Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Shernbroke 1-6 Shernbroke Road Waltham Abbey Essex EN9 3JF The quality rating for this care home is: one star adequate 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: Carolyn Delaney Date: 1 3 0 3 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home
Name of care home: Address: Shernbroke 1-6 Shernbroke Road Waltham Abbey Essex EN9 3JF 01992700545 01992761735 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) : Essex County Council care home 25 Number of places (if applicable): Under 65 Over 65 0 6 1 0 learning disability physical disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 25 persons) Persons of either sex, under the age of 65 years, who require care by reason of a learning disability who also have a physical disability (not to exceed 6 persons) One named service user, over the age of 65 years, who requires care by reason of a learning disability The total number of service users accommodated in the home must not exceed 25 persons Date of last inspection
Care Homes for Adults (18-65 years) 3 0 0 9 2 0 0 8 Page 4 of 36 A bit about the care home Shernbroke is a home for people who have a learning disability. There are five bungalows which make up the home. Staff help residents with their daily lives. The home is close to the town and bus stops outside. Each person has their own bedroom. Care Homes for Adults (18-65 years) Page 5 of 36 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 36 How we did our inspection: This is what the inspector did when they were at the care home We spoke with residents and staff about the home. We looked at care plans. We looked at how complaints were dealt with and how residents were protected. Care Homes for Adults (18-65 years) Page 7 of 36 We looked at how many staff worked at the home and how they were trained. We looked at the home to see if it was safe and comfortable. What the care home does well Every person has a care plan. This tells staff what the
Care Homes for Adults (18-65 years) Page 8 of 36 resident likes and dislikes. Staff care for residents. Residents have medicine and treatment they need. Staff listen to resident’s complaints and put things right. Staff protect residents. Care Homes for Adults (18-65 years) Page 9 of 36 The home is clean and safe. What has got better from the last inspection Staff listen to residents to see what they want. Care plans show what residents want. Care Homes for Adults (18-65 years) Page 10 of 36 Staff help residents to take their medicines. Staff have more training so that they can care for residents. What the care home could do better Residents could be involved in more activities and things they like to do. Care Homes for Adults (18-65 years) Page 11 of 36 More staff are needed to be able to help residents. Care Homes for Adults (18-65 years) Page 12 of 36 Residents could be more involved about making decisions about the home. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 13 of 36 If you want to speak to the inspector please contact Carolyn Delaney CPCI Capital Park Fulbourn Cambridge CB21 5XE 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 - 0870 240 7535 Care Homes for Adults (18-65 years) Page 14 of 36 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 15 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who move into the home know their needs will be assessed and met and they will be given information to help them decide if the home will suit them. Evidence: The manager told us in the Annual Quality Assurance Assessment that Shernbroke provides a homely atmosphere. They told us that there are good relationships between staff and care management teams who are involved in ensuring that resident’s needs are met. The home had a policy and procedure in place for admitting people to the home so as to ensure that their individual needs would be assessed to help determine that the home would be suitable. This included a procedure for admitting people to the home as emergency admissions where there was insufficient time to carry out a full assessment of the persons needs. When we carried out a random inspection (a follow up visit to check on areas of concern) the home in January 2009 we found that nine people had moved into the home as emergency admissions. No assessments of these peoples needs had been carried out. At the time of this key inspection six of these people were still living in the home and we looked at how the needs for two of these people had been assessed. The manager
Care Homes for Adults (18-65 years) Page 16 of 36 Evidence: told us that the assessments had been carried out with input from the Care Management team including occupational and language therapists and community nurses who were involved in each persons care, as well as staff spending time with people so as to learn more about how they wished to be supported. We saw that for both people a detailed assessment of their physical and emotional health needs had been carried out. There was information recorded about both residents personal care needs and how the wished to be supported. Assessments of their general health had been completed and where issues were identified there was evidence that the appropriate health care professional had been consulted and a treatment plan was in place. Three residents completed surveys and they told us that they had not been asked if they wanted to move into the home as they had moved into the home as emergency admissions. However they told us that they were happy living in Shernbroke. One person said I am happy here. Another person told us that they came as an emergency to this place. I do like it, the people are friendly. We saw that the people who were responsible for commissioning (purchasing care packages) for these people had made positive comments about how the residents had been cared for since moving into the home. One care team manager said As you are aware there was very little information about service users and staff have been at all times have been supportive and proactive in supporting and managing needs as they have emerged. Care Homes for Adults (18-65 years) Page 17 of 36 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
