Care Home: 1 Longmore Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Longmore Road Shinfield Park Reading Berkshire RG2 8QD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mark Hemmings     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 1 Longmore Road Shinfield Park Reading Berkshire RG2 8QD 01189867457 Telephone number: Fax number: Email address: Provider web address: www.milburycare.com Name of registered provider(s): Name of registered manager (if applicable): Milbury Care Services Ltd The registered provider is responsible for running the service care home 7 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 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 Seven people who have a learning disability can make their home in 1 Longmore Road (the Service). At present, seven women live there and they are all quite settled and at home. The premises are a detached house that has a conservatory at the back. Everyone has their own bedroom. Each of these has a wash hand basin. There is a Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 7 Brief description of the care home sleep in room for staff. There is main lounge/dining room and a separate lounge in the conservatory. There are two bathrooms one of which has a shower. There is also the kitchen, the laundry and an office. The Service is in a residential street thats in a suburb of Reading. Its quite near to the M4 motorway and when the windows are open the drone from the traffic is very noisy. There arent many shops within walking distance. The Service has its own people carrier vehicle. The Registered Provider is a private company. It runs a number of other similar residential services in the area. People who might want to move in can find out things about the Service. There is a Service Users Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. If you want to find out more about 1 Longmore Road, you can also have a chat with the Manager. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was a Key Inspection. We arrived at the Service at about half past eight in the morning and we were there for about seven hours. It was a thorough look at how well things are going. We took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since the last inspection. We spoke with and generally spent time with all of the women who live there. Also, we spoke with the Manager and with four of the support workers. We looked at some key records and documents and we had a look around the accommodation. Care Homes for Adults (18-65 years) Page 6 of 30 Before we called to the Service, we asked all of the people who live there and 10 support workers to fill out a questionnaire for us. We wanted them to tell us what they think of 1 Longmore Road. Five people who live in the Service and six support workers kindly filled them in for us. As we go through our report, well tell some of the things that people are saying in their answers. Last year the Registered Provider asked people who live in the Service to fill out a questionnaire about what they think of their home. We looked at three of the completed questionnaires at random. Again, well tell you whats being said. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: No one has moved into the Service since we were last there. Therefore, we couldnt check out how the moving in process works in practice. However, we were able to speak with the Manager to get an idea of what will be done in the future when someone does say that they want 1 Longmore Road to be their home. The Manager says that she will speak with the person concerned to find out what support they want and what sort of life they want to follow. She will also speak with other people such as family members and care managers (social workers). This will be done so that she can check out points of detail that help her to be clear about what is needed. After this is done, the person will be invited to visit the Service. This is so that they can get a first hand feeling of what 1 Longmore Road is like. Also this will be done, so that they can meet the other people who have already made the Service their home. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The Manager recognises that moving into a new home is a big step for everyone involved. She emphasises that the Service wants to do everything possible to make the move a positive experience for everyone. In our questionnaire for people who live in the Service we ask, did you get enough information about this home before you moved in so you could decide if it was the right place for you? Everyone answers that yes they did. We asked support workers about how things have worked in the past. They say that they have met the person before they moved in. Also, that they were given lots of useful information about the support they need and about how the person wants this to be provided. One support worker summarises the general mood when they say, we always remember what a big thing it must be to move somewhere new and we do everything we can to make the person feel welcome. We check out what there is to know about the person so that we can take this in to account. We also involve members of the family because they need to be reassured that their relative is going to be okay. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7, 9 and 10. There are quite detailed individual written plans of support. People are helped to manage their money. Medicines are handled safely. There is a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. There is a written individual plan of support for each person. These are important documents. This is because they are one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be done. The plans are a source of information for support workers. This then helps them to provide support in the right way. We looked in some detail at three of these plans. They have information about a number of relevant things. For example, there is information about how to help the people say what they want and about how to support them in managing parts of how they go about things. There is Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: information about how to help them with practical things such as getting dressed and using the bathroom. We spoke with three of the support workers about whats in these plans. They know it. They also know how to use the information in practice to give people the support they need. The plans are kept up to date so that theyre accurate. This involves support workers making daily notes about how things are going. There are also more organised meetings. These are when family members and care managers call to the Service to support the person to look ahead to what they want to do in the next year. All in