Inspection on 13/03/09 for The Old Galleries

This inspection was carried out on 13th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Galleries 14/03/07

The Old Galleries 22/02/06

The Old Galleries 18/09/05

The Old Galleries 15/03/05

The Old Galleries 13/08/04

The Old Galleries 15/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Old Galleries High Street Bideford Devon EX39 3AA 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: Susan Taylor 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:  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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 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 32 Information about the care home Name of care home: Address: The Old Galleries High Street Bideford Devon EX39 3AA 01237425601 01237425842 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) : Mrs Barbara M Haywood care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: This variation allows three named persons, in the category of MD Mental Disorder to remain in the home The maximum number of placements, including that of the named persons, will remain at 8 On the termination of the placement of the named persons, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to the category LD Learning Disability only Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home The Old Galleries has provided 24-hour care for 8 adults under 65 years of age with learning disabilities. The emphasis of the home is to enable residents to lead fulfilling lives through the development of social and daily living skills. The home is a listed building, situated in the main High Street of Bideford, and has been totally refurbished. The accommodation comprises of single accommodation, five of which have ensuite facilities. To the rear of the property is an enclosed garden, with outbuildings containing a laundry room. There are no parking facilities at the home, but it is in easy walking distance of a number of street parking bays and public car parks. Fees levied vary from £343 -- £755.27 a week with additional fees levied for transport, chiropody and hairdressing. In some instances people also fund from certain of their benefits 1:1 staff support for accessing the community. This does not include transport and support for medical appointments, which are provided within the fees. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We talked to all the people who live at the home. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We sent surveys that people filled in. The comments people made are in the report. What the care home does well People are asked lots of questions before they move into the home. This is so that the staff know what the persons needs are and how best to support them. Every person has a plan of care that is agreed with them. It is reviewed regularly with the person. This ensures that the team meet that persons needs. People tell us that they like living at Old Galleries and make comments like I do not want to ever leave. People tell us that they have a good social life. For example, they go to see shows at the local theatre. People tell us they feel safe and well Care Homes for Adults (18-65 years) Page 7 of 32 supported. There are rules about how to keep safe, which they understand and follow. The staff do a lot of training. This means that they know how to look after people properly. The manager checks that people at the home are happy and well cared for. The staff are said to be very good and listen to what people have to say. The provider will not allow people to be abused by anyone. People are listened to and know who to contact if they are unhappy. The provider will not allow people to be abused by anyone. What has got better from the last inspection The guide for the home now tells people exactly what extra charges they have to pay for. Records show exactly what people have paid for. New carpets and furniture have been bought. People live in a comfortable place that is bright and modern. Care Homes for Adults (18-65 years) Page 8 of 32 What the care home could do better Equality and diversity issues should be discussed with people when they move in to ensure that their needs are met. The risk of falls for a person with poor mobility should be assessed. This would ensure that staff know all the persons needs and plan as to how these will be monitored. Peoples controlled medicines should be kept secure in a cupboard that meets legal requirements under the Misuse of Drugs Act. Quality surveys could be in easy words that people understand, so that they dont need as much help to fill them in. The home is being run by a company, which is not registered. It is a legal requirement for the provider to be properly registered, so that people living in the home are protected. Care Homes for Adults (18-65 years) Page 9 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Susan Taylor 33 Greycoat Street London SW1P 2QF 02079792000 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 10 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 32 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 . Potential new people benefit from a good admission and assessment process, which ensures that the home can meet their needs. Evidence: 100 percent of people living in the home that responded to a survey [3] verified that they received enough information before they moved in so that they could decide if it was the right place for them. Similarly, they all had a contract of residency. We looked at the documentation the provider had sent to the Commission. However, no information had been provided with regard to diversity issues like, religion, sexuality or disability in the dataset. We discussed this with the assistant manager and provider and looked at the documentation that they used to assess people. We were told that this forms the basis on which a decision is made as to whether the persons needs can be met before the senior team agree a persons move into the home. Whilst a lot of information is obtained about an individual, the assistant manager and provider recognised that this process did not sufficiently explore peoples diversity for example sexuality. They told us that they were updating the assessment proforma and would include diversity prompts within it. Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: We looked at 2 care files, which demonstrated that comprehensive assessment information had been obtained from placing authorities. These had been reviewed since. Staff told us that the information had enabled them to get to know people when they first moved into the home. We tracked the experiences of someone that had moved into the home since the last key inspection. The person showed us their bedroom, which they told us they had chosen when they visited before deciding to move in. They said I like it here, I would recommend it to anyone. Care Homes for Adults (18-65 years) Page 13 of 32 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 who live at Old Galleries benefit from having regularly reviewed plans of care, which reflect their individual needs and choices. Evidence: We looked at the care files for 2 people to establish whether they had a care plan that had been discussed and reviewed with them and or their advocate. Peoples needs included individuals with diabetes, poor mobility, communication, behaviour and mental health issues. The provider sent information to the Commission AQQA about improvements that had been made to the care planning system since the last inspection to ensure people had full access to the information kept about them. All the care plans seen had been regularly reviewed. The plans were person centred and in a format that made them accessible to the individual, in symbol format with simple language. Additionally, individuals personal preferences, routines and social activities had been recorded. The plans also outline the abilities of individuals to manage their own finances, travel independently and manage personal hygiene and what actions need to be taken to Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: maximise their independence in issues relating to these. 100 percent of people responding in a survey verified that they make their own decisions about what they do during the day, during the evenings and at weekends. We observed this to be the case whilst we were at the home. We looked at duty rosters that showed that additional staff were rostered to work at times when people were going out to places like clubs or outings. This means that people get the support they need to learn new skills and specific staff have the time to completely focus on the needs and wishes of individuals. 2 peoples financial records were examined. The provider told us that fees are paid into a business account from which money is transferred into individual accounts. We were shown statements for this account. People had their own savings accounts and we were shown statements for these. Balance sheets had been completed and were audited and found to be in order. Two signatures were seen on balance sheets denoting withdrawals. Receipts for purchases tallied with entries seen in the records. The provider told us that a qualified accountant audits the accounts. Additionally, records demonstrated that transactions are regularly audited as part of the organisations quality assurance processes. Since the last inspection, the provider had ensured that additional costs charge to people for transport are properly accounted for across both their homes-Old Galleries and Bidna House . Additionally, the costs which individuals can expect to pay for is publicised in the statement of purpose that had been reviewed and updated following our last inspection. The provider told us that these additional costs are for non medical or activities and no charge is made for hospital or GP appointments for example. We saw receipts that tallied with the entries and in turn, corresponded with outings that people living in the home had gone out on. The home had policies and procedures about risk assessment and management. In practice comprehensive risk assessments had been completed and were detailed. Each file clearly set out ways to minimise identified risks and hazards, whilst at the same time encouraged the individual to be as independent as possible. We observed that staff followed the measures set out. People were kept safe; whilst at the same time had freedom to do what they wanted to do. For example, we looked at the file for a person that is at risk of falls due to poor mobility. Whilst this is covered in the persons care plan, no assessment had been completed to determine the level of risks. We met the person and support workers. The staff had a clear understanding of the persons needs and staff were knowledgeable about the persons condition and verified that they had had first aid training. We looked at the accident records and read that the person had had a fall and had been given first aid for a minor graze. Care Homes for Adults (18-65 years) Page 15 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Old Galleries are able to take part in activities that suit their needs and wishes and are supported to access the local community and maintain family and friends contacts. Evidence: We looked at daily records for 2 individuals and it was clear that people enjoy an active lifestyle. The daily records showed that people went to different places in North Devon, went shopping to buy clothes and food, attended social activities such as playing, watching skittles and went to local specialist clubs such as Breakaway and Gateway. The home charges a fee for transport to these activities and the provide has ensured that this is made explicit in their information they give to people (the Statement of Purpose and Services Users Guide). The provider told us that in the last 12 months, people have had the opportunity to join with individuals living at Bidna House to go on 2 holidays to Butlins and numerous trips out to fun fairs, carnivals and theatre trips. Additionally, people have access to computer courses, art classes, a Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: cookery course and drama groups run by the local college and Devon County Council. In a survey, 100 percent of people verified that they can do what they want to during the day, evening and at weekends. In the files we looked at we saw that people are in the process of discussing a document with their key worker entitled My Goals. This will ensure that peoples views about how they wish to lead their life is taken account of and that support is given to help them achieve this. People told us that they keep in contact with relatives. One person said they liked to visit their relations regularly and records demonstrated that they were enabled to do so. People had keys to their rooms. We observed that staff were respectful towards people and addressed them according to the individuals preference that had been recorded in their care file. People told us that they have unrestricted access to all communal areas, except the main kitchen when it is not in use it . We discussed this with the provider who told us that they wanted to come up with a better solution to this arrangement that would enable people to be more independent, whilst at the same time ensuring their safety. People have control of their lives. For example, we observed a person telling a member of staff Im off out to Barnstaple please put my tea aside and Ill have it when I come home. We observed another person having a discussion with the manager about a planned evening out to the theatre to see an ACDC tribute band and said they are looking forward to it. The same person told us that they had been out to the supermarket to get some things that he and another person needed. A copy of the menu for the week was displayed in the dining room. People invited us to join them for lunch. We observed that people were offered a choice and second helpings at the meal. It was clear that peoples likes and dislikes had been taken account of when we spoke to the group about the meals. We tracked the needs of a person with diabetes, who told us that they have a low fat diet, which is appropriate for them. Records demonstrate that meals provided are varied and ensure there is a good nutritional balance for people. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are treated with dignity and respect. Old Galleries has good systems for capturing medical information, which means that healthcare is individualised and takes account of peoples needs. Evidence: Plans of care gave details of how individuals personal and health care needs were met. 100 percent of healthcare professionals responding in a survey verified that the staff always and have the right skills and experience to care for people. Additionally, their comments verified that the team usually seek advice and act on it. Correspondence in care files demonstrated that other social and healthcare professionals, for example a community psychiatric nurse, have a lot of input into the care of people living in the home. This has ensured that personal and healthcare needs are regularly assessed and well met for people living there. We observed that staff were respectful to people and always knocked before entering a persons bedroom. In a survey 100 percent of people verified that they were always treated well by the staff. We tracked the assessment process for a person that has diabetes. Records Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: demonstrated that the person needs to be monitored closely to ensure that they remain in the best of health. The person told us that they have regular health checks at the GP practice. Additionally, the assessment was detailed and provided staff with a clear picture of how the person should be monitored, how the diabetes was being treated and that they person required a low fat diet. Staff verified that that they were aware that this person was diabetic and acurately described what the persons needs were in terms of diet and treatment. Information sent to the Commission by the provider verified that 2 people who live at Old Galleries administer their own medications. We read risk assessments in both peoples files and the individuals themselves told us that this had been discussed with them. Medicines were stored securely and records relating to when these had been given as prescribed to individuals where well maintained. Similarly, the registered manager verified that they do not have anyone on any controlled medications, but they were aware that should this change they would need to ensure that this is stored appropriately, i.e. double locked in a cabinet secured to a solid wall by rag bolts. Care Homes for Adults (18-65 years) Page 19 of 32 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 views are listened to and acted upon. Improvements have ensured that individuals are fully protected from possible financial abuse. Evidence: In a survey, 100 percent of people verified that they knew who to speak to and how to make a complaint if they needed to. We saw the complaints procedure prominently displayed on the notice board of the home. This had been updated and shows the correct contact details of the Commission for Social Care Inspection (CSCI) and is in a total communication format making it more accessible to people living in the home. We told the provider that this will need to be updated again by 1/4/09 to show the contact details for CQC. Information sent to the Commission by the provider verified that no complaints have been received since the last inspection. In a survey, all of the people responding verified that they are treated with respect. A person that we met at the home said the staff are very good and listen. Similarly, all of the people we spoke consistently told us they were very happy living at Old Galleries. 1 person said they did not want to ever move from the home. We spoke to 2 staff, both of whom had a good understanding of what constituted abuse and what they should do to report any suspicions of abuse. Training records demonstrated that staff have received training in the protection of vulnerable adults and policies are in place to ensure that any allegations are followed up. Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: We found that a POVA and CRB check had been done after a newly appointed staff member had started work at the home. We discussed this with the registered manager who had been unclear of the regulatory requirements as to the sequencing of preemployment checks such as this. We recommended that the assistant manager familiarise himself with the Commissions guidance. Since the last inspection, the provider has ensured that additional costs charge to people for transport are properly accounted for. Additionally, the costs which individuals can expect to pay for is publicised in the statement of purpose that had been reviewed and updated following our last inspection. The provider told us that these additional costs are for non medical or activities and no charge is made for hospital or GP appointments for example. We saw receipts that tallied with the entries and in turn, corresponded with outings that people living in the home had gone out on. Care Homes for Adults (18-65 years) Page 21 of 32 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 comfortable, well-maintained home that is clean. Evidence: Old Galleries is a large house situated on the main High Street in Bideford. We toured the premises. There is a large and small lounge and separate dining room, which provide people with a comfortable place to sit and relax in. Since the last key inspection, new furniture had been bought by the provider that had been chosen by the people living in the home. The kitchen is large and separate to the dining room for health and safety reasons. We observed some people using the tea and coffee making facilities with varying levels of support from staff. For example, we saw one person offer to make hot drinks for everyone. People showed us their bedrooms, which reflected their individual tastes. One person said that they liked pictures of girls and had been told to do whatever you want to make it home. Another person showed us their en-suite bathroom. They said they preferred to use the newly refurbished wet room for a shower that is next to the office. 100 percent of people responding in a survey verified that their home was kept clean and fresh and we also observed this to be the case. People told us that they have support from staff so that they can clean their own bedroom. The accommodation is comfortable for the people that live there. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Information that the provider sent to us verified that an audit using Essential Steps guidance [Department of Health] had been carried out. Additionally, 100 percent of the staff had attended training covering infection control management. The laundry was clean. Staff verified that there was a plentiful supply of gloves and aprons for them to use when delivering personal care to people or doing cleaning. Safe systems were observed being followed with regard to separation of bed linen and clothing to maintain good infection control, whilst at the same time did not detract from some people being supported to participate in the process of doing their washing. Care Homes for Adults (18-65 years) Page 23 of 32 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 . Improvement of recruitment practices across the two services owned by the provider has ensured that people living at Old Galleries are protected. Training and staff development has also ensured that competent and knowledgeable staff care for people. Evidence: We examined duty rosters for February and March 2009, which accurately recorded the names of staff, and duties that had been worked. Staff in a survey verified that there is usually enough staff to meet the needs of people. Similarly, people we met verified that their needs were met. The manager told us that the number of staff on duty had increased since the last key inspection. We observed that staff did not appear rushed and were attentive to people living in the home. At the last key inspection, we reported that staff files did not have evidence of people being checked to see if they were suitable to work with vulnerable people i.e. POVA check prior to employment. We examined records for 3 staff. These staff also work at Bidna House so our findings were the same as reported when we last did a key inspection there. Pre-employment checks had been carried out properly in 2 out of 3 [75 percent] of files. We found that a POVA and CRB check had been obtained after a newly appointed staff member had started work at the home on 5/5/08 (verified by duty rosters). We discussed this with the registered manager who said that they had Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: already made changes to the recruitment procedure following the inspection of Bidna House and appropriate checks are now being made prior to employment. Therefore, in view of this we decided that improvements have been made to ensure that recruitment practices are more robust and protect people living at the home. Information sent to us by the provider/manager tells us that 80 percent of staff hold NVQ level 2 in care and a further 27 percent are in the process of doing the NVQ level 3. In the 3 staff files examined, we saw that induction records follow the Skills for Care standards. Additionally, all of the senior management team have completed the Registered Managers Award ensuring that high quality cover is available when the manager is on leave. Training records demonstrated that staff receive a high standard of training and are working towards accreditation with the National Autistic Society. We spoke to staff during the inspection and was told that they had regular 1:1 supervision sessions with the manager and team leader. We looked at 3 staff files; all recorded that a recent supervision session had taken place. This was also borne out when we spoke to staff that told us they felt well supported by the manager and provider. Old Galleries been awarded the Investors in People Award, which demonstrates that the provider is committed to staff development Care Homes for Adults (18-65 years) Page 25 of 32 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 . Old Galleries is a well run home in which the peoples views are listened to and acted upon. Evidence: The registered manager has been in post for some years and holds the Registered Managers Award and NVQ Level 4 in care. Additionally, in the AQAA the assistant manager has verified that he is in the process of doing a Masters Degree in Autism. 