a current annual fire safety certificate dated
Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: 07/03/2008. The home had a fire evacuation plan. A maintenance log book of repairs needed and carried out is kept. The home has received a 5 Star Food Hygiene rating from Peterborough City Council Environmental Health Department. A range of appropriate policies were kept at the home. The home has always informed the Commission of significant events and has done this promptly and has frequently discussed these issues with either the Commission or with the Local Authority who have been involved in these issues. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 The home should share the written care plan with the person, so they are aware and included in what the home has recorded as their aspirations. The home should ensure that the progress of each persons development is measured and recorded. The home should ensure that staff promote independence at every opportunity and recognize peoples rights and personal development. The home should ensure that people are not disturbed by excessive noise from self closing doors. Consideration should be given to where the dining rooms are located so that people are not disturbed when using this room when eating and are not expected to be seated in a part of the home that is an essential passageway. 2 3 11 16 4 5 28 28 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!
