Care Home: 1 Greville Road

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What the care home does well All potential service users have their needs fully assessed over a period of time with a gradual introduction to the home and other service users before they move into the home. The care planning system in person centered and contains all the information the staff would need to know how that person likes to be supported and these are in pictorial format to enable the service users to participate in. Staff provide good support to the service users, helping them to make decisions about their lives, the activities that they take part in and to maintain contact with their families. Surveys received from the service users indicated that they are able to choose what they wish to do and are supported to do so. Comments on an advocates survey returned to CQC told us that `The staff are very caring and respectful to the residents` individual needs. The house is always welcoming and the residents always appear well cared for`. Another comment from an advocate and friend said `They provide a warm, caring ambience and they treat each person with respect. I cannot think of anything they could do better. It is my friend`s home and I want him to live out his days there`. A nutritious diet is provided and service users choose and plan their own menus and shopping lists and accompany staff to do the shopping. The home also provides good support to meet the personal and health care needs of the service users and medication is stored safely and administered by suitably trained staff. A structured programme for a range of training is in place to ensure that the staff can meet the needs of the people living in the house. Staff said in their surveys that they receive training that is relevant and gives them the knowledge to support the service users in their care appropriately. The manager promotes the health, safety and welfare of the service users and staff. Staff are well supported by the manager and they say that the `team work well together and puts the needs of the service user first`. What has improved since the last inspection? The requirements made from the previous inspection report have been complied with. The rubbish on the fire escape and in the garden has been cleared and the garden is now tidy and accessible to the service users. Service users choose what they would like to eat for each meal. The communal rooms and bathrooms and shower rooms have been redecorated. The garden shrubs have been cut back to ensure they do not block the pathways. What the care home could do better: The medication cupboards could be kept cleaner. Information and consultation with the pharmacist must be sought with regards to the length of time liquid medicines can be opened before they expire. Medication must be stored at the appropriate temperatures as stated on the information label to ensure its effeciency. Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Greville Road 1 Greville Road Shirley Southampton Hampshire SO15 5AW     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: Janette Everitt     Date: 0 9 1 2 2 0 0 9 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 31 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) 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 31 Information about the care home Name of care home: Address: 1 Greville Road 1 Greville Road Shirley Southampton Hampshire SO15 5AW 01242512964 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: HM4011Smart@mencap.org.uk www.mencap.org.uk Royal Mencap Society care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies 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 Brief description of the care home 1 Greville Road is a residential home providing care and support to 7 older service users with learning disabilities. The homes standards are measured using the Care Homes for Adults (18-65) because of the complex needs of the service users living within the home. The home is a large domestic style house providing a homely and comfortable appearance inside and out, blending well with other homes in the local area. Each service user has a room of their own that has been decorated and adapted to meet their individual needs and characters. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 7 1 8 1 2 2 0 0 8 Brief description of the care home The home is situated in Shirley, a residential area of Southampton. It is close to Southampton city centre, Shirley High Street and a local amenities store with in easy walking distance. The home is local to Southampton common and Southampton sports centre where yearly attractions and community events are held. The home is owned by Hyde Housing and is leased to Mencap, a national organisation providing care and support to service users with learning disabilities. For information about fees contact the manager of the home. Care Homes for Adults (18-65 years) Page 5 of 31 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: We got our information to write this report in lots of different ways. For the purpose of this report CQC will be referred to as we and us. We checked to see if anyone had made a complaint to us about 1 Greville Road and found that they had not. We also looked at any information the home had given us about what might have happened since we last visited. We used some of the information that the manager, Helen Smart gave us about the home. We got this information in a big form the registered manager has to fill out each year called the Annual Quality Assurance Assessment (AQAA). It tells us what the staff are doing to make it a good place to live and if there is anything they want to do better. We visited the home on the 9th December 2009 and stayed for 5 hours. During the Care Homes for Adults (18-65 years) Page 6 of 31 visit we were able to speak with four of the people who live in the home and ask them what it was like to live there. We were also able to see how the people who live there spend the day and what they do with staff. We were able to talk to two staff about what it was like to work at the home. Some time was spent looking at the records for three people who live in the home. This was to make sure everyone knew how the person liked to spend their time and what help they needed from staff to let them do these things. Other records were looked at to make sure the home was safe to live in. We distributed surveys to the service users, staff, visiting professionals and advocates. We received five surveys back from service users, six staff surveys, one visiting professional and two advocates. Comments received were very positive and indicated a high level of satisfaction with the service provided in the home and staff indicated that they have good training opportunities and feel well supported by the manager. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 8 of 31 The medication cupboards could be kept cleaner. Information and consultation with the pharmacist must be sought with regards to the length of time liquid medicines can be opened before they expire. Medication must be stored at the appropriate temperatures as stated on the information label to ensure its effeciency. 