Inspection on 14/11/08 for Sedgemoor & Framley

This inspection was carried out on 14th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sedgemoor & Framley 28/11/06

Sedgemoor & Framley 21/02/06

Sedgemoor & Framley 09/08/05

Sedgemoor & Framley 09/03/05

Sedgemoor & Framley 18/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sedgemoor & Framley 2-4 Mill Road Eastbourne East Sussex BN21 2LY     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: Judy Gossedge     Date: 1 4 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. 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 30 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 30 Information about the care home Name of care home: Address: Sedgemoor & Framley 2-4 Mill Road Eastbourne East Sussex BN21 2LY 01323725825 01323412118 paula@eastbournemencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Paula Wheeler Type of registration: Number of places registered: Eastbourne & District Mencap care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 23 The registered person may provide the following category of service only: Care home only ( PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability (LD) Date of last inspection Brief description of the care home Sedgemoor and Framley is a care home for 23 adults with learning disabilities. The registered providers are Eastbourne and District Mencap. The premises have been converted into one home from two large Victorian houses. The home also provides a bungalow which offers two residents more independent living arrangements. There are two lounges, two dining rooms and two large kitchens. One dining room opens onto a raised terrace area that looks out to a large well-maintained rear garden. Sedgemoor and Framley continues to provide a safe and happy environment whereby young people can learn to live as independently as their disability will allow, within their own home. Residents are enabled to access work placements, college courses, day centres Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 23 Brief description of the care home and a range of leisure activities within the home and in the local community. The fees at Sedgemoor and Framley, at the time of the inspection, are £690.00 per week. Additional charges are made for hairdressing, chiropody, magazines and toiletries. A Statement of Purpose and Service Users Guide is available for new and existing residents to reference. 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: 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 uses the term service users to describe those living in care home settings. For the purpose of this report those living at Sedgemore and Framley will be referred to as residents. This unannounced inspection took place over five hours on 14 November 2008. The last key inspection took place on 28 November 2006. Since the last inspection an Annual Service Review has been completed. It does not involve a visit to the service, but is a summary of new information given to us or collected by us since the last key inspection. No concerns were raised. Care Homes for Adults (18-65 years) Page 6 of 30 An Annual Quality Assurance Assessment (AQAA) has been requested for this service, which was detailed and information from this has been included in this report. A tour of the premises took place to look at communal areas and a selection of residents bedrooms and care records were inspected. Twenty-two people were resident and three were spoken with individually. The Inspector sat with eleven residents whilst they had their evening meal and spoke to a number of residents as part of the inspection process. The care that four of the residents received was reviewed. The opportunity was also taken to observe the interaction between staff and residents in the communal areas. No residents or care workers surveys were sent out on this occasion. Four support workers, a domestic assistant, a senior support worker, the deputy manager and the Registered Manager were all spoken with. A relative visiting the home was also spoken with during the visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed information about Sedgemore and Framley is available to be viewed prior to any admission to the home and there are detailed pre-admission procedures in place to ensure that residents are appropriately placed in the home. Evidence: Information is available to prospective and existing residents in various formats. The Statement of Purpose and Service User Guide have been thoughtfully and imaginatively produced to a high standard and are both comprehensive and informative. Both documents were viewed during the inspection and detailed they had been reviewed this year. Some further updating is required to detail further changes in the home. A copy of the latest inspection report is available to read in the home. The Manager has confirmed that Sedgemoor and Framley continues to maintain a good working relationship with the local Community Learning Disability Team, who consequently have a sound understanding and awareness of the suitability of the home and the range and quality of the services provided. A referral to the home from the Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: team consists of a thorough Social Care Assessment and any additional relevant reports. The Manager or deputy manager will also visit the prospective resident and carry out a full pre-admission assessment. The AQAA detailed that the pre-assessment form has been redesigned to add pictures photographs and symbols; this has made it more user friendly for people who have literacy and communication problems. As well as being invited to visit the home to look around and meet with existing residents and staff, prospective residents have the opportunity to stop overnight or occasionally for a weekend stay before moving in. There have been no new residents since the last inspection, so it was not possible to evidence the admissions procedures had been followed. