Care Home: 1 Larch Road

What the care home does well The bungalows are clean, and have good quality fixtures and fittings, which means that they are well suited to meet the needs of the people who live there. Both bungalows are well equipped, and are very homely and comfortable. Comments received from people living at the home in surveys included: "They give good care and support." "It`s nice and homely and friendly, and they care for me well." "They give good care." Two people who live at the home were on holiday in Spain on the dayof the inspection, which demonstrated that personal choice is respected and supported, and the care home takes `ordinary living` seriously, and helps people to make the most of opportunities. The expert by experience who assisted with the inspection made a number of positive comments, and observations, following discussions with three people who live at the care home. Comments received from members of staff in the surveys included: "Provides a holistic approach to all residents, and supports individuals in all their care needs." "Care and supports in very individual ways, and provides dignity on a very personal level." "We try to meet the needs of the service users individually. As a team we have very good communication." What has improved since the last inspection? At the last key inspection, a statutory requirement was made, relating to clarifying the management arrangements at the home. This has now been done, with a new home manager in the process of being registered. In addition, since the last keyinspection in March 2009: Four bedrooms have been redecorated, and two have had new carpets fitted. A new extractor fan has been fitted in the shower room (to combat the mould problem). New dining tables and chairs have been purchased, and outside a new patio has been developed, and a new bench has been bought. What the care home could do better: No statutory requirements have been made as a result of this key inspection. However nine good practice recommendations have been made. These relate to: Information relating to the fees should be up to date and current. Each person living at the home should have a Mental Capacity assessment, including Deprivation of Liberties (DoLS) assessments, and documentation should be held within their care files. People living at the care home who receive prescription medication should have a care plan in place outlining their particular needs. People who are self-medicating should have a risk assessment and care plan in place to support their self-medication. The signs & symbols version of the complaints procedure should be updated. All staff should receive safeguardingadults training, and have this training updated a minimum of every two years. A programme of National Vocational Qualification (NVQ) training for staff, should be supported with a view to 50% of the staff team being NVQ qualified to level II. All staff should receive a minimum of six formal supervision sessions per year. The manager should have time built into her weekly rota to enable her to carry out her managerial responsibilities and tasks. Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Larch Road Eckington Sheffield Derbyshire S21 4ED 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: Rob Cooper Date: 3 0 0 9 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 Larch Road Eckington Sheffield Derbyshire S21 4ED (01246)431158 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Enable Care & Home Support Limited care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection 0 9 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home 1 Larch Road is a purposebuilt home for eight people with learning disabilities. The home consists of two adjoining bungalows no 1 and no 3 with separate entrances. It is situated in Eckington, approximately six miles from Chesterfield. The home provides personal care and accommodation. The home is spacious and accessible, providing ground floor accommodation with single bedrooms and a pleasant garden. The home is near to local shops, pubs and public transport. Two mini buses are available for the use of the people who live there. The acting manager said that the fees range from: £1,324 to £1,158 per month depending on needs. 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 The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of the key inspection process, so that no one at 1-3 Larch Road knew that the inspection visit was going to take place. The visit took approximately four hours through the middle of the day, with one inspector present. In addition as part of the Commissions methodology an expert by experience also assisted the inspector. An expert by experience is a person who has special knowledge or experience of the type of care on offer, and uses this knowledge and experience to help gain insight into the needs of the people living at the home, and how they are being met. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and Care Homes for Adults (18-65 years) Page 7 of 33 reviewing any notifications made relating to incidents that affect the well being of people living at 1-3 Larch Road. The methods used during this key inspection and visit were to visit Larch Road, where a method called case tracking was used; this involved identifying four people who live at the care home and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was followed by a partial tour of the bungalows, looking at the activities on offer, and talking to three people who live there and two members of staff about the quality of the service, and their experiences of living and working in Larch Road. We also sent out an Annual Quality Assurance Assessment (known as an AQAA), which allowed the care home to carry out a selfassessment; and provide a range of information relating to their service. Information provided helped to form the judgements in this report. We also sent out five surveys asking