Inspection on 19/02/09 for Polesworth Group Laurel End

This inspection was carried out on 19th February 2009.

CSCI found this care home to be providing an Excellent 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

Polesworth Group Laurel End 11/04/07

Polesworth Group Laurel End 07/11/05

Polesworth Group Laurel End 04/07/05

Polesworth Group Laurel End 21/02/05

Polesworth Group Laurel End 15/10/04

Polesworth Group Laurel End 04/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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: Polesworth Group Laurel End Laurel Avenue Polesworth Tamworth Staffordshire B78 1LT     The quality rating for this care home is:   three star excellent 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: Patricia Flanaghan     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Polesworth Group Laurel End Laurel Avenue Polesworth Tamworth Staffordshire B78 1LT 01827896124 01827892500 polesworthhomes@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Polesworth Group Homes Limited care home 9 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home 9 2 Laurel End is part of Polesworth Group Homes, which was established as a Limited Company in June 1991 with the aim of providing accommodation and support to adults with learning disabilities. The home cares for nine service users with medium to high levels of need, including two service users with physical disabilities as well as learning disabilities. The home is a large detached dormer bungalow in extensive grounds sited discreetly on the edge of Polesworth. It offers seven single and one double bedroom. On the ground floor there are the shared facilities of a large conservatory and kitchen, dining room, lounge, laundry and bathroom. The bathroom is fully adapted to meet the disability needs with a walk-in shower and Parker bath. There are five bedrooms and a staff office also situated on the ground floor. On the first floor, extensions to the dormer roof space have created one double and three single bedrooms, one of which is a staff sleep in room. There is also another large Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home bathroom with shower facility on this floor. Four bedrooms also have en-suite facilities. The Companys offices and training room are based in the converted and extended former garages adjacent to the home. Land to the rear is used for an outdoor bowling green and agricultural and smallholding use where much of the fresh fruit, vegetables and eggs provided to all of the care homes in the Company is produced. The current scale of charges is available on request from the registered provider. Additional costs that have to be met by service users include toiletries, outings, holiday spending money and hairdressing. 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: three star excellent 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 quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. We carried out this inspection over one day on 19th February 2009, with the home being given no prior notice of the visit. Time was spent examining records, talking to people who use the service, staff and observing care practices, before giving feedback on our findings to management. The last key inspection visit to Laurel End was undertaken on 11th April 2007. Prior to the inspection the home supplied information us in the form of its Annual Care Homes for Adults (18-65 years) Page 6 of 30 Quality Assurance Assessment (AQAA). This document contained helpful information about the home. We also received three completed surveys from people living at Laurel End and three surveys from staff members. Information from both these sources was also used when forming judgements on the quality of service provided at the home. The inspection included meeting people living at the home and case tracking the needs of two people. This involves looking at their care plans and health records and checking how their needs are met in practice. An Expert by Experience accompanied us during part of the inspection to give their views on the home, in particular, social activities. An expert by experience is the term used to describe people who may receive a service themselves and may also have a disability. Their findings are also included in this report and used as evidence when deciding on the quality of service provided at the home. We would like to thank the people who live at Laurel End, the manager and staff for their assistance during this inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made as a result of this inspection. The expert by experience Care Homes for Adults (18-65 years) Page 8 of 30 made some good practice recommendations that the home should consider implementing. A bigger picture menu on the wall; There needs to be more choice on the menu; An activity board on the wall; The garden to be made more accessible to make sure that everyone gets to use it; Everyone to have a communication passport. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person who chooses to live here can be sure that they will have a full assessment of their needs before they move in. Evidence: It was previously confirmed that appropriate information is provided about the service, including a statement of purpose, a service users guide and a terms and conditions of residence. Relevant documents are also available in a format with symbols and photographs so they should be easier for people who have learning disabilities to understand. People living at the home have all been given the guide. The previous inspection confirmed the home has a comprehensive policy in place outlining how the admission of new people will be achieved. In view that no one has moved into the home since the last inspection visit, it was not possible to discuss the assessment and admission of a new resident and check their care records. The processes the home would follow were therefore discussed with the manager and information in their annual quality assurance assessment (AQAA) used to make this Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: judgement. The manager would visit prospective residents to fully assess their care needs and desire to live at the home. Visits to the home would then be arranged, followed by overnight and trial stays and this process would be tailored in the best way to suit them. A review would be held after the trial period involving staff, the prospective resident and their representatives to decide if the placement is suitable and if they stay there. We looked at the care files of two people who live in the home and saw that comprehensive pre-admission assessments had been undertaken by management before they moved in to Laurel End. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in decisions about their lives, and where possible play an active role in planning the care and support they receive. Evidence: All people have plans that give details of likes and dislikes, family contacts, medical issues, history, communication, personal details, hygiene and preferences. All care plans seen contained good levels of information to help staff to meet the persons needs properly. We also saw some essential information about an individuals communication needs. The manger told us that a speech therapist is involved in helping one of the people living there develop their life story. Plans are regularly reviewed to ensure peoples needs are appropriately monitored by the home. Staff also complete daily records that give brief overviews of the individuals wellbeing, times of rising and retiring, activities, appointments and meals taken. The two files sampled included numerous risk assessments and management plans for Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: any identified risks. For example, there were management plans in place for any challenging behaviours which detailed the types of behaviour, how they were to be discouraged, what the triggers were and how staff were to respond the behaviours. All incidents of challenging behaviour were recorded by staff including the actions and consequences. The records clearly showed staff were following the management plan. There were risk assessments and management plans in place for such things as showering, moving around the home, bathing, swimming and receiving visitors. There were also risk assessments which indicated how many staff were needed for activities. The manager had actioned the requirement made at the last inspection visit to ensure risk assessments are put in place for people who might develop pressure sores. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. There was evidence that full care reviews were being held every six months. This meant there were in depth discussions with people living in the home about all areas of their lives at Laurel End, progress made towards their goals and what else they wanted to achieve. Their families and social workers were also present at reviews, where applicable. Some of the people living here have communication difficulties and rely on staff recognising signs to understand their needs and wishes. Staff have a good awareness of individual needs and treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. The expert by experience reported, I had been told that some of the people in the home dont use verbal communication so I asked a resident and one of the staff how people communicate? I was told that some people use Makaton and some people have made their own signs for things and the staff understand these. One person is hearing impaired and uses sign language. The member of staff that we spoke to had only been there for a couple of months but she had an understanding of how people communicated which was good. The resident I was speaking with also had a good understanding of how the others communicated and she knew some Makaton signs, I thought this was really good. I asked if people had communication passports and I was told that they did not. Everyone should have a communication passport that includes the way that they communicate so that new staff can be made aware. I was shown a yellow folder that had lots of Makaton symbols in it and it explained what they meant. This was good. The new staff member also told me that she was having lots of training, which is good. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People take part in activities that meet their personal interests and are supported to live ordinary and meaningful lives. Staff treat them as individuals and respect their privacy. Evidence: Activity plans were in place for the people living in the home. The plan for a person whose care was being tracked included such things as swimming, outings and personal activities. Daily records showed these activities did take place and staff included comments as to how people had reacted to activities. The expert by experience chatted to people about their life in the home. The expert reported, One person told me that she cleans her own room with support from the staff. It is good that she is doing so much for herself. She also told me that she Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: doesnt go out as much as she used to because of her health but there seemed to be lots of activities for her to do around the home. She told me that she really liked living there and said they let us do what we want and the staff are really good. This was good to hear. One of the members of staff was sat with the person at the table and she was helping her to make the cards. They seemed to get on really well and the staff member treated her with respect. The home has a number of vehicles, which are used for supporting social and leisure activities in the community. People told the expert by experience about their holidays. The expert says, Everyone has separate holidays unless they want to go together. This is good, as the people who live together should not have to go on holiday together if they dont want to. They all choose where they go on holiday which is good. I saw lots of photos of the holidays and days out that the residents had been on. Contact with families, friends and advocates were detailed in care files and daily records showed when people had seen their