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 9 of 31 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 31 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. Service users benefit from having their needs and aspirations assessed prior to moving into the home. Evidence: A sample of three care plans and assessments was viewed by us. These evidenced that the home requires a full care management assessment for each person from social services before they move into the home. Records showed that all assessments were in place prior to the person moving in and that service users and, where possible, their families had been involved in the assessment and signed by them. The manager told us that once she has received the referral and care needs assessment she undertakes a comprehensive assessment of the service users before they move into the home. The assessments seen covered all aspects of the persons care for their physical, psychological and emotional needs as well as stating their preferences and abilities and their aspirations for their future life. The current residents are quite elderly and have been living at the home for many years. The last resident to move into the home was four years ago. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: It was observed that the service users records contain a House brochure that is produced in a photograph and graphic format and is shown to the service user before they visit the home. The manager told us that prior to a person moving into the home, the visits to the home extend each time and that there is a gradual introduction to the home for them to meet the other service users living in the home and get familiar with the environment. Care Homes for Adults (18-65 years) Page 12 of 31 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. Service users have care plans and risk assessments in place to support their needs and are supported to make decisions within their daily lives. Evidence: A sample of three care plan records were viewed. The care plans seen were person centred and clearly related to the initial assessment and ongoing information that had been gathered about the person. The care plans were produced in a pictorial format to allow the residents to better understand and be involved with their plans. The care plans are also very informative to enable staff to support the person appropriately. It was observed that the service users had signed the care plans to say they agreed with them. Two service users receive support from an advocacy service and they are involved with the reviews of the care plans for their clients. Two surveys were received from advocates that said the staff are very caring and respectful of the residents and their individual needs. There is genuine respect between the carers and the residents. It is their home in all senses of the word. Another said the home provides a warm, caring ambiance and the staff treat each person with respect and I Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: cannot think of anything that needs to be changed with regards to my friend. The home has a system in place that demonstrated that the service users have monthly meetings with the key worker to discuss and review the care plans. Records were kept of these meetings making good use of pictures and diagrams to make it easier for service users to describe how they felt about the service and the support they were receiving. There was evidence in the care records that each service user has an annual review meeting with the key worker, the family or representative and the care manager to discuss if their needs have changed. There was evidence through observation that service users were supported to make their own decisions to include the activities they were involved with and their choice of food and decoration of their rooms. One service user told us that he was doing his washing that morning and would be cleaning his room after lunch but would need help from the support worker on duty to complete that task. Risk assessments were seen to be written and reviewed on a regular basis and staff were clear about risk management. One service user goes out into the community on his own and there was evidence of a risk assessment for this activity and a care plan documented to manage any risks. The staff surveys returned indicated that the staff always receive all the information they need to be able to support the service users with their daily lives and that they put the needs of the service user at the forefront of everything we do. Care Homes for Adults (18-65 years) Page 14 of 31 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. Service users benefit from having their rights respected and from a balanced nutritious diet. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. Evidence: The care records evidenced that each service user has a programme of activities planned for each week based around their interests and preferences. The programmes demonstrated that service users go out into the community and are escorted by a support worker. One service user, who was out at the time of this visit, goes to a day centre twice a week. Another service user was going to the local shops to do some shopping for the home and other service users and another was going swimming with a support worker who comes to the home specifically to do this once a week. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: It was observed that two service users were engaged in doing puzzles together and the manager told us that this is a daily routine and they enjoy one anothers company and enjoy choosing the puzzles to do together. Two of the service users are quite elderly and they prefer not to go out into the community for local activities. The manager told us that a few family members do visit the home but not frequently except for one service user who has regular contact with their family and who are involved with the service users care. The service users told us they do not have to do anything they do not wish to do. Service users are encouraged to form relationships outside of the home and have done so when visiting other homes in the same organisation. Service users spoken with at the time of this visit said they were happy with their lives. Five service users completed surveys with the assistance of their key workers and returned them to CQC. They all indicated that they could do what they liked and had choices in their activities of daily living. One comment was I can do what I like and I am happy as I am. A survey returned by an advocate commented that more time should be allotted to each resident to enable the support workers to help them enhance their lives by going out more frequently and participate in outside activities. A staff member who returned a survey said if the home had access to a vehicle we could take the residents out on a regular basis. Service users enjoy a nutritious diet. A menu plan is decided upon once a week with the service users writing down suggestions for meals for the coming week. Two of the service users help with the weekly shopping. There is a choice of food at each meal time and there was evidence that what each person eats is recorded daily. There is a choice of a cooked breakfast every day if requested. The staff go around each morning to discuss what is on the menu for the day. They are aware of the service users food likes and dislikes and these are recorded in the care plan assessments. The main meal is served in the evening to allow for people going to day centre and other activities. The meal is served in the dining room and the manager told us that the service users enjoy eating together and this becomes a time for socialising and talking, although she emphasised that the service users do have the choice of eating where they wish. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The lunchtime meal is sandwiches or whatever the service users wish to have and one service user spoken to confirmed that he had had what he had chosen for his lunch. The manager told us that snacks are available throughout the 24 hour period and service users have access to the food at any time. Service users told us that they enjoyed their meals. Weights are monitored every three months and healthy eating is encouraged. If a risk is identified the person is monitored and would be referred to the GP for dietary advice. Care Homes for Adults (18-65 years) Page 17 of 31 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. Service users benefit from having their health care needs met and are protected by the medication policies and practises in the home Evidence: The care plan records how the service users prefer to be supported with their personal care. The care plans detail to what degree the service users needs support with specific tasks. Most of the service users are quite independant but do still need some degree of support with their personal care. The health status of the service users is recorded and all visits from healthcare professionals and outcomes from the visits are recorded in the care plans. Service users are supported to use the appropriate health care services like GP, the mental health team, chiropody, dentist and opticians, as needed. Service users have yearly healthcare checks and medication reviews. The home has blister pack system for the administration of medications. The medications are stored in a locked cupboard in the dining room. The cupboards were viewed. The shelves were very sticky and in need of cleaning. It was observed that Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: there was one persons medication bottle which had been open for some time and needed to be returned to the pharmacist as being out of date. A new bottle of medication to use on an as needed basis was in stock. It was also observed that a medication to be stored below 25 degrees needed to be in a fridge as the atmosphere was quite warm. This was discussed with the manager who said she would arrange this immediately. The home has clear policy and procedures for the administration of medication. Staff have received appropriate training and staff training records evidence this., The home has protocols in place for people who have been prescribed as needed (PRN) medications. The medication administration recording (MAR) charts were seen to be well recorded and had a photograph of each of the service users on the front page. There were no service users choosing to administer their own medication at the time of this visit. Care Homes for Adults (18-65 years) Page 19 of 31 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. The policies and practices of the home protect service users and promotes their involvement in the running of the home. Evidence: The home has a complaints policy and service user surveys received by CQC indicated that the service users would know how to make a complaint. The complaints policy is presented in an easy read format and service users have their own copy. The AQAA told us that no complaints have been made since the last inspection. The manager said she would log any complaints and any outcome actions from the complaint. None had been recorded. The manager told us that key workers discuss any issues with the service user at their monthly review meetings and therefore any issues can be resolved at the time. The home has an adult protection policy and the manager is clear about the responsibility to work within the local procedures. Staff are aware of the procedures associated with any form of abuse and receive safeguarding training. The member of staff spoken to demonstrated that they understood their roles within the safeguarding procedures. Service users told us they felt safe in the home and observation of the interaction between staff and service users demonstrated that service users appear relaxed and Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: comfortable with the staff. The manager and her deputy have received training on the mental health act (MCA) and the deprivation of liberty safeguards (DOLS) and this is to be disseminated to staff by them. Each service user has a financial risk assessment in place. The home does store small amounts of monies for some service users. Each service user has a bank account that their pensions and allowances are paid into. It is from this that the service users withdraw any monies they need and this is stored in the home in individual containers. These were viewed by us and records checked and demonstrated that the balance of monies matched that of what the records showed. All outgoing monies has been recorded with receipts for purchases. The manager told us that two members of staff audit the monies every day. Care Homes for Adults (18-65 years) Page 21 of 31 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. Service users live in a clean and comfortable environment. Evidence: The AQAA stated that the home now has a new shower, toilet and radiators and wet chairs fitted. The bathroom and shower room has been re tiled and new floors and decorated. There has been other areas of redecorations. The home has regular maintenance checks. The AQAA says that staff support service users to maintain the cleanliness of the home and some are able to clean their own room. We looked around the home. The house is well maintained and in good decorative order and service users told us they chose the colours for their own rooms. The rooms visited were very individual and reflected the service users hobbies and favourite football teams. The previous report identified some rubbish in the garden and on the fire escape and immediate requirements were made. This has been complied with and removed and the garden, although winter, looked tidy and accessible to the service users should they choose to go out into the garden which has a patio area for sitting. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: The manager told us that all repairs to the house are undertaken by the housing association that the property belongs to. The manager told us that currently there is discussion between the managing organisation and the housing association for the installation of a lift and quotes are being obtained for this. It is anticipated that with the ageing service users currently living in the home there may be a time that the stair lifts in use will not be sufficient to meet their mobility needs. The house was observed to be clean and service users clean their own rooms with the support of the key worker. One service user told us that he had changed his bed and done his washing and would be cleaning his room that afternoon. The carer told us that he would be supporting the resident to do this. The home has an infection control policy in place and staff have received training on this. Hand washing facilities are in place in toilets and bathrooms. Care Homes for Adults (18-65 years) Page 23 of 31 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. Service users are supported by adequate numbers of well trained staff and are protected by the homes recruitment policies and procedures. Evidence: There are two members of staff on duty throughout the day and night. In addition the manager is at the home during the daytime. The home employs separate housekeeping staff which enables the carers to concentrate on supporting the residents. The surveys returned to the CQC from service users indicated that they felt that staff treat them well, are available and listen to them. From observation there appeared to be sufficient staff on duty to meet the needs of the service users in residence. Six staff surveys were returned to CQC and said that the staff team work well together and are very supportive. It could do better to have more access to transport to allow service users to go out together more often. Another saying less paperwork would enable us to spend more quality time with the service users. Staff training is well managed. Staff training files were viewed by us. These evidenced that the organisation does provide a variety of training that is specific to the client Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: base. The training files record when training has taken place, when updates are due and what training is to be done in the future. The member of staff spoken to and the surveys received from staff told us that the organisation supply training that is good and relevant to their role. Support and supervision records were seen and these demonstrated that all staff were receiving regular supervision sessions. The manager has a staff appraisal programme and all staff have been appraised through 2009. More recently recruited staff have, to date, not received this. Staff surveys told us that staff feel well supported by the manager and that she is always available for advice and support in relation to their work. The home has robust recruitment procedures. A sample of two recently recruited staff members personnel files were viewed by us. These evidenced that the Criminal Bureau Records and the Protection of Vulnerable Adults register have been checked and cleared, two references and proof of identity were found in the files along with notes taken at interview. A recently recruited support worker was spoken to at the time of this visit and he confirmed that all the appropriate checks were taken up and that he had undergone a thorough induction programme. He said that it had taken about twelve weeks to complete this. Service users are invited to be involved with the recruitment process but the manager told us that they choose not to be. The home employs a mixed gender of support staff to accommodate the preferred wishes of the service users who are also of a mixed gender. Care Homes for Adults (18-65 years) Page 25 of 31 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. Service users live in a well managed home that is effectively quality assured by the manager. The health and safety of the service users and staff is now promoted and protected. Evidence: The registered manager has been in post for some years. She has the NVQ level 4, Registered Managers Award (RMA) and the assessors award and has the experience to do the job. She has a deputy manager in post and told us that they are very supportive. There was evidence in the records that the manager continues to up date her knowledge by attending various courses throughout the year and the deputy manager is working towards the NVQ level 4. Staff spoken to at the time of this visit said they were well supported by the manager and she was always available when necessary. Observations throughout the visit identified that there are good working relationships with the manager and her team and the home has a homely atmosphere. The manager told us that she really enjoys her role and has no aspirations of being the manager anywhere else. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: The home has a quality assurance system in place that is based on the monthly visits from the area manager for the organisation, staff meetings, service reviews and issues identified from within the home. Information gathering from these sources is fed into the continuous improvement plan (CIP) which identifies the areas for improvement. The CIP is presented each month at the staff meetings to be discussed and ideas from the staff are recorded. The CIP is reviewed by the manager and area manager monthly and together they create an improvement plan for the year. The manager told us that she randomly audits throughout the month the MAR charts, care plans, risk assessments and the general cleanliness of the home. Survey questionnaires are given to the service users to complete annually. These have been analysed and the report seen told us that generally the service users are very happy living in the home. Four of the service users spoken to on the day of this visit said they liked living in the home. The manager told us that the organisation is about to introduce a new service user survey that includes all aspects of the service users life and is titled What Matters to Me. It involves more participation and time of the service user and key worker, who asks the service users the questions about all aspects of their lives and then records the responses. The results are then validated by the area manager as part of the QA system. The organisation is trying to involve the service users more by finding out what is important to them in their lives and how to improve the quality of their lives. Health and safety issues in the home are well managed. Records are maintained of risk assessments for the environment and a fire risk assessment, which were seen. The previous report identified immediate requirements for ensuring that the fire escape and garden area was cleared of rubbish that presented a safety risk to service users if they chose to use the garden or needed to use the fire escape. This was complied with and recorded on the improvement plan. The records demonstrated that staff have received training in health and safety and there are regular health and safety checks on the building. Individual service users have risk assessments in place concerning which cleaning materials they can use. Cleaning materials under COSHH were seen to be kept in a Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: locked environment. We viewed the fire log and this evidenced that the fire alarms and equipment are tested at appropriate intervals and that the fire alarm is serviced accordingly. A sample of other servicing certificates was viewed for equipment and systems and these were seen to be current. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 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. 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. 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