Inspection on 10/10/08 for The Royd

This inspection was carried out on 10th October 2008.

CSCI found this care home to be providing an Good 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

The Royd 17/12/07

The Royd 20/10/06

The Royd 17/02/05

The Royd 28/06/04

The Royd 09/03/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 06/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Royd 27 Selbourne Road Handsworth Wood Birmingham West Midlands B20 2DN     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: Kerry Coulter     Date: 1 0 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: The Royd 27 Selbourne Road Handsworth Wood Birmingham West Midlands B20 2DN 01215543544/523659 01215548700 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Kay Marie McIntosh Type of registration: Number of places registered: West Regent Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD) 16 Date of last inspection Brief description of the care home The Royd offers rehabilitative residential care for up to 16 younger adults with mental health problems and work closely with mental health rehabilitation and recovery teams. Accommodation is spread over two premises 23 - 25 and 27 Selbourne Rd on a core and cluster model. Extensive refurbishment, redecoration and building work was carried out to the home in July 2006. The premises are located next to one another on a residential street in Handsworth Wood and blend in well with other housing in the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 16 Brief description of the care home area. The home is conveniently situated for bus routes into Birmingham and around the city on the outer circle. All residents? rooms are large single rooms with en-suite bathing and toilet facilities. There are some communal toilets in each house. Both houses have large-scale communal kitchen and smaller laundry facilities. The managers and administrators offices are sited on the 2nd floor of house 23 - 25 and small staff offices are located on the ground floor of each house. There are large lounge and dining areas in each house and both houses have enclosed rear gardens. Copies of reports from the CSCI are available at the home, on request. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was carried out over one day, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Care Homes for Adults (18-65 years) Page 6 of 30 Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. Surveys were sent to four people who live at the home and all were returned, ten staff and six health professionals.Three staff and three health professionals returned surveys. Four of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. A partial tour of the premises took place. A sample of care, staff and health and safety records were looked at. Most people who live at the home were spoken to, however some people were out for part of the day. Discussions with staff took place and the manager was available for the visit. Information in the service user guide says the fees range from four hundred and seven pounds to eight hundred and thirtyseven pounds. The reader may wish to obtain more up to date information from the care service regarding the levels of fees. What the care home does well: What has improved since the last inspection? Lifestyle plans have been completed with people so that staff know about people likes, dislikes and personal preferences. Menu planning has been improved so that people have a more nutritious diet that helps keep them healthy. Arrangements have improved to makes sure people are supported to attend regular health checks, such as dentists and opticians. Medication practice has improved so that people get the medication they need, safely. Communal rooms have been redecorated and new televisions purchased so that the Care Homes for Adults (18-65 years) Page 8 of 30 home remains a nice place to spend time in. The system for ensuring the gas safety check is done has been reviewed to ensure the check is done annually so that gas installations are safe. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that prospective service users have the information they need to make a choice as to whether or not they want to live there. Before a person moves in their needs are assessed so to ensure that they can be met there. Evidence: It was observed that the Service User Guide was readily available in the home. This was up to date and included all the relevant and required information to help people decide if they would like to live at this home. Three out of the four people who returned surveys said that they were given enough information about the home before they moved there. The admission procedure for one person who had moved in since the last key inspection was looked at. Their records showed that an assessment of their needs was completed before they moved in to ensure they could be met at the home. They told us that they had the opportunity to visit the home before they moved in and also Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: undertook some overnight stays. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have most of the information they need so they know how to support the people living in the home. Risk assessments generally ensure that risks to people living in the home are managed in a safe manner. People are consulted on how they wish care and support to be provided. Evidence: The care files of four people were looked at, all had written care plans in place that people had signed to say they had agreed them. Care plans are regularly reviewed and cover areas of support such as mental health, physical health, support with managing finances and healthy eating, social and personal care. Since the last inspection staff have completed essential lifestyle plans with people to establish their likes, dislikes and preferences. Plans sampled were generally adequate to enable staff to safely meet peoples needs, however some plans needed further detail so that staff had all the information they Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: need. For example, one person had a care plan regarding their epilepsy but this did not describe the type of seizures they have or usual duration. Another person had a care plan regarding possible incidents of aggression, this guided staff to try and defuse the situation but did not say how they should do this. Meetings are held on a regular basis with people who live at the home, issues discussed include activities that people would like to do, self medication, health and safety, holidays and meals. Minutes of the meetings were