Inspection on 28/10/08 for Sunnybank

This inspection was carried out on 28th October 2008.

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

Sunnybank 10/11/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sunnybank Elizabeth Court Elizabeth Drive Castleford West Yorks WF10 3SD     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: David White     Date: 2 8 1 0 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Sunnybank Elizabeth Court Elizabeth Drive Castleford West Yorks WF10 3SD 01977559458 01977559458 sunnybank@mcare.info Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Millennium Care Services Limited Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Sunnybank is a large detached house in Airedale a residential suburb of Castleford. The home is located in a community setting, close to all the local facilities. The accommodation is comprised of a six bedroomed two-storey house and two bedroomed single story detached self-contained annexe. Both properties have garden areas which are safe and where people can sit outside. The annexe facilitates a more independent way of life for the occupants as they are supported with everyday tasks, such as cooking, cleaning, washing and managing their own budget. The home is registered for eight adults who have learning disabilities. Each person has his or her own bedroom. Six people are accommodated in the main house with the other two people being accommodated in the annexe. The fees at the time of the site visit on 28 October 2008 ranged from £1696.99 upwards. The service provider ensures that information about the service is available to people who are thinking about or who already live at the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 Brief description of the care home home through the homes Statement of Purpose, Service User Guide and through CSCI inspection reports, which are available within the home and upon request. The previous inspection took place on 10 November 2006. 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: We went to the home without telling them we were going to visit. This report follows the visit that took place on 28th October 2008. The visit lasted from 09:00 until 14:00. The purpose of the visit was to make sure that the home is operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include reviewing information that has been received about the home since the last inspection visit. Prior to the visit information was provided by the manager on an Annual Quality Assurance Assessment (AQAA) questionnaire. Surveys were returned by people living in the home and by a GP (General Practitioner) and a health professional who visit the service. Care Homes for Adults (18-65 years) Page 6 of 30 During the visit time was spent talking to people who live at the home, care staff and the assistant manager. There was observation of how staff interacted with people. Various documents and records were looked at and some areas of the home used by people living there were visited. The assistant manager was available throughout the visit and the findings were discussed with her at the end of the inspection. At the time of the site visit on 28th October 2008, the fees ranged from 1696.99 pounds per week upwards. Additional costs are made for hairdressing, relexology, activities and toiletries. What the care home does well: What has improved since the last inspection? The home has introduced a new assessment tool that provides more detailed and personal information about individuals. This enables people who live at the home to be more involved in the care planning process so that care is more person centred. The introduction of Individual Reactive Strategies have helped staff to have a better understanding of peoples behaviour and how to manage this in a way that minimises peoples anxiety and distress. Some staff have attended some Makaton training so that they are able to communicate more effectively with people living in the home who use Makaton as a means of communication. This helps in making sure peoples needs are understood and met. A new more detailed induction workbook has been introduced so that new staff are fully prepared and clear about their roles and responsibilities in meeting peoples needs. The home has achieved the Investors in People Award for the quality of the care and Care Homes for Adults (18-65 years) Page 8 of 30 services on offer at the home. Previous problems with the homes water systems have been rectified to minimise any risks to people. 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 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. People can feel very confident that the home will be suitable to meet their needs. This is because they, or people close to them, are involved in an assessment of their needs before they are offered a place. Evidence: Although no people have been admitted to the home since the previous inspection visit, it was noted within the care records of two people that the home did have proper pre-admission procedures in place and these had been followed in the past. The care records contained information that had been obtained from other sources such as placing authorities before any decision had been made about whether the home would be suitable to meet the persons needs. A comprehensive needs assessment would be undertaken on any person being considered for a placement at the home before they moved in. This includes an assessment of the persons needs and abilities and any risks they may present with. A person living at the home said, the manager came out to see before I moved in here. People living at the home who returned surveys to us commented that they received enough information about the home beforehand to help Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: them to make a decision about whether they wanted to move in there. The home has introduced the ROSYH (Regional Outcome Systems for Yorkshire and Humberside) assessment tool. This new tool encourages people to be more involved in the assessment so that care can be planned in a more person centred way. This assessment focuses on achieving postive outcomes for people and takes into account peoples individuality about such things as their age, disability and sexual orientation. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make their own decisions about how they live their lives as much as possible. This is supported by good care planning systems that involve people in planning their care and provide staff with detailed information about how to meet peoples needs. Evidence: The home has been able to produce person centred goal planning through the use of the new assessment tool. This tool has only recently been introduced so in some cases peoples previous care planning documentation has not been fully implemented into the new documentation. Those care plans that did contain the new documentation were very individualised, informative and person centred, focusing on peoples strengths and abilities. One persons care plan described how staff should sit down with the person and write a schedule for tasks to do during the day which are ticked off after completion. This was recognised as a way of communication with the person that enabled them to see what they had achieved and to minimise their anxiety Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: through having structure to their day. During the visit staff could be seen carrying this out with the individual. Another person with communication difficulties liked to know which staff were on duty at any one time. To help the person undertsand this, pictures of staff on duty at any one time are on display on a picture board at the entrance of the home. One person had a care plan to address any inappropriate sexual behaviour. The care plan clearly set out how the person was to be supported in meeting their sexual needs in a way that would not cause offence to others. Care plan reviews regularly take place and involve people living at the home where possible, relatives and professionals who are involved in peoples care. People living in the home also said they have regular meetings with their key worker to discuss how things are going. A survey returned to us from a health professional said, the service does well at providing person centred care within the limitations of the environment and is good at managing behaviour. People were encouraged to live their lives as they choose as much as possible. Because of peoples differing levels of ability, some people needed more support with this than others. Staff could be seen throughout the visit to be giving people choice and peoples wishes and aims are recorded in their care plans. Those staff spoken to had a very good understanding of the needs of individuals living in the home and about person centred care. Staff said that the introduction of the new assessment tool had helped with this. The home has a very positive attitude towards risk taking. A wide range of individual risk assessments are in place to support people with their independence and safety. These show how decisions have been made where people could be restricted in what they are able to do. The ROSYH assessment tool uses a scoring system to access risk in a number of aspects of daily living. Risk management plans are drawn up from this and this is monitored and reviewed as needed. The home has also developed Individual Reactive Strategies for individuals. These provide excellent information about possible trigger factors for behaviour, indicators that a persons behaviour may be deteriorating and actions to be taken if this happens. This helps to identify problems at an early stage so that anxiety to the person and others is minimised. A member of staff said, the Individual Reactive Strategies are very good. In one persons case because of this we are able to now diffuse situations with this individual solely by the use of de-escaltion techniques instead of having to use physical interventions. The Individual Reactive Strategies are also very good at providing guidance to staff about when and how physical intervention is to be used. Staff said physical intervention is not used often and only as a last resort. All staff have received Timian training on the use of de-escalation and physical intervention techniques. The manager is also a Timian trainer. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Throughout the day of the visit staff were observed being respectful in helping people to maintain their dignity. One person living at the home needs constant attention from staff and this was managed in a patient and dignified way. People can receive support from advocacy services if they need help to protect their rights and with decisionmaking. The recently introduced Mental Capacity Act has implications on how peoples rights are safeguarded, particularly in areas of capacity and consent. The organisation are planning for staff to attend training to develop their understanding of this. Care Homes for Adults (18-65 years) Page 15 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 enjoy a lifestyle that suits their individual needs. Evidence: The home has a full-time activities organiser who plans activities with people who use the service. Discussions about forthcoming events are also held in house meetings. Each individuals care records detail peoples hobbies and interests and care plans describe how these needs are to be met. Most people attend the local resource centre for activities such as walking, gardening, healthy eating, computers and golf sessions. One person attends the local swimming baths for aqua aerobics. Earlier this year people went on holiday to Centre Parks or Disneyland depending on their preference and a number of day outings have been enjoyed. The home has their transport. This enables flexibility for people to go out either as planned or on impulse. Six of the seven people living at the home need two members of staff to support them when Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: going out. Staffing levels are good to ensure that people are able to get out at all times and staffing rotas are planned around peoples needs. A survey returned by someone living at the home said, I like swimming, bowling and having dinners out. Staff at the home respect peoples choices and individuality. Peoples birthdays and special events are celebrated. People who do not wish to go out and join in activities are not put under any pressure to do so. At the time of the visit a number of people received support from staff to go out to various activities. In-house staff could be seen helping people to complete jigsaws. Another person was working alongside a member of staff making toffee apples in preparation for planned Halloween celebrations. A health professional survey commented staff respond well to needs and promote choice in everyday life and activities. People are encouraged to maintain their relationships with family and friends who can visit at any time. In most cases staff prepare and cook meals for people. The annexe part of the building accommodates two people who have a greater level of independent skills. Both of these people plan and cook their own meals. All the surveys returned by people living in the home said that the meals are good and there is always choice. Healthy eating options are available in the menu options and the home grows their own vegetables to encourage this. Mealtimes are relaxed and people are able to eat alone if they wish to do so. 