for views and information to people who live at the home, and five to staff. Of these all five surveys from people living at the home, and four from members of staff were returned, which also helped with the judgements that we made. Care Homes for Adults (18-65 years) Page 8 of 33 The acting manager Jean Frith provided much of the information during this key inspection visit. On the day of this inspection there were seven people living at 1-3 Larch Road. People who might want to live at the home can obtain information about the home direct from them, and this would include seeing previous inspection reports prepared by the Care Quality Commission. What the care home does well The bungalows are clean, and have good quality fixtures and fittings, which means that they are well suited to meet the needs of the people who live there. Both bungalows are well equipped, and are very homely and comfortable. Comments received from people living at the home in surveys included: They give good care and support. Its nice and homely and friendly, and they care for me well. They give good care. Two people who live at the home were on holiday in Spain on the day Care Homes for Adults (18-65 years) Page 9 of 33 of the inspection, which demonstrated that personal choice is respected and supported, and the care home takes ordinary living seriously, and helps people to make the most of opportunities. The expert by experience who assisted with the inspection made a number of positive comments, and observations, following discussions with three people who live at the care home. Comments received from members of staff in the surveys included: Provides a holistic approach to all residents, and supports individuals in all their care needs. Care and supports in very individual ways, and provides dignity on a very personal level. We try to meet the needs of the service users individually. As a team we have very good communication. What has got better from the last inspection At the last key inspection, a statutory requirement was made, relating to clarifying the management arrangements at the home. This has now been done, with a new home manager in the process of being registered. In addition, since the last key Care Homes for Adults (18-65 years) Page 10 of 33 inspection in March 2009: Four bedrooms have been redecorated, and two have had new carpets fitted. A new extractor fan has been fitted in the shower room (to combat the mould problem). New dining tables and chairs have been purchased, and outside a new patio has been developed, and a new bench has been bought. What the care home could do better No statutory requirements have been made as a result of this key inspection. However nine good practice recommendations have been made. These relate to: Information relating to the fees should be up to date and current. Each person living at the home should have a Mental Capacity assessment, including Deprivation of Liberties (DoLS) assessments, and documentation should be held within their care files. People living at the care home who receive prescription medication should have a care plan in place outlining their particular needs. People who are self-medicating should have a risk assessment and care plan in place to support their self-medication. The signs & symbols version of the complaints procedure should be updated. All staff should receive safeguarding Care Homes for Adults (18-65 years) Page 11 of 33 adults training, and have this training updated a minimum of every two years. A programme of National Vocational Qualification (NVQ) training for staff, should be supported with a view to 50 of the staff team being NVQ qualified to level II. All staff should receive a minimum of six formal supervision sessions per year. The manager should have time built into her weekly rota to enable her to carry out her managerial responsibilities and tasks. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 12 of 33 If you want to speak to the inspector please contact: Rob Cooper Care Quality Commission Citygate Gallowgate Newcastle-upon-Tyne NE1 4PA 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 13 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 14 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 who live at the care home know that their needs and personal goals are identified in their individual plan of care. People have the information they need and are supported to make decisions about their lives with assistance if needed. Evidence: Both the service user guide and the statement of purpose were seen. Both documents contained a great deal of useful information about 1-3 Larch Road, and the service user guide was in a pictorial form, to help people who have difficulty with written English to understand its content. Copies of the service user guide were seen in bedrooms, and everyone living at the home had received a copy. The files of four people who live at the home were seen as part of the case tracking process. Each file contained a formal assessment which had been completed by a Social Worker before the person moved to 1-3 Larch Road, or a copy of the Social Workers review of the placement. There was clear evidence of a person centred approach in the documentation, with the assessments and the reviews being focused on the individual rather than the processes to support them. Page 15 of 33 Care Homes for Adults (18-65 years) Evidence: Each file that was seen contained an occupancy agreement which detailed the room to be occupied and the scale of charges (the fees). The fee information was not up to date, with the 2008 fee level recorded. A telephone call to the providers offices was needed to identify the current fee level, although even then this information was not readily to hand. 