available. Two people spoken with said they were happy with the frequency of meetings and that they were held when people wanted them. Surveys that we received from people living at the home indicate they are involved in decision making. One person told us that independence is encouraged, they gave examples of having their own bedroom key and own fridge in their bedroom for making drinks. Records sampled included individual risk assessments. These stated how staff are to support the person to minimise risks from areas such as manual handling, falls, self harm, mental health, roads and misuse of money. Some of the assessments sampled did not make clear all of the control measures in place to reduce risks to people. For example, the manager told us that for one person who may self harm that their bedroom is checked to make sure there are no sharp objects they might cut them self with. This was not recorded on their risk assessment, this needs to be recorded to make sure all staff know about it. One person has a risk assessment regarding having epilepsy, this guides staff to call an ambulance if the seizure causes breathing problems or unconsciousness. This would be improved by guiding staff on what to do if seizures are prolonged or repeated. Another persons risk assessment states they may sometimes run into the road, records showed this had happened twice in recent months but the assessment was not actually clear about what measures staff should take to prevent this happening. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that the people living there experience a meaningful lifestyle. Evidence: Records sampled and people spoken with indicate that people who live at the home have the opportunity to participate in an active lifestyle if they want to. One person said they loved living there and that they did their own food shopping and cooking, another told us they never get bored. Records sampled showed that activities on offer include visits to the pub, swimming, gym, college, employment training centre, cooking, shopping, gardening, religious services, trips out to places such as safari parks. A weekly activity time table is on display in the home so that people know what is on offer, this is in addition to peoples Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: own individual activity schedules. The manager said that the home had a new people carrier and this had made it easier to organise trips out. People are consulted about what activities they would like to do at meetings, records of meetings showed that people had also chosen the destination for their holiday. The manager said eight people had been on holiday to Bognor Regis. Since the last inspection one room has been changed so that it can be used for activities. The manager said it was intended to purchase a snooker and table tennis table for this room in the future. Some people enjoy doing in house leisure activities. One person spent most of the day knitting, they told us they prefer knitting to going out. Another played a board game with staff. At the last inspection in House 25 the television picture was observed to be of very poor quality. New flat screen televisions have now been purchased for both houses and the picture quality was much improved. People who live at the home are encouraged and supported by staff to maintain contact with friends and relatives and a record is maintained of each persons contacts. It is good that a relatives surgery is held monthly by the manager where relatives can visit the home and know that the manager will be available to discuss any issues they have relating to the home. People who live at the home confirmed they have opportunities to do their own food shopping and cooking. Some people prepare their shopping list and go out shopping with staff, others do this alone. At the last inspection it was identified that some people were not having a healthy diet. To improve things several staff have attended nutrition training, some people who live at the home also attended. People who live in House 27 continue to prepare most of their own meals as they are generally more independent but staff now cook most of the meals in House 25 where people need more support. This has meant that people are having a healthier diet. The home has a rotating four week menu and the choice of meals is put on a board so that people know what is on offer. There were plentiful supplies of fresh fruit and vegetables available, many vegetables to include runner beans and potatoes are grown in the homes own garden. One person told us the food was good, another said that they could have anything they wanted. As part of the homes quality assurance system people completed a questionnaire about their views of the home, the results of this indicated that people were happy with the meals on offer. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are generally well planned for and responded to ensuring that their health is promoted. People who live at the home usually receive their medication safely and as prescribed by the GP, where people self medicate they are assessed as safe to do so. Evidence: Most people who live at the home manage their own personal care, where people need support this is indicated in their care plan, this includes peoples preferences such as having a bath or shower. It was evident that people are able to dress, use cosmetics and have hairstyles that are individual and of their own personal choice. The health care records of four people were looked at. At the last inspection it was difficult to establish when some people had attended routine health appointments such as the dentist or optician. A new form has since been introduced that shows the health appointments attended by people so that staff know when they attended and when they are due to go again. Records were also available to show that peoples weight is regularly monitored as sudden weight loss or gain can be a sign of ill health. All Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: records sampled had information about signs that may show the person was experiencing mental ill health so that staff know what to look out for. We received surveys from three health professionals, these told us that the home always meets peoples health needs. One professional told us that the home prioritises their clients physical problems and ensures they get appointments. Some people at the home have health needs such as epilepsy or diabetes, training records show that most staff have received training in these areas so that they should know how to support people to