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. Peoples personal and healthcare needs are very well met by a respectful staff team who help to maintain peoples privacy and dignity. Evidence: Staff gave good support with any personal care needs and made sure they were carried out in private to respect peoples dignity. The individual type of support that people need is documented in their care plan and this makes sure the health needs of people are properly met in a person centred way. The care plans contain excellent information about health professionals that people see and reasons for and outcomes from appointments. In particular the home has a good system in place for sharing and passing on information about peoples visits to outpatient appointments. This helps in making sure that staff are aware of what has been agreed and any actions they need to take. Each person has a GP (General Practitioner), dentist, optician and chiropodist. The homes works alongside the Community Learning Disability Team and mental health services to support people with specialist needs. Referrals are made to other agencies as appropriate. The Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: organisation also employs a nurse co-ordinator who supports the manager with any health issues. A survey returned by a GP said, I am always impressed when I visit the home or staff bring patients to the surgery. The home also received praise from a local NHS (National Health Service) Trust for the help, support and information provided about a person living in the home to help with the assessment and treatment process. A survey returned by a health professional commented the manager and staff always seek advice when needed and attempt to act on it. Staff said they receive specific training on health care matters such as epilepsy. The home uses a monitored dosage pre-packed system for medicines. Staff who take responsibility for the administration of medication have been trained to do so. This includes training on specific medication issues such as when medication has to be given in an emergency. There are good ordering and checking systems in place. Medication records were up to date and all medications administered had been countersigned to minimise the risk of errors. The manager undertakes monthly medication audit checks so that any discrepancies can be identified at an early stage. A risk assessment is to be completed for one person who wishes to take responsibility for their own medication to make sure it is safe for them to do so. 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. Peoples concerns are listened to and acted on. Systems are in place to safeguard people from abuse. Evidence: Each person living in the home is given a copy of the complaints procedure and this is also on display at the entrance to the home. Some of the people who live at the home are unable to understand how to make a complaint. Staff said they would be aware of any dissatisfaction through observations of the persons behaviour and this is then passed on to the manager. All the surveys returned by people living in the home indicated that they know who to speak to if they were unhappy about anything. The home has a policy and procedure on how to safeguard people from abuse. The organisation has adapted a new safeguarding adults training plan that incorporates the new local authority safeguarding procedures. A recently employed member of staff said they had received information about how to recognise and respond to abuse at an early stage of their induction to the home. Since the previous inspection visit there had been one incident which required safeguarding procedures to be followed. Because staff did not report this immediately to the manager there was a delay in the local authority being notified which could potentially have put people at further risk of harm. Since then the manager has held meetings with staff about this so that staff are fully clear about procedures to be followed. At the time of the visit those staff spoken to Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: had a good understanding of their responsibilities in responding to suspected or incidents of abuse. Good individual risk assessments and management plans are in place for people at risk of or from abuse. Physical intervention is only used as a last resort and incidents where this has been used was well recorded. Staff support people to manage their own monies. People have their own personal bank accounts and records are kept of any transactions involving monies that are held on behalf of people by the home. The financial systems are audited to make sure monies can be accurately accounted for and so that any discrepancies can be looked into. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, friendly, comfortable and safe environment that meets their needs. Evidence: The home has a friendly atmosphere and people said they felt comfortable living there. There is ramped access to the building so that people with mobility problems can visit. However there is no bathroom on the ground floor of the main building and the first floor can only be accessed by stairs so this aspect of personal care would be difficult for people with mobility problems. There are two separate parts to the home. The main building accommodates six people, two people who are more independent live in the annexe part of the building. Earlier this year people in the annexe requested more privacy from people in the main building. In order to accommodate this a fence was erected and a courtyard built to offer more privacy. A summerhouse has been built in the garden for one person who likes their own space and had requested this. This has been funded by the individual and is not used by anyone else at the home. A corridor in the home has been updated into a sensory area with tactile boards, mood lighting and sensory lighting and music systems. It is also used by the relexologist when carrying out sessions such as head massages. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Risk assessments have been carried out on a number of areas of the environment. Some of the furniture and fittings have been made secure to help maintain a safe environment. A key code locking system is in place on the kitchen door as there have been incidents where one person throws items around the room potentially putting themselves and others at risk from scalding. In order to manage this situation the kitchen is locked for a short period in the afternoon. People are still able to ask staff for drinks at any time during this period. At all other times the kitchen is always accessible to everyone. The home is clean and fresh smelling throughout. People living at the home said, the home is always like this. On the day of the site visit a new cleaner was starting her job and being shown around the home. Staff were observed to follow infection control procedures and hand washing facilities were available throughout the home. The home has recently received a four star rating from environmental health for their food and hygiene standards. 