all, theres a lot of written information. Special things have been done to help the people who live in the Service take part in whats being said. This includes having their own summary that is presented in an interesting and colourful way. Each person also has another user friendly document too. This one is about looking forward and it lists something new that the person wants to do. For example, one person wants to have their bedroom repainted. The plan illustrates this. Then it says that she is going to phone the handyman about this to get it done. Some of the people who live in the Service are helped to manage their financial affairs by the Registered Provider. Others are supported by their families. Each person has their own bank account. The Manager and some of the other members of staff can sign to make withdrawals from some of them. This is done so that each person has enough to buy what they want. The arrangement has been put in place with the agreement of the people concerned and with their families. Support workers hold small amounts of money for each person. They do this so that it doesnt get lost and so that they always have enough to buy the everyday things that they want. This is a sensible arrangement. Support workers keep a record of the various transactions involved to make sure that everything is above board. We checked parts of these records to make sure that the system is working okay. For example, we looked to see if there is a record of cash coming into the Service after its withdrawn from the bank accounts. We also checked to see that there are receipts for things said to have been bought for people. We then looked at the cash balance held for one person to see if it matches what the records say should be there. Everything is in order. At the moment, the Registered Provider says that support workers have to get a receipt for everything they help someone to buy for themselves. We think that this is going a bit too far. Its a bit odd for example to have to ask for a receipt at a fish and chip shop, or in the pub. It might make people feel awkward and different. We think Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that it might be possible to make other less obvious arrangements for these occasions. Sensible consideration is given to peoples personal safety. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, one person needs to be supported when they are out and about to make sure that they dont get lost. Unfortunately, most of this information is written in a management style that most of the people who live in the Service are likely to find difficult to use. We think that more can be done to make it interesting and user friendly. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14, 15, 16 and 17. People can do occupational and social things that interest them. They are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: People are free to do things that interest them. Some of these things involve helping out a bit around the house. They help with tidying up and they go food shopping with support workers. Last year two of the people did a vocational course at a local college. People also do more fun things. For example, they attend various day opportunity services where they can do things such as arts and crafts. They also go out to social events. We checked out in some detail who is doing what and when. We wanted to see that no one is getting overlooked. No one is. In our questionnaire for people who live Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: in the Service we ask, can you do what you want to during the day and in the evening? Everyone says that yes they can. The Registered Providers questionnaire also asks about this. It says, do you (have) enough opportunities to access recreational/social activities? Everyone says that theyre extremely satisfied or very satisfied. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service whenever they want. We looked at the records about this. They show that most people are seeing their families regularly. Support workers keep in touch with family members so that they know how things are going in the Service. People say that they have good quality meals and that they have enough to eat. Support workers do most of the main cooking, but some people do help with bits of it. There is a weekly menu. However, its not too rigid. People can and do change it if they want something different. Over time, everyone has got to know what each other likes and dislikes. The menu pretty much reflects this. We looked at the record of meals served. People are having normal things such as spaghetti bolognaise, chicken and roast beef. The Manager says that people are encouraged to eat a balanced diet and not have too much instant food. The Registered Providers questionnaire asks, do you like the meals provided and are they sufficient? Everyone says that theyre, extremely satisfied. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are helped in ways that are right for them. Support workers are helpful without crowding people out. Their manner is informal and kind. The overall feeling is one normal family life. The people who live in the Service are relaxed in the company of support workers. They dont wait to be spoken with, theyre quite happy to say and indicate if they want something. They show by their manner that they see support workers as being their friends rather than being members of staff as such. Things are orderly without being too much so. When things look like they might be getting a bit too much, support workers gently point people in a different direction. This isnt done in an obvious or bossy way. For example, when we were there one person was getting concerned that they might be left behind when the others went out to a social event that morning. The support workers reassured her that this wouldnt Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: happen. Then they helped her to focus on making sure that she was dressed and ready to go. People are helped to wear neat and clean clothes so that they can look how they want. They are helped to sort out any post they get. In our questionnaire for people who live in the Service we ask, do you make decisions about what you do each day? and do the carers listen and act on what you say? Everyone says that they always do. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, people have seen their doctors as and when necessary. One person has a special medical need. We looked in detail about how they are being helped to deal with this. They have seen their doctor and they have had various tests done. Special arrangements have been made to support the person so that theres less chance of them becoming unwell again in the future. Support workers manage medicines for all of the people who live in the Service. We think that its reasonable for them to do this, because people will find it very difficult to do for themselves. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. We looked at three sets of these records. They are correctly completed. We looked at three medicines in more detail. We wanted to see if the remaining stock matches what should be there and it does. One person has a special medicine that can be given when its needed rather than on a regular basis. There are some written guidelines to help support workers when giving this medicine. However, they arent very detailed and theyre not completely up to date. The Manager is going to get this sorted out by 1 April 2009. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 22 and 23. People are free to make a complaint if they want to. People are kept safe. Evidence: There is a written complaints procedure. This uses some pictures to make it easier to use for the people who live in the Service. There is a special phone in the hallway. This can be used by the three people who live in the Service who can readily say what they want. Instead of the normal numbered keys, there are a few much larger keys. When you press one it dials a pre-selected number. Three of the keys have a picture of each persons relatives. One of them has a picture of our logo if someone wants to call us direct. We think that this is a very good idea. In our questionnaire for people who live in the Service we ask, do you know how to make a complaint? Everyone says that yes they do. We also ask, do the staff treat you well? Everyone says that they always do Since our last inspection, the Registered Provider has received one complaint. This was from a parent who was concerned about one of the flagstones on the patio at the back being loose. The Manager says that the matter was attended to straight away. The records of what was done and when to address the complaint havent been completed in full. The Manager says that in future she will make sure that she records fully how complaints are dealt with. This is important because we need to sure that Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: any complaints are sorted out promptly and effectively. People say and show by their relaxed manner that they feel safe living in 1 Longmore Road. The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, if someone is not being treated kindly. We spoke with two support workers about this. They know what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. In our questionnaire for support workers we ask, do you know what to do if a service user has concerns about the home? Everyone says that yes they do. One person summarises the general mood when they say, theres no real need for us to tell people to do things. Thats not how it is here. This is the ladies home and over time theyve all worked out their own daily pattern and we know how they like things done. Each person has their own way and we respect that. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24, 29 and 30. People live in a comfortable setting that promotes their independence. The kitchen is clean and well equipped. There is a separate laundry. Evidence: The accommodation is comfortable. In general, its like anyones home is. Its got a lived in feeling and things arent too fussy. The Assessment emphasises that the people who live in the Service are involved in making decisions about changes to their home. For example, they are asked their views when new paint colours are being selected and when furniture is being bought. People say their home is kept warm enough in winter. The central heating was on when we arrived and it was still on when we left. The radiators are fitted with guards. This has been done to reduce the risk of someone being burnt if they fall against one. The hot water is temperature controlled. This is to help reduce the risk of someone being scalded. We tested a few of the hot taps. The water isnt too hot. The building is fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the Berkshire Fire and Rescue Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Service says that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. For example, it looks at things such are the exit routes clear? The assessment hasnt been sent to the fire brigade people yet. Its a good idea for this to be done. This is so that they can have a look to make sure that its detailed enough. The Manager is going to do this by 1 May 2009. The local Department of Environmental Health hasnt called to the Service for some time now. We understand that an inspection will be done in the near future. Since we were last in the Service, the kitchen has been completely refurbished. There are new cabinets and there are new appliances including a much larger cooker. We looked at the kitchen. Its neat and clean. Theres a system to make sure that the refrigerators are cold enough to store foods safely. Checks are also done to make sure that things like meat are properly cooked through. Sensible steps are taken to promote good hygiene. For example, support workers know about the importance of washing hands. In particular, if theyve been doing other things like working in the laundry. Two of the people who live in the Service need help with getting about. There are various things to help them. These include wheelchairs, a mobile hoist and a special easy-access shower. There are other things such as assistance poles. These are fitted to the wall so that theres something to hold onto. Support workers have looked carefully at the help each person needs. This has been done so that they know how best to make sure that the person is safe and comfortable. The laundry has got a washing machine and a dryer. These are working okay. Support workers say that they are able to get the laundry done without too much difficulty. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 33, 34 and 35. There are enough support workers around to make sure that people get the help they need. Security checks are completed on staff. Support workers know what they are doing. Evidence: There are four support workers on duty from early in the morning until the afternoon when the number reduces to three. There is a waking staff presence in the Service at night. They are supported by special security arrangements. We looked at the roster to see if the various shifts are being filled reliably. We found that they are. The Registered Providers questionnaire asks, do you get the support you need? Everyone says that they are extremely satisfied. In our questionnaire for support workers we ask, are there enough staff to meet the individual needs of all the people who use the Service? Four people say that there always are enough and two people say that there usually are. One of the former people adds, this is a priority of the home. Service users first always! Its very important that all of the support workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, getting references and doing a police check. We looked at the checks that have been completed for two support workers who have been appointed since out last visit. The necessary checks have been done. New support workers have introductory training before they begin supporting people. After their introduction to the Service, they start completing a more detailed training programme. This involves them completing various conventional courses on subjects such as on health and safety. Some of the training is also completed electronically. This involves support workers using a laptop that has got various training modules on it. When you open one of the modules up, its got information for you to read. Then its got questions to answer to show that youve understood what youve read. We checked two records of who has completed which of the modules. Support workers have done training in a number of relevant subjects. These include how to safely assist people who have difficulty getting about, in basic first aid, in food hygiene and in how to support people when they become anxious and distressed. In our questionnaire for support workers we ask, are you being given training which helps you to understand and meet the individual needs of service users and keeps you up to date with new ways of working? Everyone says that yes they are. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to support people being helped in ways that are right for them. At the moment, there are 12 support workers employed in the Service and five of them have obtained the award. The Manager says that all of the others will be encouraged to study for the qualification. When we spoke with support workers we asked them about points of detail to do with their work. They have a sound understanding of important things. Such as about how people prefer to express themselves, what sorts of activities they like to do and what they like to do for themselves. Throughout our time in the Service we saw them using this knowledge so they were supporting people in ways that are right for them. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 and 42. The Service is reliably managed. People are asked what they think about how things are going, but this could be a bit more developed. Peoples health and safety is promoted. Evidence: The Manager has a good knowledge of how things are going in the Service. Support workers like the way that shes hands on and is quite happy to work alongside them. The Manager has both of the formal qualifications she needs. These qualifications are important. This is because they are intended to help managers ensure that people receive high quality residential care services. Recently, she has completed an additional management course that is intended to develop further her management skills. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: are going and what needs to be done on the next shift. Also, there is a system where each support worker meets with someone senior to look at how their work is going. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. For example, they know who needs the most support when they go out and they organise themselves accordingly. In our questionnaire for support workers we ask, do you feel you have the right support, experience and knowledge to meet the different needs of the people who use the Service? Four people reply always and two people answer usually. We also ask, do the ways you pass information about people who use the Service between staff (including the manager) work well? Four people say that they always work well and two people say that they usually do. People who live in the Service are asked about how well they think things are going in their home. These include informal everyday discussions. There are also house meetings every month or so. We looked at the records of the last one to see what was talked about. They are interesting everyday things. For example, one person was talking about their plans to go to the hairdresser with support from her mother and from members of staff. Weve already mentioned the questionnaires that people who live in the Service are invited to complete. These questionnaires are also sent to relatives. There is a separate questionnaire for support workers to complete. We only looked at the questionnaires completed by people who live in the Service. We think that more can be done to make them user friendly. For example, some of the wording of the questions is quite complicated and some of it doesnt really make sense. We also think that more can be done to tell people who use the Service what has been said. Also, there should be more focus on letting people know what is going to be done to respond to any improvements that may have been suggested. The Registered Provider arranges for a senior person who is not based in the Service to call each month to see how things are going. We looked at the records of their last visit to see what sorts of things they look at. These include things such as any accidents that have happened or any complaints that have been received. They also check health and safety things. Support workers are regularly checking that the fire safety equipment is in good working order. Also, there are more detailed checks of the system that are done by a contractor. There are unannounced fire drills. There is also a system for each member of staff to have regular fire safety training. These things are very important. This is Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: because the level of fire safety protection in the Service largely depends on staff doing the right thing at the right time. An engineer has had a look at the gas appliances in the Service and has said that theyre in a good condition. The same applies to the mobile hoist. The electrical wiring installation has also been passed. We looked at the record of accidents and other untoward events that have occurred in the Service this year. There is nothing out of the ordinary in the sense that we need to make further enquiries. The Manager says that she checks the place over to make sure that theres nothing broken that needs fixing. Also, she looks out for hazards that might cause someone to have an accident. She hasnt noticed anything so far. We kept our eyes open while we were walking around. We didnt see any obvious hazards either. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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