stay healthy. Records sampled showed that staff receive training in the administration of medication. Medication is stored safely. Recently the homes medication systems have been audited by the supplying pharmacist, their report says that systems are very good. It is good that the home also does their own monthly audit to make sure medication is being administered safely. Medication administration records (MAR)were sampled and these included a photo of the person so that new staff do not get confused about who the person is when giving the medication. The medication records sampled had all been signed correctly and there were no gaps on the records. It is good that where able, people are encouraged to administer their own medication. At the last inspection risk assessments were not available for everyone who administered their own medication. At this visit assessments had been completed and regularly reviewed to make sure that people were safe to administer their own medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that the views of the people living there are listened to and acted on. The people living there are generally protected from abuse, neglect and self-harm. Evidence: We have not received any complaints about the home in the past 12 months. The home had received one complaint about noise levels and promptly sent a letter of apology to the complainant. The home has a complaints procedure and this is clearly on display in the home. Surveys received from people who live at the home indicated they know how to make a complaint. Discussions with staff and training records show that staff receive training in safeguarding people from abuse. It is good that staff who are employed in non caring roles such as the maintenance person have also done this training. Since the last key inspection the provider has linked with Elder Abuse to provide an independent helpline for safeguarding issues, this is available to staff and people who live at the home. Recently the home informed us about a potential safeguarding issue, appropriate procedures have been followed and the home ensured that social services were Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: notified. There is a safe keeping service for small amounts of peoples money and risk assessments have been completed regarding the support people need with their money. Records were available to show when money held had been returned to the person for spending. As recommended at the last inspection systems in place have been improved to ensure peoples money is effectively safeguarded. When peoples money is given to them either two staff or one staff and the person sign the financial record. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that people live in a homely, comfortable, clean and safe environment that generally meets their individual needs. Evidence: The home is made up of two separate houses, house 23 and 25 operate as one house and house 27 is located next door, there is no internal access between the two houses. A partial tour of the houses showed that it was generally in good decorative order, was homely, clean and at a comfortable temperature. Surveys received from people who live at the home indicate it is usually clean. The annual quality assurance assessment completed by the manager recorded that communal areas had been redecorated and that it was planned to purchase new lounge furniture this year. In house 23 and 25 there are nine bedrooms across the ground and first floor, which are all en-suite. Two people gave us permission to look at their rooms, both people told us they liked their bedrooms. Both bedrooms were of a good size and were personalised. There is large lounge and dining room, a separate room designated for activities, Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: laundry facilities and a fully enclosed and pleasant rear garden. There is a large kitchen, which enables more than one person to prepare and cook food at anyone time. House 27 provides seven people with bedrooms, all en-suite across the ground and first floor, there is a large lounge and dining area. There is a large kitchen and a small laundry room. The second floor provides staff with sleeping-in accommodation. Two people gave us permission to look at their rooms, both said they were happy with their bedrooms. Both said they had their own keys to their room. There is level access for people with movement and mobility needs throughout the ground floor in both houses, this includes accessing all communal areas. The first and second floors in both houses can only be accessed by using stairs and would not be suitable for anyone with mobility difficulties. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has demonstrated that it has the ability to ensure that people are supported by staff who know them well, who are well trained, available in good numbers and who are usually supervised. This ensures people benefit from a skilled and competent workforce. Evidence: The annual quality assurance assessment completed by the manager records that over 50 of staff have an NVQ in care and this ensures that staff have the skills and knowledge to meet the needs of the people living there. Surveys received from health professionals indicate they think that staff usually have the right skills and experience. Surveys received from people at the home indicate that staff usually listen to them and support them. Discussion with the manager indicates the home is fully staffed. The annual quality assurance assessment completed by the manager records that no staff have ceased employment at the home in the last twelve months. It is good that the home uses its own bank staff rather than agency staff to cover any staffing shortages. This means that people are usually supported by staff who know their needs well. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Rotas sampled show that there are usually a minimum of three support workers on duty during the day, plus the manager and deputy manager who work Monday to Friday. At night there are two waking and one sleep in staff. Discussions with staff and people who live at the home indicate that current staffing arrangements meet peoples needs. Currently, as house 27 is for people who are quite independent there is usually only one staff designated to work there, the manager will need to ensure that staffing in this area is regularly reviewed to ensure lone working meets peoples needs safely. The records of four staff employed at the home were looked at. Three records were satisfactory and showed that references had been obtained and a Criminal Records Bureau (CRB) check had been undertaken. This helps to ensure that suitable people are employed to work with the people living there. The home has good procedures to make sure that recruitment records contain all the required information as staff records are audited monthly and a copy of the audit is sent to the providers headquarters. However, despite having these systems in place the references for one member of staff were found to be missing. Evidence was available to show that references had been sought prior to the staff starting working in the home but the actual references could not be located. The manager took action during our visit to obtain replacement references and one reference was forwarded to the home during our visit. Following our visit the manager located the second missing reference and forwarded us a copy as evidence that references had been obtained. For one member of staff there was evidence that the CRB check had been applied for and they were not on the Protection of Vulnerable Adults (POVA) list. However the full CRB check had still not been completed despite being applied for over six months earlier. The CRB have sent the home a letter apologising for the delay. The manager said that as the check had not been completed the member of staff was not working unsupervised in the home. Rotas sampled sometimes recorded that this staff was the only person working in house 27. The manager said that when in house 27 the member of staff worked alongside the deputy manager. The manager was advised to record this on the rota to show that the staff was not working unsupervised. Records showed that new staff complete an induction to the home. Staff spoken with, and staff surveys received said that training was good. Staff training records show that staff receive regular training in topics such as manual handling, first aid, food hygiene, non violent crisis intervention, health and safety, mental health, safeguarding adults, infection control, fire safety and diabetes. Minutes of staff meetings showed that they are held regularly so that all staff are kept updated with the changing needs of the people living there, best practice and any changes happening within the organisation. Supervision records showed that most Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: staff had received at least six sessions in the last year to ensure they are supported and have the skills, knowledge and training they need to work with the people living there. Some part time staff had not received supervision recently and the manager was advised to improve the frequency of supervisions for part time staff. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure that the people who live there benefit from a well run home. The people who live there can be confident that their views underpin all self-monitoring, review and development by the home. Arrangements generally ensure that the health, safety and welfare of the people living there is promoted and protected. Evidence: The manager has been a registered manager for approximately five years managing residential care homes that provide support and rehabilitation for people with mental health needs. She has attended training courses specific to managing care homes, safe working practices and managing the care of people who live at the home. The manager achieved the Registered Managers Award in 2005. The manager returned the annual quality assurance assessment to us when we asked for it and it had been completed to a satisfactory standard. Throughout the inspection the manager was able to describe many of the needs of people at the home, direct and Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: lead staff and had clearly developed a good relationship with people. Staff spoken with during the inspection said that the manager was very approachable. It is required that a representative of the provider visits the home every month and writes a report of the visit to make sure the home is well managed. For 2008 there were only two reports available in the home. The manager said that other reports were available at headquarters but that there had been some gaps in visits. A further three reports were sent to us following our inspection visit to the home. For the reports that were availale these showed that people who live at the home and staff had been spoken with as part of the visit. The home completes monthly audits to include medication, staff records, accidents and complaints. Every year the operations manager completes an assessment of the home to ensure outcomes for people are good. Questionnaires are available for relatives and people who live at the home to complete about their views of the service. Most of the people who live at the home had taken the opportunity to complete the questionnaire and the results had been collated into one report. This indicated that the majority of people were satisfied with the home. Fire records showed that staff regularly test the fire equipment to make sure it is working. Regular fire drills are held so that staff and the people who live there would know what to do if there was a fire. Staff test the water temperatures regularly to make sure they are not too hot or cold. Records showed that at the last test these were within the recommended safe limits so that the people who live there are not at risk of scalding. Records showed that a Corgi registered engineer had completed the annual test of the gas equipment and stated that it was safe to use. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Care plans should be reviewed to ensure they contain satisfactory detail about the support people need. This will ensure staff have all the information they need to meet peoples needs. Risk assessments should be reviewed to ensure they detail all the control measures that are in place. This will ensure staff have all the information they need to keep people safe from harm. Where staff are working in the home but a full CRB check has still to be received arrangements need to be clearer regarding who is supervising the member of staff. The frequency of supervision for part time staff should be improved to ensure all staff receive the support they need to enable them to meet peoples needs. The providers representative should visit the home more frequently and write a report of their visit which should be available in the home. This will help to make sure the home is being well managed. 2 9 3 34 4 36 5 39 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. 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