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. People using the service receive very good support from a staff team who are well trained to meet their individual needs. Evidence: There are enough staff on duty to meet the needs of people who use the service. Throughout the day there are usually six members of staff on duty. In addition to this two staff work middle shifts to suit peoples needs. Overnight there is one waking member of staff and two staff sleep at the home. An on-call manager is available at all times. People who use the service said they feel there is always enough staff on duty. One person said, staff are friendly and helpful and always give me support when I need it. Staff members said, morale is good and felt that the team worked well together. Most of the staff team have worked at the home for some time so are very knowledgeable and understanding about the people living at the home. A health professional survey commented staff have an in-depth knowledge of the people living in the home. Recruitment is properly managed by the home. Interviews are held and references and CRB (Criminal Record Bureau) checks are obtained before new staff start working at the home. One person who lives at the home has become a member of the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: recruitment panel and has recently been involved in staff interviews for new posts. The person attended an external course to prepare them for this role and a certificate of their achievement was seen in their bedroom. The person said, I really enjoyed interviewing people and being involved in choosing new staff. Interview questions were in picture format to prompt the person in what they were asking. Staff receive a very good range of training to support them with their jobs. Individual training files are in place to record what training has been undertaken. Personal portfolios are being developed to enable staff to record their achievements and to reflect on their practices so they can learn from situations. One member of staff has a role as training co-ordinator and this staff member receives information from the organisations head office about the training available and is informed when training updates are due. A new induction booklet has been introduced for staff to complete in their first 12 weeks of employment. This helps them to understand their responsibilities and the values and principles of the organisation. A new member of staff said their induction was detailed and that they were being supervised until their induction was completed. This person said, staff are brilliant, they made me feel so settled straight away. The majority of staff have either completed or are doing NVQ (National Vocational Qualification). Staff receive a very good range of in-house and external training that includes training that is specific to the needs of people living in the home such as autism. Four staff members have recently completed a Makaton course and they are to cascade this training to other staff members. This will enable staff to interact more effectively with people who communicate in this way. 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. The home is managed in the very best interests of people living there. Good systems are in place to maintain peoples health and safety. Evidence: Since the previous inspection visit a new manager has taken over in post. He has completed his application to register with the commission as manager of the home and is awaiting an interview. People using the service and staff both said they like the hands on approach of the manager and commented that improvements had been made to the way the home was run since his arrival. A survey returned by a health professional who visits the service said, the manager has the needs of people living at the home at the heart of all his actions. He engenders a culture of positive regard amongst the staff team. During the visit it was clearly evident that the ethos of the home is based on person centred care that shows an understanding of peoples individuality. The organisations quality assurance system has recently achieved the Investors in Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: People Award. This recognises the improvements that have been made in ensuring good outcomes for people who use the service. The home has various systems in place to monitor and improve the care and services on offer. The organisations Head of Care carries out monthly visits to the home. Reports from these visits detail any action that is to be taken to improve the service. Health and safety, medication and care planning audits are carried out on a monthly basis so that any issues can be addressed. People who use the service, their relatives and professionals who visit the home are asked to completed questionnaires that are sent out by the organisation. Comments from these are then acted on to make any neccessary improvements. People living at the home said they hold house meetings with staff to plan activities and to discuss issues about the home. One person attended the Millenium Service User Partnership Board meetings where discussion takes place on such things as staffing and information given to people about the service. Bi-annual employee forum meetings are held to enable staff to be involved in decision-making about the organisation. Staff meetings are held and all staff said they receive suppervision on a regular basis to support them in their job. The self-assessment form (AQAA) completed by the home indicated that all the required maintenance and safety checks were up to date and a sample of records seen confirmed this. All staff receive updated health and safety training. Health and safety is well monitored and recorded by the organisations health and safety officer. Since the previous inspection visit better regulation of water temperatures is now maintained. A yearly check of the water systems are undertaken by a water company and the last check in May 2008 confirmed that the water systems were satisfactory. Daily checks are made of the boiler temperatures and shower heads so that any problems can be identified quickly and acted on. 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 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!