. Residents are supported to make choices and take risks as part of living independent lives. Evidence: The manager told us in the Annual Quality Assurance Assessment that each person living in the home had an individualised care plan, which described how they are to be supported. When we visited the home we looked at the care plans for two residents. We saw that improvements had been made in the way that information about residents was recorded within their care plans. Staff had spent time with residents to see how they wished to be supported and this was documented in each persons care plan. In addition there was detailed information from other health care professionals involved in residents care such as occupational therapists and dieticians. We saw that where residents were capable of doing things such as washing, dressing and preparing meals that they were supported by staff to live as independently as possible. We saw that residents were supported to make decisions about their daily lives such as the times they went to bed, the clothing they wore etc and residents who were physically capable were able to carry out some domestic chores such as cooking, washing and
Care Homes for Adults (18-65 years) Page 18 of 36 Evidence: laundry. Residents who completed surveys and those we spoke with during the inspection told us that they could make choices and that staff supported them. One person said I do have choices and I get the support from carers, I do go out every day and I enjoy it. Staff told us that they always receive enough information about resident’s needs and any changes to the level of support that people need. We looked at how residents were supported to take risks as part of living their lives as independent as possible. Risks to the health and safety of residents were assessed and plans were developed to minimise the risks without infringing on the rights and choices of the individual. For example peoples understanding of road safety and money management were assessed and residents were supported to go out alone and to manage their money if they chose to and were capable. We observed for one person who had complex communication difficulties that a picture rota which used photographs of staff who were covering daily duties so as to help communicate to them who would be supporting them later in the day etc. Photographs and pictures were also used to help this person make choices and decisions about meals etc and seemed to work effectively. Care Homes for Adults (18-65 years) Page 19 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Residents are not always supported to enjoys a lifestyle which suits their wishes and expectations. Evidence: The manager told us in the Annual Quality Assurance Assessment that staff support residents to access local shops, restaurants and leisure facilities and to attend college courses for self development. The manager said that appropriate transport could be provided and that staffing levels could be increased so as to support residents better. The home is situated very close to local bus routes and the manager told us that he was looking into assisting residents to obtain bus passes. Residents who completed surveys and those we spoke to during the inspection told us that they could make choices about the things they liked to do. They told us that they went out to local shops, pubs and restaurants etc. We asked the manager about how residents were supported to attend college or engage in any employment or
Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: occupational activities outside of the home. He told us that he was looking into what opportunities were available for those residents who had moved from the home at Cowdrey Avenue. However he said that it was unclear as to how long these residents would live at the home so none of these residents were involved in these activities. We saw that residents had a plan in place for the activities they participated in. We saw that generally residents were supported to access activities outside the home during the day. However there was little evidence that residents were supported to go out during the evenings and staff rotas we looked at did not indicate that staffing levels were flexible to be able to facilitate this. On the day of the inspection one resident expressed that they wished to go out to the pub that evening. However we observed some discussion between staff and the resident where staff appeared to be discouraging the person from going out and commenting that staff were not available to support them. The manager intervened on this occasion and the residents wishes were accommodated however it was not clear that this would had happened were the manager not on duty at this time. Generally we saw that residents interacted with residents and not exclusively with each other. However we observed that one resident was left for periods in a lounge area. The television was on but they showed no interest in the programme and staff did not support or offer alternative activities for this person. One resident told us that they did not like living with another resident in the bungalow they both occupied. It was recorded in this persons plan of care the impact this had upon the residents behaviour and mood, there was no evidence that alternative arrangements had been considered even though there were other rooms available in some of the other houses. Residents told us that they could have visitors to the home when they chose and the manager told us that there was an open visiting policy for the home. Residents were supported to maintain contact with friends and relatives as they wished. We saw that the routines of the home were generally flexible. Residents who were capable and chose to had keys to their bedrooms and unrestricted access to the home. Where residents were capable they were involved in day to day tasks such as household chores, laundry and preparation of meals with the support of staff. The majority of people said that they enjoyed the meals provided by the home and that they had a menu to choose from. We saw that staff supported residents to choose meals for the coming week and to shop for food. In the houses we visited we saw menus and recipes