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents individual care plans and supporting risk assessments provide staff with the information they need to ensure that residents individual care needs are met. The care plans are very detailed and comprehensive. Residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. Evidence: High quality, person centred care plans have been developed for each resident, clearly linked to the individuals assessed needs. The effective use of pictures, photographs and diagrams in the plans ensure the assessment and ongoing care planning process is more clearly focused on and accessible to the individual resident. Four residents individual plans were viewed, which were all detailed and formulated by the key worker, Manager and evidenced the involvement of the resident or family member, as appropriate. All the care plans contained detailed information about the individual support to be provided for each resident to enable them to achieve maximum independence and develop their skills, and had been subject to a review to Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: ensure that the agreed goals are being worked towards. Staff spoken with demonstrated that they are aware how they should provide support to assist each resident. Supporting risk assessments were also seen to be in place, which had been reviewed. One to one support remains a feature of the weekly training day, when instead of attending day centres, individual service users stay in the home and have the opportunity to catch up with their personal laundry and shopping. Sedgemore and Framley continues to operate a key worker system and staff were observed working closely and sensitively with residents to meet their identified personal care and support needs. Regular staff meetings provide an opportunity to review the residents care needs, and for any significant changes are addressed immediately. The daily routines of the home are determined by the residents individual programmes, and the three residents spoken with confirmed flexibility in their daily routines and respect for their personal freedom and lifestyles. During the inspection residents were observed to move around the communal space freely, choosing which rooms to be in and what level of company they wanted to enjoy. Residents were able to choose when to spend time on their own, and can do so in their own bedrooms. Residents, staff and records viewed evidenced that residents are consulted with regarding many aspects of their day to day living, including menu planning and choosing both individual and collective social, recreational and leisure activities. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged and supported to pursue their educational, vocational and social interests. Residents are enabled and supported to maintain contact with family and friends as they wish and links with the community enrich their social and educational opportunities. The meals on the home are good offering both choice and variety. Evidence: The AQAA details that some residents choose to attend a day centre the majority of residents attend work experience work either in a hotel or garden centre and one of the residents attends work experience in a local residential home. Many of the residents attend workshops or college courses to further enhance their life skills or to learn a new skill. Courses currently chosen include: cookery, computers, gardening, Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: art and craft, music and movement, community awareness and aerobics. Three residents whose day services are term-time have been introduced to summer workshops and they are now enjoying attending sessions including cookery, computers, community awareness and music and movement. Care plans and programmes viewed discussions with residents and staff evidenced that residents are being supported to access a range of educational vocational and social activities. During the inspection the majority of residents returned to the home after attended day services and work experience. The AQAA details that recreational and leisure interests of residents are identified and recorded in their individual care plan. The sample of four residents care plans detailed that residents continue to be supported to access activities and facilities individually, or as a group reflecting their individual needs, preferences and abilities. This includes shopping trips, theatre trips, picnics or just a drive out for tea and cake or an ice cream. One resident spoken with spoke of their visit to the theatre the previous day and another stated they were looking forward to their theatre trip due before Christmas. Residents are supported to have an annual holiday, and choices made this year were a week on the Isle of Wight staying in log cabins, a long weekend at a hotel enjoying a tribute band and a night out at a show, a week in Bournemouth staying in caravans, and a long weekend to see a girl band show. Three residents chose not to go away on holiday preferring to have day trips and these have included trips to local activities and several theatre trips. The AQAA details that the residents are supported by staff to visit family and friends. The Manager confirmed this, however not all residents have regular family contact. Care plans viewed feedback received from residents spoken with the visiting relative evidenced residents had been supported to maintain contact and relationships with their families and friends. Residents reviews include the opportunity