Care Home: 1 Ford Road

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What the care home does well There is a relaxed and friendly atmosphere in the home and staff know how each person likes to be supported.There is a reliable staff team who have training to make sure that they can meet the needs of everyone who lives in the home. People who use the service can take part in a range of activities, both in and outside of the home.Page 9 of 33Care Homes for Adults (18-65 years)Visitors are made welcome.People can keep in touch with their friends and relatives and the home helps them to do this. A relative told us that staff and managers respect the people who use the service and treat them as individuals. A person who lives in the home told us "I like to stay here". What has improved since the last inspection? Care plans are being written in a better way.A communication co-ordinator is working with people who live in the home and with staff to help them with their skills.The bathrooms now have locks that work on the doors so that people have more privacy.Work has been done in the garden to make it look better.The home has a system to make sure that it listens to what people who live there think about the service. What the care home could do better: A place to store particular medication that people living in the home should be provided, in line with changes in the law. Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Ford Road 1 Ford Road Gosport Hampshire PO12 3ET 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: Laurie Stride Date: 1 9 0 6 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 33 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) 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. 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 CQC 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 33 Information about the care home Name of care home: Address: 1 Ford Road 1 Ford Road Gosport Hampshire PO12 3ET 02392501001 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): nikkiey.quirke@has.org.uk Hampshire Autistic Society Name of registered manager (if applicable) Miss Amy Jane Sanger Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: The maximum number of service users who can be accommodated is 5. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - (LD). Date of last inspection 0 2 0 7 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Five people live at the home. The home is near to the town and they can use the bus to get there. They all have their own bedroom. Fees range from 62051.62 pounds to 62217 pounds per year. Care Homes for Adults (18-65 years) Page 5 of 33 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 33 How we did our inspection: This is what the inspector did when they were at the care home We (the commission) visited the home and did not tell them we were coming. We looked at how well the home was doing since we last visited them on 02/07/07. We were in the home for five hours. Care Homes for Adults (18-65 years) Page 7 of 33 We met the people who live in the home and spoke briefly with some of them. We also talked with the manager, a staff member and the relatives of someone who lives in the home. The home gave us information about what they were doing in their annual quality assurance assessment (AQAA). We sent survey questionnaires to people who use the service, staff and other people who have contact with the service. We received replies from all the people who use the service and two staff members. Staff helped the people who live in Page 8 of 33 Care Homes for Adults (18-65 years) the home to complete the form. What the care home does well There is a relaxed and friendly atmosphere in the home and staff know how each person likes to be supported. There is a reliable staff team who have training to make sure that they can meet the needs of everyone who lives in the home. People who use the service can take part in a range of activities, both in and outside of the home. Page 9 of 33 Care Homes for Adults (18-65 years) Visitors are made welcome. People can keep in touch with their friends and relatives and the home helps them to do this. A relative told us that staff and managers respect the people who use the service and treat them as individuals. A person who lives in the home told us I like to stay here. Care Homes for Adults (18-65 years) Page 10 of 33 What has got better from the last inspection Care plans are being written in a better way. A communication co-ordinator is working with people who live in the home and with staff to help them with their skills. Care Homes for Adults (18-65 years) Page 11 of 33 The bathrooms now have locks that work on the doors so that people have more privacy. Work has been done in the garden to make it look better. The home has a system to make sure that it listens to what people who live there think about the service. Care Homes for Adults (18-65 years) Page 12 of 33 What the care home could do better 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 Laurie Stride Care Quality Commission SE Citygate Care Homes for Adults (18-65 years) Page 13 of 33 Gallowgate Newcastle upon Tyne NE1 4PA Tel 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 14 of 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 15 of 33 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 interested in using the service have their individual needs assessed before a place is offered, to make sure that the service can meet their needs. Evidence: The homes annual quality assurance assessment (AQAA) told us that there have been no new admissions. The people who live at the home have done so for 17 years. The AQAA stated that the assessment procedure will be reviewed with the introduction of the Individual Support Framework for all people who use the service. The Statement of Purpose and Service User Guide are regularly reviewed and updated. During our visit we saw that a care review was taking place in relation to one person who lives at the home, who had chosen not to attend. The persons parents and care manager were attending the review with the homes manager. We looked at a sample of two individuals care and support plans and saw that their assessed needs are reviewed on a monthly basis. Care Homes for Adults (18-65 years) Page 16 of 33 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 use the service have their assessed and changing needs reflected in their individual plan. The service supports people to make decisions and to take risks