Care Home: 1 Church Road

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What the care home does well 1 Church Road offers comfortable accommodation for the people who live there. All bedrooms are for single occupancy and all have full en suite facilities where personal care can be carried out in private. The home employs both male and female carers giving people some choice about the gender of the person who assists them with personal care. There is a complaints procedure in the home and all complaints are investigated. Recruitment practises are robust and minimise the risks of abuse to people living at the home. The home informs the Care Quality Commission of all significant incidents in the home. What has improved since the last inspection? Since the last inspection the management and staff have demonstrated a commitment to improving the care offered to people living at the home. A new manager was appointed in November 2009 which has bought leadership and direction to the home. Staff commented that they now felt well supported and were clearer about their job roles and responsibilities. The manager has also put systems in place to ensure that information is easier to access. One member of staff said that they felt that better communication and team work was leading to better care for the people who lived at the home. Since the last inspection all care plans have been reviewed and up dated and care plans seen were reflective of the peoples` current needs. People living and working at the home have been involved in the creation of new care plans meaning that they are now more personal to the individual. Staff are now asked to sign each care plan to say that they have read the plans. Staff commented that they now felt that the care plans were more useful in their day to day work. Monitoring and recording of health care needs has greatly improved. For example where there are concerns about peoples weight, a care plan has been put in place and people are being weighed regularly in line with the care plan guidelines. Weight records show action that has been taken to address issues including referrals to outside professionals. Recording of peoples epilepsy is now clearer and records give details of where hospital admissions have been required. Activities and social interaction has improved. Daily records now record the activities that people have taken part in and whether the person enjoyed the activity. On the day of this inspection some people went out shopping and others went out to lunch. It was observed that one person was helping to prepare lunch and another person said that staff assisted them to clean and tidy their room. One care plan seen showed that there is now a greater emphasis on encouraging people to learn and develop independent living skills. Many of the people living at the home are unable to fully express themselves and the home are beginning to use pictures to assist people to make choices about activities and food. One member of staff said "We have more ways of offering people choices." The manager stated that they are planning to expand the ways in which people are able to make choices and decisions. What the care home could do better: One requirement has been made as a result of this inspection. At the time of the inspection it was observed that doors on the landing had been wedged open to meet the needs of a person living at the home. To ensure safety in the event of a fire, doors must only be wedged open with devices that activate and close the door in the event of the fire alarm sounding. Assurances were given that a device would be fitted to the affected doors before the end of the week. 4 recommendations for good practise have also been made. Although care plans have been up dated, and provide guidelines for staff to follow, they remain bulky and could not be easily understood or accessed by people living at the home. The home should therefore look at how care plans can be made more meaningful to people. The home have begun looking at ways of offering more choices to people. It is recommended that all staff receive training about the Mental Capacity Act 2005 to ensure that where decisions are made on behalf of another person they are made in line with legal guidelines. Where food and fluid intake is being recorded the amount as well as the type should be recorded. This enables peoples intake to be more effectively monitored. There are two lounges in the home but these are attached to each other and can become noisy. The home should continue to explore the provision of an alternative lounge for people who wish to spend time quietly. Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Church Road 1 Church Road Wembdon Bridgwater Somerset TA6 7RQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Poole     Date: 2 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 1 Church Road 1 Church Road Wembdon Bridgwater Somerset TA6 7RQ 01278453635 01278456656 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Home First & Foremost Ltd Name of registered manager (if applicable) Mr Gary Bush Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 13. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD Date of last inspection Brief description of the care home 1 Church Road is registered to provide care for up to 13 people who have a learning difficulty and/or additional physical disability. The house is set in its own grounds in a quiet residential area on the outskirts of Bridgwater. All bedrooms are for single occupancy and all have en suite facilities. The registered providers are Milbury Care / Voyage. There is currently no registered manager at the home. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 13 1 0 1 1 2 0 0 9 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: At the last key inspection in November 2009 the home was rated poor and therefore the Commission held a management review to decide an action plan for improvement. Since the last key inspection the Commission has met with the providers of the service to discuss their improvement plan, carried out a random inspection with a specialist pharmacy inspector and shared information with the Local Authority under our Safeguarding Vulnerable Adults policy. The home has co-operated fully with all interventions and demonstrated a commitment to improving the quality of the service offered which has resulted in the new quality rating of 2 stars. This means that people who use the service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for Care Homes for Adults (18-65 years) Page 5 of 26 people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over a one day period by one inspector. During the day We, The Commission, were able to meet people living and working at the home, observe care practises, tour the building and view records. Many of the people who live at the home are unable to fully express their views therefore much of the information in this report has been gained from talking with staff and observing interactions and practises within the home. The manager and area manager were available throughout the day and all information requested was made available. Fees at the home range from £1066. to £2000. per week. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? Since the last inspection the management and staff have demonstrated a commitment to improving the care offered to people living at the home. A new manager was appointed in November 2009 which has bought leadership and direction to the home. Staff commented that they now felt well supported and were clearer about their job roles and responsibilities. The manager has also put systems in place to ensure that information is easier to access. One member of staff said that they felt that better communication and team work was leading to better care for the people who lived at the home. Since the last inspection all care plans have been reviewed and up dated and care plans seen were reflective of the peoples current needs. People living and working at the home have been involved in the creation of new care plans meaning that they are now more personal to the individual. Staff are now asked to sign each care plan to say that they have read the plans. Staff commented that they now felt that the care plans were more useful in their day to day work. Monitoring and recording of health care needs has greatly improved. For example where there are concerns about peoples weight, a care plan has been put in place and people are being weighed regularly in line with the care plan guidelines. Weight records show action that has been taken to address issues including referrals to outside professionals. Recording of peoples epilepsy is now clearer and records give details of where hospital admissions have been required. Activities and social interaction has improved. Daily records now record the activities that people have taken part in and whether the person enjoyed the activity. On the day of this inspection some people went out shopping and others went out to lunch. It was observed that one person was helping to prepare lunch and another person said that staff assisted them to clean and tidy their room. One care plan seen showed that there is now a greater emphasis on encouraging people to learn and develop independent living skills. Many of the people living at the home are unable to fully express themselves and the Care Homes for Adults (18-65 years) Page 7 of 26 home are beginning to use pictures to assist people to make choices about activities and food. One member of staff said We have more ways of offering people choices. The manager stated that they are planning to expand the ways in which people are able to make choices and decisions. 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 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 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 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. People wishing to move to 1 Church Road are able to visit and spend time getting to know other people before deciding to make it their home. Evidence: The statement of purpose for the home has been updated to reflect the changes that have occurred at 1 Church Road. Since the last key inspection one person has moved into the home. This person moved from another home owned by the same company. There was evidence to demonstrate that the person had been able to visit the home and spend time with other people living there before deciding to move in. After a short time a review was carried out to make sure that the person was settled and to enable them to express their views about their needs and expectations. Care Homes for Adults (18-65 years) Page 10 of 26 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. Care plans have been up dated to reflect current needs and are now more person centred. They would benefit from further development to ensure that they are more accessible and meaningful to the people living at the home. The home has improved the way that choices are offered to people by using a variety of communication methods. Evidence: Since the last key inspection all care plans have been up dated and are now more person centred. Care plans are large and not very user friendly for the people who live at the home but contain all information required by staff. Each care plan now contains a sheet that staff sign to say that they have read the care plan. These showed that a large number of staff had read each individual care plan. Staff spoken with said that they had input into the creation of the care plans and gave evidence that these are now being used by staff to ensure more consistent practise. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: 2 care plans were looked at in detail. One for the person who had recently moved from another home still contained their care plan that related to the previous home although new risk assessments had been put in place. The majority of issues that had a care plan raised for them had a short and long term goal, there was however no indication what timescales were being used or how the plan would be evaluated. The care plan only gave guidance for how the short term goal would be met. The second care plan seen had been fully developed in the home and was much more person centred and gave clearer guidance about how goals would be achieved. The staff and manager gave evidence that people living at the home had been involved in their care plan creation where this was appropriate. Each care plan gave a brief summary of the persons preferred routines and likes and dislikes. Risk assessments have been put in place for all areas of the care plan. In some instances the hazard was unclear, for example in one risk assessment the hazard section stated only behaviour in another a risk assessment had been written regarding slips and trips although the assessment and care plan did not highlight this as an issue for the individual. In addition to care plans each person has a daily record that is kept in a separate file. 4 daily record files were viewed in detail and discussed with staff. These now contain much clearer information about the persons day to day life, including the activities that they have taken part in and how successful and enjoyable the activity was to the individual. The home has also worked hard to develop the way in which choices are offered to people. Many of the people who live at the home are unable to express their preferences verbally and staff are now using pictures to enable people to make choices about activities and food. Staff spoken with were very keen to develop this further to ensure that people were able to make choices about all aspects of their lives. It is recommended that all staff receive training in the Mental Capacity