for residents relatives and representatives to attend if the resident wishes. The AQAA details that there is a four-week rolling menu, which changes to reflect summer and winter choices, dishes included on the menu have been chosen by the residents to reflect their favourite choices. That dishes served are healthy and nutritious and are adapted to suit various dietary needs. A copy of the menu is displayed in the kitchen and was viewed. Residents write their chosen dishes on their menu sheets, there are two main dishes on offer each day with a third if these are not suitable. Support workers cooked the evening meal during the inspection as the cook was not on duty. The evening meal provided was fish, fish fingers or pizza with chips with peas or baked beans, or sausage and mash followed by fruit sponge and either Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: custard or cream. Fresh fruit is also available in the home. The Inspector sat with the residents in the Sedgemore dining room. It was a relaxed environment, staff provided support where required, taking into account the different length of time that individual residents would need to finish their meal. Feedback from the residents spoken with was that the food was good. Records were viewed of meals provided to individual residents to ensure an adequate diet is provided. Many residents are evidently involved in various aspects of meal preparation, including baking, laying the table, washing up and drying and preparing packed lunches. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the provision of a flexible and respectful personal care and health care support. Systems are in place to manage medication and protect residents. Evidence: Residents at Sedgemore and Framley are supported to manage their own personal care, some with the offering of verbal prompts where required. Risk assessments are in place to ensure the safety of residents. Care plans viewed evidenced that following consultation with residents, specific guidelines have been developed for all staff, ensuring that support is provided in a structured and consistent manner, and in a way that the individual prefers. Relationships between staff and residents and the care given were observed to be very good, and residents were treated with respect at all times. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. Four individual care plans that were examined were found to contain detailed information, clearly developed through close consultation with and direct involvement of residents and their relatives. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The AQAA details that residents are registered with local General Pracitioners (GPs) and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. That residents continue to be supported to access a range of health care professionals in the community. The four care plans viewed and staff feedback evidenced this, and there were records of appointments with, or visits by, health care professionals. The AQAA details that all policies and procedures relating to the storage, administration and recording of medication have been reviewed and updated, four members of staff have recently attended a safe handling of medication refresher course and four senior staff have recently attended training on assessing staff who administer medication. Only senior support workers administer medication and the senior support worker on duty was spoken with who confirmed they had received medication training, and who confirmed procedures had been further developed where residents are out from the home and needs to take medication during this time. Medication storage and a sample of the recording were viewed and the administration practices were observed when evening medication was administered. The Manager stated that a local pharmacist continues to carry out monitoring visits, but the record of the last visit were not available to view during the inspection. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to enable residents or their representatives to raise any concerns about the care being provided and that residents are protected from abuse Evidence: The AQAA details that the residents complaint procedure is in a format that residents understand and it is clearly displayed on the residents notice board. That there is an open section on the residents meetings agenda where the resident can discuss any concerns or complaints they might have. No complaints in relation to the service have been received during the last year. The CSCI have not been informed of any concerns in relation to Sedgemore and Framley. The residents spoken with stated that they were aware of the complaints procedure and knew who to speak to if they were not happy. During the Inspection residents were confident to approach the Inspector and were articulate in their feedback regarding their positive experiences at the home. The AQAA details that the Manager holds regular meetings with the residents at which they can express their views on the care provided. That the key worker system enables good communication between staff and residents, who are encouraged to voice any concerns freely to the management team and key workers. The AQAA details there are written policies covering adult protection and whistle blowing. The Manager stated that she has recently attended a further training update Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: and a copy of the East and West Sussex, Brighton and Hove Multi-Agency Adult Protection Guidelines is available for reference in the home. Only one of the support workers spoken with had received safe guarding adults training. The Manager stated that training is in the process of being provided for staff to attend, and that a number of staff were attending this training on the day of the inspection. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment is good and provides residents with a comfortable, clean and homely place to live. Residents benefit from the provision of all the necessary specialist equipment. Evidence: The premises have been converted into one home from two large Victorian houses. Decor in the home is to a good standard, and furnishings are of a good quality and domestic in style. A tour of the building was made. The AQAA details that there is ongoing improvement of the facilities in the home, that two residents have recently had their bedrooms refurbished to reflect their changing needs and both chose new furniture and fittings and had their rooms redecorated. Framley kitchen has been completely refurbished, re-floored and has had all new equipment installed. Framley dining room has been completely refurbished and redecorated with new carpet and dining room furniture. The home has a full time handy person who was working in the home during the inspection. The three residents spoken stated they were happy with the homes environment. Residents accommodation consists of six single bedrooms and three double bedrooms in Sedgemore, and five single bedrooms and one double bedroom in Framley, all Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: situated on all floors in the home. There are sufficient numbers of communal bathrooms and toilets located around the building. Three bedrooms provide en-suite facilities of a bath or shower toilet and wash-hand-basin. A sample of the bedrooms were viewed all of which had been personalised, and displayed residents individual styles and interests. To the rear of the property is a two bedroom bungalow with ensuite facilities for residents who are able to live a more independent lifestyle. The AQAA details that temperature regulators are fitted to all hot water outlets, accessible to the residents. A sample of records were viewed of regular checks of the hot water supply at these outlets to ensure these are maintained close to the recommended safe temperature. The residents spoken with confirmed there is adequate heating and hot water provided in the home. Communal space consists of a lounge, and a dining room/area in each of the houses. The bungalow has a lounge and a kitchenette. There is a landscaped garden at the rear of the property, with a covered walkway from Sedgemore to the bungalow. All necessary specialist equipment is made available to meet residents assessed mobility needs, including assisted baths, wheelchairs and hoists. Residents with bedroom accommodation on the first and second floor will need to be fully mobile. The AQAA details that there is a policy in place for managing infection control and that Department of Health Guidance has been used to assess current infection control management. That twenty-two staff members have received infection control training. The home was clean and free from offensive odours at the time of the Inspection. A domestic member of staff was spoken with and who stated that they had received training in infection control and Control of Substances Hazardous to Health (COSHH). The three residents spoken with confirmed the home was kept fresh and clean. There is a separate laundry room for residents to use. Routine fire checks of the building, which had been completed were viewed. Records detailed some omissions in checks being completed. This was discussed with the Manager who stated this would be addressed. So a Requirement has not been made on this occasion. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust recruitment procedures and it should be ensured these are always followed to protect residents. Training is provided to staff to enable them to perform their roles effectively. Evidence: The home was calm and relaxed on the day of the inspection, and the staffing in place on the day provided support for the residents to access a range of activities. The Manager stated staffing levels vary in accordance with residents individual programmes and day centre commitments. The AQAA detailed that there had an increase in staff numbers at weekends. A waking night and a sleeping in member of staff were due to be on duty that night. Staff spoken with spoke of a team that are very supportive of each other and of good communication. The AQAA details a thorough and robust recruitment procedure, which ensures protection for the residents. That all staff are interviewed, two satisfactory references are sought and a Criminal Records Bureau check (CRB)/Protection Of Vulnerable Adults disclosure. The documentation for four new members of staff who have been recruited since the last inspection, which evidenced the completion of an application form, a detailed health questionnaire and a CRB/POVA First check. Three of the staff had Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: started working in the home prior to receipt of two written references. The Manager stated that verbal references had been sought, but there was no record of these and to fully meet the standard written references should be received prior to staff commencing work in the home. New staff also complete a probationary period. A sample of records was also viewed to evidenced the existing staff working in the home have also undertaken a CRB check. The AQAA details that residents continue to be actively involved in the recruitment and selection process and meet with all prospective members of staff. The AQAA details that of the twenty-eight members of staff seven hold NVQ Level 2 in care and a further seven are working towards this qualification. Also of the homes seven bank staff, two hold NVQ Level 2 in care and four are working towards