as part of an independent lifestyle. Evidence: The AQAA told us that person centred support planning is continuing to be developed by the service and that care plans and risk assessments are reviewed following any incidents. We saw that the home is introducing a new format for care planning and there were records of monthly reviews of individuals current care plans undertaken by their key workers. Records were also on file in relation to wider reviews held on a six monthly and annual basis and we observed one such meeting taking place. Prior to our visit we had received notifications from the home about incidents involving people who use the service, in particular one person displaying behaviours of a physical nature towards other people who live in the home. We looked at this persons support plans and saw that a risk assessment had been drawn up in April and updated in May and Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: in June. This and a behaviour support plan gave clear guidelines for staff working with the individual. Another persons support plan included guidelines for reducing their anxieties about missing out on attending a club through supporting them to understand time. We saw that the service has a designated communication co-ordinator who was working with this person and the staff team, in the home and at the day service, on developing sign language and communication skills. Through working on improving communication and understanding, the home supports people using the service to make choices and decisions. We spoke with a member of staff who demonstrated a good knowledge of the care plans we had seen and of the agreed ways of working with the individuals concerned. We observed staff speaking in a calm manner to people who use the service, explaining things to them and helping them to exercise choice and control over everyday things, such as making drinks and discussing visits to relatives. We received responses to our survey from the five people who use the service, who were assisted with the questionnaire by members of staff. Three people indicated that they always make decisions about what they do each day. One person said they usually do and the other said sometimes. Responses to our survey by two staff members indicated that they are always or usually given up to date information about the needs of the people they support (for example in the care plan). They also indicated that they feel they always or usually have enough support, experience and knowledge to meet the different needs of people who live at the home. The staff training programme provides training that is relevant to meeting the needs of people who use the service, for example autism awareness and understanding behaviour/communication. Care Homes for Adults (18-65 years) Page 18 of 33 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. The service is run in a way that promotes flexibility in daily routines and is focused on the needs and wishes of the people living there. A range of activities is offered and individual food preferences are catered for. Evidence: The AQAA told us that people who use the service have full involvement in community activities and daily living activities. Each person has a day service package with clear structures and support guidelines to meet their needs. Daily routines are individualised and people who live in the home take part in menu planning. The AQAA also stated there are plans to look at options for supported employment via the day service. At the time of our visit all of the people who live at the home were at the day service until late afternoon. The sample of support plans we looked at showed the structured activities schedule for each person while they are at the day service. For example, environmental studies, musical movement, history project, communication/advocacy, social outings and needlework. The manager told us that, as a result of listening to Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: people who use the service, there is one day a week when service users take a day off from going to the day service and take part in daily living activities such as shopping. The manager said the home has a good relationship with the local supermarket staff, who understand and are supportive of the service users needs. People who live in the home are encouraged to take part in other daily routines within the home, such as cleaning and doing their own laundry, and this is reflected in their support plans and schedules. We saw menu books that show individual food preferences and choices of meals. Staff support individuals to eat healthily. We saw that fresh fruit was available in the dining room. The home has a visitors policy and encourage the involvement of peoples families in planning individuals care and support. During our visit we met the parents of one person who uses the service and they were very positive about all aspects of the service being provided. They told us that staff and managers respect the people who use the service and treat them as individuals. One person who lives in the home indicated in our survey that they like all the dinners. Another told us they like to watch particular television programmes and that they like their bedroom. One individual person said that they like going in the minibus for a drive at the weekend and added that this is not always possible. We also received survey responses from two staff members. One told us that the home could do better at enabling people who use the service to have more varied time outside of the day service, but that this was hampered by financial constraints and staffing levels. During our visit the manager showed us the staff rota and told us about a recent change that had been made in the deployment of staff and one-to-one time for service users. This allows for a third staff member to be on duty every other weekend, which increases opportunities for people living in the home to go out if they wish. Care Homes for Adults (18-65 years) Page 20 of 33 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 who use the service receive personal support in a way that suits their needs and wishes and are protected by the homes policies and procedures for dealing with medicines. Evidence: Each person who uses the service has a designated key worker and a health action plan. The daily records and office diary showed that people have access to health care services when needed and the outcomes of medical appointments are recorded. Care