which residents and staff used to prepare meals. Where residents had particular likes or dislike these were recorded in their individual care plans. Where people required specialised diets there was information regarding these and evidence of advice and input from appropriate health care professionals. Care Homes for Adults (18-65 years) Page 21 of 36 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 living in the home are well cared for and receive the treatment and medicines they need. Evidence: The manager told us in the Annual Quality Assurance Assessment that they closely support and monitor individuals health and that care plans clearly outline each persons needs and the plan for how to support them. The manager said staff receive training to enable them to be able to support residents, including safe moving and handling and training in the safe handling and administration of medicines. Residents who completed surveys told us that they were looked after well. One person said that staff are supportive and friendly and always listen to me. When we visited the home we looked at how staff supported residents with their personal care and health care needs. We looked at care plans for two people. The level of support both individuals required to maintain good personal and oral hygiene was clearly recorded for both people. There was information recorded as to how female residents were to be supported sensitively during their menstrual cycle and the impact this had on their behaviour and general wellbeing. We saw that residents were registered with a local doctor and that they were supported to attend for routine appointments and health
Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: checks. Where residents had specific medical conditions such as digestive disorders or skin conditions there were detailed plans in place and these included details of the treatment the person needed. We saw that where appropriate the input of health care professionals such as dieticians had been sought and implemented. At the last inspection serious concerns were raised about the way in which staff handled and administered medicines and some residents did not always receive the medicines prescribed for them. Since then more rigorous procedures were put in place to ensure that staff administered and handled medicines safely. This included staff training and assessments to ensure that they were competent to administer medicines safely and in line with the homes policies and procedures. When we visited the home the manager told us that people living in the home were unable to take responsibility for managing their medicines and we saw that there were assessments in place to support this. We looked at medication practices in two of the five houses. We saw that staff completed records to evidence that residents had received their medicines. There were regular audits in place to check on staff practices. We randomly checked medicines against records and these all indicated that medicines were administered correctly. Care Homes for Adults (18-65 years) Page 23 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People living in the home can be assured that their complaints and concerns will be listened to and investigated and that they will be safeguarded. Evidence: The manager told us in the Annual Quality Assurance Assessment that complaints about the service were welcomed, encouraged and dealt with quickly and professionally. They told us that all complaints and concerns were treated seriously and investigated. During the inspection the manager showed us a copy of the complaints policy and procedure and we saw that this was made available to residents and visitors to the home. The policy and procedure was detailed and there was a summary in picture format to assist some, but not all residents to understand how to complain. Three residents completed surveys and they told us that they knew who to speak with if they were unhappy. One person said I would speak to the duty officer or the manager. Another person told us It can be noticed and I am asked if I am unhappy. Residents who completed surveys and who spoke with us during the inspection told us that staff treated them well. The manager told us that there had been no complaints made since the last inspection. There were no recorded complaints for this period and we had not received any complaints about the service during this time. The manager showed us a number of compliments received about the service from relatives and care managers who were responsible for funding peoples place in the home. One relative said that were very happy that (resident) was living at Shernbroke and that they were supported very well
Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: by staff. We saw that there was a detailed policy and procedure in place for safeguarding people from abuse. This included details of how staff were to act if they witnessed or suspected ill treatment of residents. The procedure included a whistle blowing policy. This helped to assure staff that they would be supported in the event that they needed to raise concerns. We looked at the arrangements in place for providing safeguarding training for staff. We saw that since the last inspection that nine of the twenty staff working at the home had received training. The manager said he was arranging training for the remaining staff. We had received no safeguarding alerts about the home since the last inspection. However due to the serious concerns we had following the last inspection we raised a safeguarding alert with the Essex safeguarding team. The safeguarding team on review of the alert took the decision that the issues raised did not constitute abuse of people living in the home. At the last inspection we identified that staff had not received training to help them care for and support people who may be verbally or physically aggressive. On the day of the inspection some staff were undertaking training in dealing with aggression and training was planned for the remaining members of staff. We spoke with staff and they told us that they found the training very useful. Care Homes for Adults (18-65 years) Page 25 of 36 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