100 percent of Healthcare professionals in a survey verified that the service is well run and the registered persons work in parnership with them. Therefore, people live in a safe place where their views are listened to. The provider gave the Commission a reasonable picture of the current situation in the service, in a document entitled AQAA (Annual Quality Assurance Assessment), which we received on time. The information provided was clear and enabled us to know what to focus on during the inspection. More supporting evidence would have demonstrated what has been improved or needs improving as a result of listening to the views of people. It was clear that the manager and provider fully embraces quality assurance Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: and puts the people living in the home at the centre of everything they do. At the same time, they were open about what they could do better and able to demonstrate continous improvement in various areas throughout the course of the inspection. As the provider owns another service - Bidna House - we found some shortfalls in the recruitment procedure when we looked at the same staff files. However, we inspected Bidna House in November 2008 and the provider and manager told us that they have reviewed the procedure and will ensure that independent safeguarding authority checks are done prior to employment. Therefore, improvements have ensured that people living at Old Galleries are protected. The certificate of registration was displayed in the hallway, which is a legal requirement. We also saw the public liability certificate, which was valid. A certificate of public liability was examined, which states that Old Galleries is being run by Lycette Care Ltd. We discussed this with the registered provider who verified that the business is now trading as a limited company. We verified that an application for registration would have to be made as the registered person had changed as a result of the service being run by a limited company. We have made a requirement about this. We were shown a file containing Quality Assurance questionnaires. This contained questionnaires relating to quality assurance surveys carried out in 2008, including one relating to the Investors in People Award. A variety of people, such as residents relatives, care managers, general practitioners and friends. The questionnaires sought information about what the respondents thought about the management of the home, the social activities provided, the staff team and the environment together with a question about what might be improved. A separate questionnaire had been compiled for people to complete. However, this was not in a suitable format for learning disabled people. A recommendation is made with regard to this to improve the ways in which people living in the home are enabled to give formal feedback about the service they receive. Comprehensive Health and Safety policies and procedures were seen, including a poster displayed near to the office stating who was responsible for implementing and reviewing these. Staff we spoke to told us that they had been regular training. We were shown the induction pack and saw that completion of this had been recorded in the files we looked at. We toured the building and observed that cleaning materials were stored securely. Records of accidents were kept and showed that appropriate action had been taken. For example, 1 person had fallen and received first aid from appropriately qualified staff. The fire log was examined and demonstrated that fire drills, had taken place regularly. Similarly, the fire alarm had also been regularly checked. People living in the home told us that the alarm was regularly sounded. Certificates verified that an engineer had installed the fire alarm. First aid equipment was clearly labelled. Maintenance certificates were seen for fire alarm and electrical systems. The provider had verified in information sent to the Commission that a local electrician had inspected both the Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: electrical system and appliances. The provider verified that the electrical system was last checked in April 2004, so will be due another inspection shortly. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 29 of 32 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 43 7 The registered person, which 03/07/2009 runs the home and is trading as a limited company must apply to the Commission for registration. People must be confident that the provider is appropriately registered. 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 2 Equality and diversity issues should be explored with people during the assessment process to ensure that needs are met. A recognised tool for assessment should be used to assess the level of risk of falls for a person with poor mobility. This would ensure that staff are prompted to look into all aspects of the persons needs so that there is a clear plan as to how these will be monitored. 2 9 Care Homes for Adults (18-65 years) Page 30 of 32 3 20 The provider should ensure that in the event of controlled medication being prescribed, peoples medicines should be kept secure in a cupboard that meets legal requirements under the Misuse of Drugs Act. Surveys should be in a total communication format so that people can use them independently to give formal feedback about the service they receive. 4 39 Care Homes for Adults (18-65 years) Page 31 of 32 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. 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. 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