plans contained information and guidance for staff about how individuals like to be supported. A member of staff talked to us about the involvement of the communication co-ordinator in supporting staff in monitoring health issues for the two individuals whose care plans we saw. The home ensures that female service users have access to health screening through liaison with the Community Learning Disability Team. The home has policies and procedures for the safe management of medications and we looked at a sample of the medication administration records. These were signed by staff and up to date and matched the medication remaining in the monitored dosage system. A second record is signed by a member of staff who observes the medication being given. The night staff undertake an audit of the records and medication stocks and this is also recorded, so that any errors would be quickly identified. The medication is stored in a Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: wooden cabinet and there is no facility for controlled drugs if these were needed, which does not comply with current legislation. There were no controlled drugs being held in the home at the time of our visit. However, the legislation requires that care homes have a controlled drug facility, which is a metal cupboard of a specified gauge, with a specific double locking mechanism, fixed to a solid wall or a wall that has a steel plate mounted behind it and fixed with either Rawl or Rag bolts. The manager told us that training for staff in the medication procedures is currently delivered by line managers, but that the organisations training and development manager is undertaking more in-depth training that will be then be passed on to staff in July this year. Care Homes for Adults (18-65 years) Page 22 of 33 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. People who use the service can be confident that their views are listened to and acted on. The homes policies and procedures, backed up by staff training, protect people from abuse, neglect and self harm. Evidence: The home has policies and procedures for dealing with complaints. Responses to our questionnaire from the five people who use the service, who were assisted with the questionnaire by a member of staff, indicated that three of them know who to speak to if they are not happy. Two individuals did not respond to the question. No one indicated that they know how to make a complaint. There are monthly one-to-one meetings in the home where people who use the service are encouraged to raise any issues or concerns. The AQAA told us that the home plans to use these meetings and the improved individualised communication systems to raise service users awareness of the complaints procedure. Both staff members who took part in the survey confirmed they know what to do if someone has concerns about the home. We observed that people who use the service expressed themselves freely and approached staff about things they were concerned about. A complaints log is in place to track any complaints and the homes response to them. We spoke to the parents of one of the people using the service and they told us that the staff and manager were very approachable and that they were confident that if they had any concerns these would be dealt with appropriately. We saw that behavioural support plans were in place for one person whose behaviour occasionally caused problems for other people living in the home. The way these Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: guidelines were written demonstrated a positive approach to understanding and working with the individual and the behaviour. Any incidents were recorded and the home had notified us in line with the regulations. At the time the AQAA was written there had been one safeguarding referral made by the home, followed by an investigation by Adult Services in line with the local authority procedures. The manager showed us the minutes of the final strategy meeting on 11/03/09 concluding the investigation and detailing the actions the service had taken to ensure that all staff work in accordance with the homes policies, procedures and code of conduct. Since the AQAA was written, the home had notified us of other incidents that they had referred to Adult Services, one of which was followed up by a strategy meeting on 02/06/09. The decision made at this meeting was for the home to continue monitoring the situation in line with the relevant behavioural support plans. The home has demonstrated that any allegations or matters of potential abuse are dealt with in line with the local authority procedures to protect people who live in the home. Records showed that training in safeguarding adults is given to staff. We spoke with a member of staff who told us they would report any suspected abuse to the manager. The manager was clear about her responsibilites in line with the local procedures. Care Homes for Adults (18-65 years) Page 24 of 33 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 who use the service benefit from living in a homely environment that promotes their independence. Evidence: The manager showed us round the home, which is kept as homely and domestic as possible. There are photographs around the home of the people who live there, two televisions, a computer and an exercise bike. People who use the service had personalised their bedrooms and can participate in choosing decoration and furniture for the communal areas. The homes service user survey had identified that one individual wanted a new sofa for the lounge, as the old one is showing signs of wear and tear. The lounge walls and area around the patio door were also looking worn and there was a burn mark on the carpet from an iron. The manager said she has put in a request for the lounge and dining room to be re-decorated. Since the last inspection the garden has been revamped with new plants. The previous inspection report made a recommendation about the home having working locks on bathrooms to uphold peoples privacy. During this visit we tested the locks on both bathrooms and found these to be in working order. All but one of the people who live in the home have their own bedroom door key and the manager said it was the choice of the individual not to have a key. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: One of the people who live in the home had recently had obscure glass fitted in her bedroom window, which overlooks the street at the front of the house. This was due to the persons lack of understanding about privacy. At the time of the previous inspection report, staff had worked successfully with her and had got to the stage where she was able to use the curtains and have clear glass in the window. We saw that staff were engaged in ongoing discussion with the individual about the reasons for the current change, which demonstrated a flexible approach to meeting peoples changing needs. The laundry facilities are domestic in scale and people who live in the home had chosen the days on which they do their laundry. A kitchen cupboard containing cleaning chemicals had a lock on it. Records showed that all staff received an infection control training update on 15/04/09. The people in the home all indicated in our survey that the home is kept fresh and clean. Care Homes for Adults (18-65 years) Page 26 of 33 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. People who use the service are supported by suitable numbers of trained and skilled staff and are protected by robust recruitment procedures. Evidence: The AQAA told us that the retention and recruitment of suitable staff had been a barrier to improvement in recent months. In order to try to address this, the rotas had been reorganised and the service had been raising the profile of the organisation through advertising. A staffing coordinator had been employed within the company to co-ordinate relief staff and there were plans to fill two vacancies and to develop service user involvement in the staff recruitment process. During our visit we saw how the rota had been changed in order to improve the staffing level at weekends and the manager told us that two new staff members had been recruited and were awaiting start dates. We looked at the personnel files for two members of staff and saw that these contained records of all the required pre-employment checks, including Criminal Records Bureau (CRB) and two written references. Completed application forms with employment histories, interview notes, contract of employment and probationary reviews were also on file. Two staff members who completed our survey confirmed that their employer carried out checks, such as their CRB and references, before they started work. The AQAA told us that out of five full-time and three part-time staff, four have achieved Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: National Vocational Qualifications (NVQ) in care at level 2 or above and three other staff members are working toward the qualification. The manager confirmed this and certificates were held in the individual staff members files. There is an induction and training programme and we saw that the manager has a system of recording scheduled and completed training for each staff member. A staff member we spoke with said that the training is good, there is a good and settled team and that she feels well supported by the organisation. The two staff members who completed our survey told us that their induction covered very well or mostly everything they needed to know to do the job when they started. Both confirmed that they are being given training that is relevant to their role, helps them understand and meet the individual needs of people, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. Both indicated that their manager gives them enough support and meets them regularly to discuss how they are working. Asked what does the home do well, one staff member told us I think the unit has a good staff team and the service users like living here. Another said it works well to ensure that all service users have a secure environment to live and work in. People who use the service indicated in our survey that the managers and staff treat them well and listen and act on what they say. During our visit we observed that staff were skilled in communicating with people who live in the home and had a good understanding of their needs and of issues relating to autism. Care Homes for Adults (18-65 years) Page 28 of 33 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. People who live in the home benefit from a well run service and can be confident that their views underpin its development. The health, safety and welfare of people who use the service and staff are promoted and protected. Evidence: Since the last inspection the home has had a change of manager. The current manager has been in post since 10/11/08 and has applied for registration. During our visit we observed that the manager was responsive to and interacted well with people who live in the home, visitors and staff. A quality assurance system has been implemented since our last visit and we saw samples of the service user questionnaires, which are in picture format. The manager said that feedback obtained through the survey informs individuals person centred planning and circle meetings. Staff and relatives surveys for this year had not yet been sent out. Relatives also have opportunities to give feedback at reviews. We saw reports of monthly visits to the home by the service providers representative, which monitor all aspects of the service and draw up action points if needed. The service had improved on this process through responding to these internal reports with written confirmation of Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: actions taken. The organisation has an annual development plan and we saw there is a plan specific to the home that links with the strategic one. Safe working practices are promoted in the home. Records showed that staff receive mandatory training in Health and Safety, First Aid, Food Hygiene, Infection Control, Moving and Handling and Risk Assessment. We saw the fire safety log book, which indicated that fire drills are carried out regularly with staff and people who use the service. There were up to date records of checks and tests of the fire alarm system, fire risk assessment and gas safety certificate. Care Homes for Adults (18-65 years) Page 30 of 33 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 31 of 33 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 20 13 The home must make sure that a suitable storage facility is available for any controlled drugs that individuals may be prescribed, in line with changes to the legislation about peoples medication. 18/09/2009 This is to ensure that the proper and legal safeguards are in place when care workers give controlled drugs to people who use the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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