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 living at the care home know their assessed and changing needs and personal goals are reflected in their individual plan of care. People are also supported to make decisions about their lives with assistance if needed. Evidence: The care home have implemented Person Centred Care plans, which include photographs, and signs and symbols which are centred around the individuals likes, and daily living activities. The care plans are being reviewed regularly, and reviews also detail family involvement, and are written from the persons point of view, so that they give a clear flavour of the persons life, and what is happening for them. A great deal of evidence was seen to support the view that people living at the home were supported to make decisions. Two people were on holiday in Spain during the inspection, and evidence was seen that those individuals had been involved in choosing that holiday, and deciding many aspects of the trip. Three people were at the home during the inspection visit, and all three were observed taking decisions, this covered the choice of lunch time meal, and decisions about drinks and activities. During the afternoon Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: there was an activity organised and staff were observed asking people if they wanted to attend. The evidence seen during the inspection visit, in peoples individual files showed that people who live at the home are doing what they wanted. All of the bedrooms that were seen, were very well personalised, and reflected the individuals interests and personality. However following the introduction of the Mental Capacity Act (2005) none of the care files had a Mental Capacity Assessment, or any information relating to the Deprivation of Liberties Standards, and therefore no indication if individuals were making decisions for themselves, or if staff were acting in peoples best interests on their behalf. All of the care files contained risk assessments covering both individual needs and risks, and more general risks related to everyday living. The risk assessments were clear and easy to understand, and followed a logical approach to the management of the risks. Observations and discussions with people living at the home showed that they had a lifestyle that included risks, and the staff supported people as necessary. Discussions with staff members showed that they understood the concept of risk management, and were aware of the main risks within individuals lives, and the steps necessary to reduce them. 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 people who live at the home are able to take part in appropriate activities, and are part of the local community, with their rights and responsibilities being respected by the staff. Evidence: On the day of the inspection, two people were on holiday in Spain with staff to support them. This was a holiday that the people concerned had chosen and been involved in arranging. the four care files that were seen showed evidence of a range of activities that people are involved in, and these clearly demonstrated a good deal of personal choice in choosing them. The expert by experience who assisted with this inspection spoke to three people who stated that: They go out for activities such as bowling, Sunday lunch, day centres and swimming. There are also in house activities such as house work, arts and crafts, gardening. Throughout the building there was evidence of peoples involvement in activities, with drawings and paintings on display, while outside in the garden there were a number of planters which people at the home had been involved in planting and watering. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: Five questionnaires were returned to the Commission by people who live at 1-3 Larch Road. All five gave positive responses to the questions posed about the care on offer, and among the comments received was: They give good care and support. Nice and homely, and friendly, and they care for me very well. They care and support well. They do everything well. The care home is located in the local community, on an ordinary housing estate. Local shops, pubs and restaurants are within easy walking distance, and discussions with people who live at the home showed that they are used regularly. Discussions with the manager about relationships with the neighbours identified that there were no problems and the home, and the people who live there are part of the local community. Three people were spoken with about family contact. They said that they saw members of their family, and that sometimes that was at Larch Road and sometimes it was either at the family home, or in town. All three people said that the staff made their family welcome, and that there were no set visiting times. People were clearly relaxed when talking about seeing their relatives, and there were no issues around family contact. Discussions with the manager identified that there were good relations with families, and that visitors to the home were always welcome. Discussions with both, people who live at 1-3 Larch Road and with staff members identified that people are involved in many of the household tasks around the home, and are quite happy to be so. The expert by experience spoke to three people and among the comments she received were: When asked do you help around the home he laughed and said Id like to run it. He is very independent and liked to do his own washing up. Observations of the staff showed a friendly approach towards the people who live there with gentle encouragement around household tasks, such as clearing the table. Everyone has one day a week at home where they clean their bedroom, and sort their clothes washing out (with as much staff support as they require.) The kitchens in both bungalows were well equipped and one in particular, provided good access for people in wheelchairs or with restricted mobility. Discussions with people who live at the home showed that there is an opportunity in the regular meetings to make suggestions about the menu, and individual likes and preferences are taken into account. Observations of staff practice showed that there was a good choice available to individuals around food, with staff supporting people to make choices and decisions. Record keeping relating to food did not highlight any concerns, and the cupboards were well stocked with good quality foodstuffs. 