. Residents live in a clean, safe and comfortable environment. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is an ongoing programme of redecoration and refurbishment in order to improve the facilities available to residents. On the day of the inspection we saw that there was some refurbishment work in the main building and the manager told us that a communal activities areas was being provided for residents. Residents who completed surveys told us that the home was always fresh and clean. One person said I live in a good environment where staff do clean the place. Another person told us I do support the carers cleaning the tables and hoovering to keep my independence. On the day of the inspection we looked at communal areas in four of the five houses. We saw that each areas was furnished to meet the needs of the people living there. The houses were clean and bright. During our visit we saw that there was no hand washing soap and hand towels in some toilet / bathroom areas. This did not promote good infection control practices among staff and residents and we brought this to the attention of the manager who said that these had been ordered. Care Homes for Adults (18-65 years) Page 26 of 36 Evidence: We looked at how the home is maintained and saw that regular checks were carried out to test fire alarms, gas and electrical equipment and that routine services were carried out so as to ensure that all installations were in good safe working order. Since the last inspection the main kitchen had been decommissioned and residents meals were prepared by staff in kitchens in each house. This meant that residents who were able could be more involved in meal preparation and cooking. Care Homes for Adults (18-65 years) Page 27 of 36 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Staff are not always employed in sufficient numbers to support residents. Staff are not trained fully to meet the needs of residents. Evidence: We were told in the Annual Quality Assurance Assessment that some of the staff team had been working at the home for over eight years and that this meant that they had developed a good rapport with residents and knew about their individual needs. The manager told us that the majority of staff have received National Vocational Qualifications in care. They acknowledged that more permanent staff were needed so as to reduce the need for temporary agency cover. Two members of staff completed and returned surveys. They told us that their induction covered everything they needed to know about the job when they started work. One person said we always take agency staff around the home to meet residents and show them care plans. Both members of staff told us that they receive training which is relevant to their roles and the needs of residents. We looked at training records and saw that there was a training plan to support and develop staff practices. However not all staff received regular training. Most staff required updates in food hygiene as they were now responsible for preparing meals for residents. A number of staff had not received training in safeguarding vulnerable people and managing conflict or aggressive behaviour. However we saw that some training was
Care Homes for Adults (18-65 years) Page 28 of 36 Evidence: scheduled and on the day of the inspection a number of staff (including agency staff) were undertaking training to manage aggression. We spoke with staff and they told us that the training was very useful and would help them in supporting residents better. Residents who completed surveys and those we spoke with during the inspection told us that staff cared for and supported them. One person said staff are nice and they look after me. During the inspection we looked at how staff supported residents and saw that staff treated residents with respect and supported them as they wished. We spoke with the manager about staffing levels in the home. There was a staff rota and this identified which staff worked in each of the five houses. We saw that extra staff were employed in houses where residents had more complex needs and needed more support. The manager told us that more staff were employed to support residents when they wished to go out. On the day of the inspection we observed that at times there was only one member of staff available to support residents in two houses which were adjoined by connecting doors. And in the evening tone resident told the inspector that they wanted to go to the pub but that staff were not available. The manager intervened and staff did support the person to do this, but it is not clear that staff would have done so had the manager not been on duty. The manager told us that there had been no new staff recruited to work in the home since the last inspection. He told us that he was advertising for staff in order to reduce the use of agency staff in the home. Care Homes for Adults (18-65 years) Page 29 of 36 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 home is well managed and improvements are being implemented so as to provide a better service to the people who live there. Evidence: A new manager had been employed since the last key inspection. We spoke with him during this inspection and he told us of the actions he had taken so as to improve the experiences for residents. We saw that regular staff meetings had carried out and the discussions held about issues of concern highlighted during the previous inspection. In addition staff supervisions were being carried out to monitor staff practices and to speak with staff about the way they work. The manager told us that staff morale was much better and that this had a positive impact on the way in which residents were supported. We observed that staff appeared happy and interacted well with residents. Residents who completed surveys told us that they were happy living in the home. Staff told us that they were supported by the manager and they felt that the home was well managed. As the home was reliant on the use of temporary agency staff the manager now provided training for agency staff. This had helped to ensure that all staff worked better as a team and that residents were better supported at all times.
Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: We saw that a system was in place for obtaining the views of residents, the people who were important to them such as family and advocates, and people who were responsible for managing the care each person receives. At the time of the inspection questionnaires had not been sent and the manager said that an action plan will be developed based upon the comments and feedback received. We saw that staff hold meetings with residents to help them be involved in how the home is run. We looked at the minutes from these meetings. We saw that they covered aspects of day to day running of the home which affect residents, such as shopping, laundry etc. We saw that the meetings tended to be led by staff and focused on staffs views rather than residents and we discussed this with the manager. We looked at the arrangements in place for ensuring that the home was maintained in good order. We saw that records and certificates were up to date and that gas, fire and electrical equipment was maintained, serviced, repaired and replaced as necessary. We looked at accident records and notifications the manager sent us about any events or incidents in the home, which affect residents. These told us that one person had died at the home since the last inspection. We were also provided with information about residents who suffered seizures as a result of epilepsy and the care and treatment they received. Overall we could see evidence of the improvements made since the last inspection and the commitment of the manager to address all of the issues and improve the service for residents. Care Homes for Adults (18-65 years) Page 31 of 36 Are there any outstanding requirements from the last inspection? Yes ï No ï£ 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 1 33 18 Sufficient staff must be on 31/01/2009 duty at all times, and the deployment of staff must be appropriate to meet the needs of residents. This was not inspected on this occasion, previous timescale for compliance was 27/10/2008. This will ensure that residents have their care needs met and their health, safety and wellbeing are maintained. 2 34 19 Ensure that robust 31/01/2009 recruitment procedures are adopted at all times for the safety and wellbeing of residents and that all records as required by regulation are sought. This was not inspected on this occasion. The previous timescale was 1/1/2009. This will ensure that people living at the care home feel assured that staff looking after them are recruited appropriately for their safety and wellbeing. 3 35 18 Staff must receive appropriate training to the 01/04/2009
Page 32 of 36 Care Homes for Adults (18-65 years) work they perform. This refers specifically to those conditions associated with the needs of people who have a learning and/or physical disability and includes core areas. Previous timescale of 1/1/09 not fully met. This will ensure that staff, have the competence, confidence and ability to meet residents care needs. Care Homes for Adults (18-65 years) Page 33 of 36 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set
No Standard Regulation Description Timescale for action 1 2 14 People must only be 29/05/2009 admitted to the home once a detailed assessment of their needs has been carried out and a decision made that the home will be suitable. This will help ensure that people who move into the home will have their needs met. 2 33 18 Staff must be employed in sufficient numbers to meet the assessed needs of residents and this should be reviewed regularly. 07/05/2010 This will help ensure that the changing needs of residents are met. 3 35 18 All staff working in the home 29/05/2009 must receive training which is relevant to their roles and the specific needs of
Page 34 of 36 Care Homes for Adults (18-65 years) residents they support. This is to ensure that residents needs are met and they are supported properly. 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 More could be done to support residents to find and keep appropriate jobs or opportunities for education, training or other occupation. More could be done to support residents to access local leisure facilities and amenities especially during the evenings. The complaints policy and procedure should be further developed so that it made available in formats which residents can understand. All staff working in the home should receive training to help ensure that residents are safeguarded from abuse. Appropriate hand washing soap and towels should be provided in all areas of the home so as to promote good infection control practices. House meetings could be led more by residents and be used to obtain their views and suggestions as part of monitoring and improving the quality of services provided. 2 13 3 22 4 5 23 30 6 39 Care Homes for Adults (18-65 years) Page 35 of 36 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. If you would like a summary in a different format or language please contact our helpline or go to our website.
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