the qualification. The AQAA details that induction procedures are in place which new staff recruited to the home will be taken through, and meets the requirements of Skills for Care. That all new staff spend their first month shadowing an experienced member of staff. Records viewed for the four new members of staff confirmed they had received an induction. One new support worker spoken with confirmed they were in the process of completing this induction. Staff spoken with confirmed training they had completed or were due to complete. The Manager confirmed that formal supervision is provided for all support staff on a regular basis. It was noted that the Manager provides supervision for the deputy manager. The organisation has an annual appraisal system for staff. All staff feedback confirmed that supervision is provided to meet requirements. Records were not available to view during the inspection. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of the home is good with effective systems to protect service users being put in place. Evidence: The Registered Manager has worked in care for over twenty-six years and has managed the home for twenty two years. She has completed the Registered Managers Award and NVQ Level 4 in Care. From direct observation and through discussions with residents and support workers, it is evident that the Manager continues to demonstrate a clear sense of leadership and direction. She is clearly motivated, positive and approachable and continues to create an open and inclusive atmosphere within the home. The Manager stated that a quality assurance system in the home to enable feedback is sought through surveys to be sent to residents, relatives and representatives and other professionals who attend the home and regular meetings held in the home. A sample of completed surveys was viewed. The AQAA details that residents meetings Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: are held monthly, they are minuted and displayed in a format using pictures and symbols that makes them able to be understood by everybody, there is an open section on the agenda where residents can bring up any issues they want to discuss. A copy of the minutes for the September meeting were viewed and Octobers meetings minutes were in the process of being written up. This years quality assurance which has been completed, and comments received included, we cannot note the care that our relative receives more highly, they is always in good spirits and my relative obviously loves Framley and all the staff who look after them, we are always made to feel welcome when visiting, all of the staff are of the highest quality you could ask for, our relative is extremely happy there, I really appreciate all the hard work Paula and her staff do to keep up the high standards and the lovely homely atmosphere, I am very grateful that my relative has such a lovely life there and an excellent service with a dedicated staff which makes a happy home. A comment box and comment cards have been introduced as part of the quality assurance system. Feedback from the quality assurance process needs to be collated, published and available to interested parties. The AQAA detailed that policies and procedures are in place and that these have been reviewed this year. The Manager stated that regular visits to meet the requirements of Regulation 26 are made and copies of these visits are kept at the organisations head office, but should be available to view in the home. The Manager stated this would be addressed, so a Requirement has not been made on this occassion. Central training lists have been compiled and were viewed, but were in the process of being updated so it was not posible to evidence all support workers have received the required training. Support workers spoken with and individual training records viewed evidenced two had received training in moving and handling and basic food hygiene, one had received first aid training and all had completed fire training. One member of staff had not undertaken a moving and handling training update. This was discussed with the Manager who stated this would be addressed and that fire aid training and basic food hygiene training was due to be facilitated for staff to attend during November 2008 and moving and handling training in December 2008. The Manager also stated that staff were in the process of receiving their annual appraisal when training needs would be discussed and identified. The fire risk assessment was in the process of being updated. The Manager stated this would be in place within the next three weeks and a system to ensure a regular detailed check of the environment and fire precautions is carried out and is recorded. Records were viewed of fire training provided in the home and the three support workers spoken with stated they had attended this training. Following a request from one of the residents to attend the staffs fire training session, fire training for residents will also be introduced. The AQAA detailed that the maintenance of equipment and Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: services has been carried out. Also that COSHH assessments and guidelines are in place. Accident records were viewed and were detailed. Details were viewed of current insurance in place for the home. 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 1 34 19 That two written references are received prior to staff commencing work in the home. To protect residents. 31/12/2008 2 39 24 That the quality assurance process is available to view and the outcome is collated. To protect residents. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 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. 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