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 receive personal support in the way that they want, and they are protected by the policies and procedures in place for dealing with medication. Evidence: All of the people who were spoken with said that they are able to make choices and express their wishes in relation to their personal care and support. Discussions showed that people are happy and comfortable with this situation and that if necessary they could and would raise any concerns about their personal care with the manager. Each of the care files contained care plans related to health care, which provided the key information and monitoring related to individuals health. In addition a new hospital admission document has been produced, which will give hospital staff essential information about a person should they need to be treated in hospital. The expert by experience asked individuals about their health care and received the following comments: I see the dentist regularly and the doctor when I need to. An inspection of the medication systems showed them to be safe and secure. A visit to the home by the pharmacist in July recommended that a new bigger medicines cupboard is purchased, and this is now on order. The records relating to ordering, dispensing, and where appropriate destroying or returning medication to the pharmacy was seen, and all Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: found to be complete and correct, with no obvious errors or omissions. Medication was also seen to be stored securely. One person living at the home currently self-medicates, and a review of the documentation showed that there is not a risk assessment in place for this person. In addition no person living at the care home has a specific care plan related to medication in their file. 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 feel that their complaints are listened to and acted upon. The policies and procedures in place ensure people are protected from abuse, neglect and self harm. Evidence: 1-3 Larch Road have not received any complaints since the last key inspection in March 2009. There is a very good signs & symbols version of the complaints procedure which forms part of the service user guide, and copies were seen in every persons bedroom. However some of the information is in need of updating. Discussions with three people who live at the home indicated that they knew who to complain to, and how to complain, although none of them had ever needed to. In their AQAA they said: We have policies and procedures in place to assist in the protection and promotion of service users rights. All service users are encouraged to speak about any complaints or problems they may have . All concerns and complaints are acted upon. A review of the staff training records in relation to safeguarding adults showed that not all of the care staff had undertaken this training in the last two years. There were still some staff awaiting this training, which is arranged through the head office. Two members of staff were asked about safeguarding adults training and said they were aware of the issues, and had undertaken this training. Evidence seen in the training records evidenced that some of the staff had been through this training. The home has not made any safeguarding adults referrals since the last key inspection. Care Homes for Adults (18-65 years) Page 23 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 live in a safe, homely and comfortable environment, their bedrooms suit their needs and lifestyle, and promote their independence. The home is clean and hygienic. Evidence: The expert by experience made the following observations about the environment: The home has two bungalows next door to each other. Both bungalows are identical in layout but are very different in decor, as currently one is for females and the other for males. It was very apparent which bungalow was which, with one lounge very feminine with pinks and lilac colours throughout. The sofas looked very comfortable, with lots of cushions and over all very homely. Both lounges had personal touches, pictures on the walls, photos and ornaments around. The hallways in both bungalows were bright with new carpets that were laid properly so there was nothing to trip up on. All bathrooms were big and bright and newly decorated. Both bungalows shared the garden; although it was small, the space was used well. There was a table and chairs for people to use, a greenhouse, potted plants and a bench. At the last key inspection a problem with black mould was identified in the shower room in bungalow 3. This is in the process of being put right, with increased ventilation and work to remove the mould currently taking place. On the day of the inspection the building was found to be clean and tidy, with no bad Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: odours or signs of stained carpets. Staff were seen cleaning and hoovering in both bungalows, and the impression created was of a pleasant homely environment. In their AQAA they said: A high standard of cleanliness is maintained throughout the home. Care Homes for Adults (18-65 years) Page 25 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 living at the care home have their needs met by appropriately trained and well supported and supervised staff Evidence: The staffing rota was seen, and this showed a good skill mix through the staff team, and a level of different staff with levels of seniority and experience. National Vocational Qualifications (NVQ) to level II are still not at the recommended level of a