families and friends. For example, we saw evidence that the home transports an individual once a month to visit their family, who live 40 miles from the home. Another person regularly visits their family and people living at Laurel End are also invited to family parties, such as Summer barbecues and Christmas celebrations. The menus in the home were planned on a weekly basis. Staff along with people living in the home planned the menu for the coming week. Menus were based on the likes and preferences of the people living in the home. The manager spoke of trying to encourage healthy eating and how specific plans had been put in place to try and discourage excessive weight gain. A person whose care was being tracked had a tendency to put on weight so at the review the issue had been fully discussed and an action plan drawn up with the agreement of the individual. The manager had also contacted an NHS dietician to give advice. The plan detailed the types of food that were to be discouraged. This was seen to be followed on the day of the inspection. There were clear records of the foods being served to the people living in the home and these showed people had a varied and nutritious diet. We were invited to join people for their evening meal, which was tasty and nutritious. The main meal was shepherds pie with mixed vegetables with a choice of pudding, one being fresh fruit salad. The manager told us that people are offered a choice of food, if they do not want this, but staff prepare meals they know all the people enjoy. The expert by experience reported; I had a look at the menu. There wasnt much choice on it and it was small and just written on a piece of paper. One person told me Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: that she helps to choose what goes onto the menu. It is good that she chooses but I hope that they all get a chance to choose? The food on the menu looked good but there could be more than one choice per meal and it would be better if it was up on the wall with some pictures of the meals so that people can choose. The manager told us in the AQAA, The home provides a varied and nourishing diet with an emphasis on home cooked and locally purchased fresh provisions. This includes fruit and vegetables grown in the grounds of the home and fresh eggs laid by our chickens. Mealtimes are a point in the day when all service users and staff enjoy time together. The expert by experience has made some recommendations that the home should consider implementing: A bigger picture menu on the wall; There needs to be more choice on the menu; An activity board on the wall; The garden to be made more accessible to make sure that everyone gets to use it; Everyone to have a communication passport. Care Homes for Adults (18-65 years) Page 17 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the care files for two people living in the home. Plans show the support each person needs with their personal care and their preferences of daily routines. They include how to promote their self care and personal hygiene. Keyworkers are involved in ensuring preferences are met and help people with shopping for their clothes and toiletries. There is information recorded about peoples health and any areas staff need to monitor such as their skin, healthy eating and weight. Records are kept of all routine, preventative and specialist health care checks and staff ensure that regular appointments are made. People are supported to attend medical appointment and that their medicines are reviewed regularly. Previous inspections confirmed that the home operates an appropriate medication Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: policy and procedures. All staff had completed an accredited training course for safe management of medication and the manager goes through the medication procedures in the home with them to ensure they are competent. Records of medication kept in the home and administered are being maintained appropriately and any medication dispensed to people at the home is checked in so there is always an audit trail. Care Homes for Adults (18-65 years) Page 19 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. Appropriate procedures are in place for investigating complaints and staff are trained to recognise and report suspicions of abuse so that people are protected from harm. Evidence: There is an accessible complaints procedure in place at the home with pictures to help people understand the procedure. The AQAA returned to us by the manager stated there had been no complaints made about the home since our last inspection visit. The surveys returned to us before the inspection indicated that people living in the home knew how to make a complaint and staff listened to what they said. The individuals spoken with said they would go to staff if they had any issues they needed to raise. Throughout the inspection it was evident that there were good relationships between the people living at Laurel End and the staff. Individuals were comfortable approaching and speaking to staff, which would give them confidence to raise any issues. Staff surveys also confirm they would know what to do if any concerns were raised with them. As at the previous inspection, a person living at the home continues to play a major active role in a variety of self advocacy forums and ensures the viewpoints of other residents are heard. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The expert by experience said, I noticed on the wall there was a poster that was written and had makaton symbols on it about how to complain or make a compliment and who to contact. I thought this was good. Policies and procedures are provided by the home for staff in relation to adult protection and whistle blowing. All staff receive relevant training during their induction and also through National Vocational Qualifications (NVQ) which includes sessions on safeguarding vulnerable adults. The training matrix seen evidenced that all staff have had appropriate training. The manager was aware of the local safeguarding procedures and how to make a referral, if necessary. Care Homes for Adults (18-65 years) Page 21 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 service provides a homely, safe and welcoming house for people to live in. Evidence: As at the previous inspection visit, there is a warm and welcoming atmosphere in the home. People who live at Laurel End are encouraged to see the home as their own and are able to move freely about all communal areas. Those bedroom we viewed were clean and personalised to a high degree, displaying a number of individual possessions including photographs. The expert by experience said, I saw some of the bedrooms and they all looked nice and had lots of personal items in them. I was told that the residents choose the colours for their rooms. The homes environment is pleasant and comfortable and the decor and furnishings are of good quality. The expert by experience commented; The first thing that I noticed was the home is very big. There were only 3 people at home as most of the residents were out doing their daily activities. The kitchen was large but very modern and there was a nice big conservatory at the back. I noticed that there were lots of pictures on the walls of the people who live there. I thought this was good. There continues to be a wide range of up to date specialist equipment and adaptations Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: available to meet the individual needs of the people living at the home. This includes hoists, walk in shower and handrails in bathrooms and toilets. The home has also purchased a specialist lifting cushion to assist with moving people safely, if necessary. It was apparent that a good standard of hygiene and safety is maintained. The home has infection control policies in place and staff have received appropriate training in this subject. They have also undertaken food hygiene training and are provided with any necessary equipment, such as disposable aprons and gloves. Care Homes for Adults (18-65 years) Page 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who live there. Evidence: Staff spoken with during the visit demonstrated an understanding of their roles, responsibilities and the support needs of people living at the home. Our observations showed that positive relationships exist between people living at the home and the staff. We looked at the recruitment records for two staff members. The records demonstrated that staff are properly recruited and included evidence of Criminal Records Bureau checks and references. The training matrix for the home indicated that staff have had a variety of training including food hygiene, first aid, moving and handling and fire safety. Information supplied by the manager states that 12 of the 17 staff are qualified to National Vocational Qualification in Care at Level 2. This should mean that people benefit from having their needs met by appropriately experienced staff. We spoke with a newly recruited staff member who confirmed that they had received a thorough induction Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: programme to help them understand their role and the needs of the people they support. The expert by experience said; Whilst I was there some of the other residents came home from their day activities. I didnt get to speak to any of them but I observed that people seemed to get along with each other. I did not see any arguing or anyone getting cross with each other. Everyone greeted each other when they entered the home, which was nice. The staff that came back with them greeted all of the residents in the home, I thought this was really good. Care Homes for Adults (18-65 years) Page 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can have confidence in the service because it is well managed and run in the best interests of the people living there. The health, safety and welfare of the people living in the home are promoted and protected. Evidence: The registered provider is currently the registered manager of the home and she is very well qualified for her role. However, a home manager has been appointed since the last inspection visit and she is in the process of applying to us for registration. The home manager demonstrated a very good knowledge of the people living in the home throughout the inspection. It was evident that the relationships between the managers, the people living at Laurel End and the staff were good. It was evident throughout the inspection visit that people living in the home were very much involved in the day to day processes in the home, for example, planning meals and involvement in staff recruitment. Their views were listened to and taken into account. The manager told us that the service is always looking for ways to involve Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: individuals further. As identified at previous inspections the registered provider maintains regular contact with people and staff and makes a monthly written report on the running of the service. An annual Carers Consultation is held and this includes discussion about future development plans for the service. The health and safety of the people living in the home and the staff were very well managed. For example, the manager told us that the home had recently purchased a special lifting cushion which lifts a person safely, minimising moving, handling and transfer risks. Staff received training in safe working practices, all the required risk assessments and management plans were in place and the home was safe well maintained. The AQAA indicated that the servicing of the equipment in the home was up to date. The manager continues to notify us of any incidents or accidents in the home as required so that we can be assured they are being managed appropriately. Care Homes for Adults (18-65 years) Page 27 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 28 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 12 The home should consider implementing the recommendations detailed in this report which were made by the expert by experience. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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