Act 2005 to ensure that where they make decisions on behalf of people living at the home this is done in line with up to date legal guidance. Care Homes for Adults (18-65 years) Page 12 of 26 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 have access to activities that are appropriate to their abilities and interests. Staff support people to maintain contact with friends and family. Evidence: People are now having opportunities to take part in activities that are appropriate to them. As previously stated daily records now record the activities that people have taken part in and how successful and enjoyable it was for the individual. Staff spoken with were enthusiastic about sourcing activities that they thought people would enjoy. People living at the home are involved in day to day chores to assist them to maintain and develop individual living skills. One care plan seen gave clear details of how to assist someone to maintain their skills by enabling them to make drinks for themselves. On the morning of the inspection one person was assisting a member of Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: staff to make lunch and another person said that staff assisted them to clean and tidy their room. As previously stated the home are now using pictures to assist some people to make choices about activities. It was also noted that this was discussed at the last residents meeting. On the day of the inspection some people went out to lunch, others went shopping and some people spent time interacting with staff in the lounge and the garden. One person said that they enjoyed helping in the house, going to the cinema and to a local club. Currently no one living at the home attends college or has a job outside the home. It is hoped that some people will attend college courses when the new term begins. The home assists people to stay in touch with friends and family. Many people have regular visits to family and staff assist people by providing transport and support where required. The home has a four week menu that offers a variety of food. There is now a selection of two meals on the menu on each day to enable people to choose the food that they eat. On the day of the inspection the majority of people went out to lunch and staff ate with the few people who remained at the home. Care Homes for Adults (18-65 years) Page 14 of 26 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. Care plans give details of peoples preferences to ensure that they are supported with personal care in their preferred manner. The monitoring and recording of health care needs has improved since the last key inspection. Evidence: People living at the home are registered with local doctors and other health care professionals according to their individual needs. The new manager in the home gave evidence that they have built up relationships with local health care professionals to ensure that people receive appropriate advice and support. Care plans show the level of assistance people require with personal care and their preferences. One persons care plan said they liked to shower rather than bath and daily records showed that they were supported to do this. The home employs both male a female staff to enable people to have some choice about the person who assists them with personal care. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: There has been improvements in the way health care needs are monitored and recorded. Each person has an individual health care record and 4 of these were viewed. Discussions with staff and records demonstrated that any concerns about peoples physical health are being monitored and appropriate action taken. One person had lost a considerable amount of weight and had a care plan which said they were to be weighed weekly. Weight records in the health care file showed that this was being done and the persons GP had been involved. For another person there were clear records regarding their epilepsy and information about hospital admissions. This person has also moved to a more appropriate bedroom in the house to enable closer monitoring and observation when required. Records for another person, who was very slight in stature, showed that they were being weighed regularly and snacks were being offered. One care manager was spoken with during the inspection, they stated that they were very happy with the care that their client received and said that Everyone has made a great effort to turn things around. The staff record food and fluid intake for people on a daily basis. Currently only the type of food or drink is written and it is recommended that in order to ensure people receive a an adequate diet the quantity of food and fluid is also recorded. This will enable staff to monitor the amount taken and address any concerns promptly. At the random inspection carried out in January 2010 a pharmacy inspector from the Care Quality Commission inspected medication policies and procedures at the home. No serious concerns were raised about medication practises at the time of the random inspection or at this inspection. No one currently living at the home holds or administers their own medication. All medication is administered by staff who have received specific training in this area. Staff spoken with said that as well as completing training they also have their competency assessed on an annual basis. Medication Administration Records were viewed, all medication is checked and signed for when it enters the home and when administered or refused. This gives a clear audit trail. There are protocols in place for the use of as required medication to ensure that people receive these medicines when needed. These include the use of rescue medication for people with epilepsy. Staff spoken with said that they had received training in the administration of this medicine and were confident to do so. The home are currently piloting a new medication system and staff said that this was making them extra vigilant in the management of medication. Care Homes for Adults (18-65 years) Page 16 of 26 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. Any complaints made are treated seriously and fully investigated. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. The complaints procedure is clearly displayed in the home and is in pictorial form to make it more accessible to people living at the home. One complaint has been received by the home since the last inspection. This was recorded and investigated to the satisfaction of all parties. Staff receive training in the protection of vulnerable adults during their induction and have 2 yearly up dates. Staff spoken with were aware of the ability to take serious concerns outside the home. Two people living at the home said if they were worried about anything they would talk to a member of staff. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable environment for the people who live there. Bedrooms have been personalised to reflect the tastes and needs of the individual. Evidence: 1 Church Road is a large older style property, with accommodation set over two main floors. All areas are fitted with a fire detection and emergency lighting system. To meet the needs of a person living at the home fire doors on one landing are propped open during the day. This practise was discussed with the manager and area manager who gave assurances that a door guard would be fitted to these doors by the end of the week (30/04/10) This will mean that the door will automatically close in the event of the fire alarm sounding and therefore help to contain any fire and promote safety for people. All bedrooms are for single occupancy and all have full en suite facilities. A sample of bedrooms was seen and these had been personalised to reflect the needs and tastes of the individual. Bedroom doors are routinely fitted with key pad locks that the majority of people are unable to use. Some of these locks have now been replaced Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: with more suitable locks and keys. Communal areas are on the ground floor they consist of two adjoining lounges and a dining room. As stated in previous inspections as the two lounges are attached there is no alternative lounge for people who wish to spend time quietly. At the time of this inspection all areas seen were clean and fresh. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate staff on duty to meet the current needs of the people who live at the home. Recruitment procedures minimise the risks of abuse to people who live at the home. Evidence: The home employs 24 care staff, 13 (54 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. At this inspection staff appeared well motivated and clearer about their roles. One member of staff said Theres more leadership, we know where we are going now and another said We are much better supported now. All staff spoken with felt that there had been improvements in the home resulting in better, more personalised, care for the people living there. One member of staff said its a nicer place to work now and there is better communication and interaction. One person living at the home said staff are all kind and another person said All the staff are lovely. Newer staff said that they had undertaken induction training and had been able to shadow more experienced staff when they began work. Staff said that there was ongoing opportunities for staff training. A copy of the training matrix showed that the Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: the majority of staff have now completed statutory training in health and safety issues and other subjects relevant to their work such as epilepsy and autism. Since the last inspection there has been some changes to the rota to ensure that there are higher staffing levels during the main part of the day to enable people to take part in activities. Staff said that there were adequate staff on duty to enable them to spend quality time with people. Copies of rotas confirmed that the home is appropriately staffed to meet the current needs of people at the home. One new person has been employed since the last inspection. Their recruitment file was seen and this gave evidence of a robust recruitment procedure, which included seeking written references and obtaining a Criminal Records Bureau (CRB) check before the person began work. Care Homes for Adults (18-65 years) Page 21 of 26 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 manager gives clear leadership and direction to the home. There are systems in place to monitor health and safety in the home. Evidence: A new manager commenced work in the home six months ago. They are currently in the process of being registered with the Care Quality Commission. The new manager has given clear leadership and direction to the home which has improved staff morale resulting in staff being more motivated and enthusiastic about their jobs. Everyone asked said that the new manager was open and approachable. The area and home manager were available throughout the inspection, both demonstrated a commitment to providing a good quality of care and making ongoing improvements. Clearer systems have been put in place making information and records accessible. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: In addition to the manager there is a deputy and a small team of senior carers. Staff said that everyone works as a team and staff are clear about their responsibilities. The home has quality audits in place and the company has its own quality assurance systems. Over the last 6 months everyone has worked to identify and address shortfalls in the service. To seek the views of people living and working at the home there are regular meetings. Minutes of meetings showed that a variety of subjects have been discussed. Everyone living at the home has had their placement reviewed and some recommendations from these reviews have been put in place. To ensure the health and safety of people living and working at the home there are weekly and monthly audits. There is a fire risk assessment. Staff receive training in fire safety and take part in periodic fire drills, alarms and emergency lighting is tested each week. Records were seen of all tests and drills. As previously stated the fire doors must not be wedged open unless this is done with a device that activates in the event of the alarm sounding. Equipment in the home is serviced regularly by outside contractors. The home informs the Care Quality Commission of all significant events in the home. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R 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 1 37 8 (1) [a][b] A manager must be registered with the Care Quality Commission. To ensure that the home has consistent leadership and is able to improve and develop the service. 01/03/2010 Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 (4) Fire doors must not be wedged open. To ensure the safety of people in the event of a fire. 30/04/2010 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 The home should continue to develop care plans to ensure that they are accessible and meaningful to the people who live at the home. All staff should receive training in the Mental Capacity Act 2005 to ensure that any decisions made on behalf of people unable to do so are made in line with the Act Where food and fluid intake is recorded the amount taken should be recorded as well as the type. This will enable peoples diets to be effectively monitored where there are concerns. The home should consider the provision of a lounge area away from the busy areas of the home to enable people to spend time quietly. 2 7 3 19 4 28 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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