minimum of 50 of the staff team, with staff training records showing only three of the seventeen staff having their NVQ level II qualification. Five questionnaires were returned to the Commission by members of staff who work at 13 Larch Road. The comments received were mostly positive, and included the following: The home cares and supports in very individual ways, while also providing dignity on a very personal level. This is a new role for me, and one that I wish i had taken on years ago, as it is very rewarding. The care home supports individuals in all their care needs. it provides a holistic approach to all residents. It would be better, if there were better staffing hours, especially at weekends. We try to meet the needs of the service users individually as a team. We have very good communication. I feel we do the best we can. Six staff files were seen, and these all contained information that showed that staff had Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: been recruited safely, in that every applicant had been through a formal recruitment process, and had filled out an application form, provided two written references and had undergone a Criminal Records Bureau check. Discussions with two members of staff showed that they had been through a formal recruitment process, and had completed all of the necessary paperwork. Staff training files were seen, and these showed that there was a training programme in place for all staff, covering training issues relevant to the work being undertaken, including the mandatory training in areas such as fire, moving & handling and health & safety. Discussions with two members of staff around training showed that they thought they were well trained and had access to on-going staff training. Formal supervision records were seen, and these showed that staff have a regular formal supervision session with a senior member of staff, however discussions with the manager identified that the National Minimum Standard which recommends six sessions per year for every member of staff, is not being met. Discussions with two members of staff showed that there is formal staff supervision taking place. Care Homes for Adults (18-65 years) Page 27 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. This is a well run home. People who live here are confident that their views underpin all self-monitoring, review and development. The health, safety and welfare of everyone living and working at the home is promoted and protected. Evidence: The acting manager has submitted her application to the Care Quality Commission, and is waiting for the clearance of her Criminal Records Bureau check, and fit persons interview. Following a recommendation at the last key inspection that the manager should be supernumery, the manager said that this was happening occasionally, but is still not a regular occurrence. The Annual Quality Assurance Assessment (AQAA) was returned within the time frame asked for. It was rather brief in many areas, and the information was not sufficient to fully inform this report. This included areas of strength, were the care home was doing well, as well as areas that needed to be developed further. 1-3 Larch Roads quality assurance system relies on questionnaires being filled in by the people who live at the home. Copies of these dated April 2009 were seen in peoples Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: individual care files. The minutes of meetings for the people who live at the home were seen, with evidence of people having raised issues which were then discussed. Regulation 26 visits (these are monthly audits by a representative of the owners management team) are taking place, with copies of reports seen; these are part of the homes quality assurance system. A number of different health & safety records were seen, including the records relating to: fire safety, and Legionella (water temperature checks) and the Control of Substances Hazardous to Health (COSHH) records, all were found to be up-to-date, with regular checks and tests being carried out by the staff, and appropriate records being kept. Care Homes for Adults (18-65 years) Page 29 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 30 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 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 5 Information relating to the current scale of charges and fees should be available within the home, and readily available when asked for. Everyone living at the care home should have a Mental Capacity assessment, and if appropriate information relating to the Deprivation of Liberties (DoLS) Safeguards. Every person living at the home who self medicates should have a risk assessment in place to direct staff, and raise their awareness of the potential issues involved. Every person living at the home who receives prescription medication should have a care plan detailing their needs in this area, and offering staff guidance on how that individual takes their medication. The signs & symbols version of the complaints procedure should be updated to ensure that the information is accurate, current and correct. Page 31 of 33 2 7 3 20 4 20 5 22 Care Homes for Adults (18-65 years) 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 6 23 All staff should undertake safeguarding adults training, and have the training updated and refreshed a minimum of every two years. The home should continue to work towards 50 of the staff team having their National Vocational Qualification to level II. All members of staff should receive a minimum of six formal supervision sessions per year. Efforts should be made to ensure that the manager has supernumery hours built into her working week, so that she can perform her managerial role and tasks. 7 32 8 9 36 37 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. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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