Care Home: 10 Spennithorne Road

Similar services:

• Clover House
• Parkside
• Park Lodge
• Mere Hall View
• St Bonaventures
• Hudson Road
• Whitewalls
• Home Farm

What the care home does well Residents live in a home which is well maintained and homely. Residents have lived there for a long time and it was clearly evident that the registered manager and members of staff respect that they are in the residents home and have attempted to minimise any effects of institutionalisation. The registered manager has been able to retain a stable work force with no staff vacancies within the last 12 months. This means that residents receive care and support from people they know, trust and who care about them. Without exceptionall members of staff and the registered manager demonstrated their commitment to supporting people with profound disabilities in a manner which promoted their self worth and independence. From residents surveys we can tell that they are happy living in their own home and with the support provided. Staffing surveys indicated that staff feel well supported, are happy in their job and feel that they work well as a staff team for the benefit of residents. What has improved since the last inspection? Since the last inspection the acting manager was promoted to become the manager of the home, she then went on to successfully complete the registration process with us to become the registered manager of the home. She has also achieved a National Vocational Qualification at level 4 and achieved the leadership and management award. New equipment has been provided for residents. New flooring, lighting, and pictures have been provided and redecoration has also been completed. Fixture and fittings are homely and indicate that thought and consideration has been given to making all areas personal and homely.Many aspects of administration have been improved since we last inspected, these include new care plans,policies and leaflets for use by residents. These come in various formats enabling residents to know about policies which are there for their protection. To ensure that residents have structured and planned activities which they have chosen to do, activity planners have been introduced. This means residents have something to look forward to each day. What the care home could do better: There are no parts of this service which fall below the required standard. We think that the registered manager has demonstrated her ability to review how the home is run and her commitment to its continued development. As a consequence we do not feel the need to make any good practice recommendation. Key inspection report Care homes for adults (18-65 years) Name: Address: 10 Spennithorne Road 10 Spennithorne Road Urmston Manchester M41 5BU The quality rating for this care home is: three star excellent 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: Sylvia Brown Date: 2 4 0 8 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 32 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 32 Information about the care home Name of care home: Address: 10 Spennithorne Road 10 Spennithorne Road Urmston Manchester M41 5BU 01617486414 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) : Calderstones NHS Trust care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The registered person may provide the following category 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 The maximum number of service users who can be accommodated is: 4 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Spennithorne Road is a bungalow which accommodates four residents who have profound physical disabilities and who have complex health care needs. Each resident has their own tenancy agreement and have a landlord. They are supported by Calderstones NHS Trust to live independently within the local community. Urmston town centre is near the home enabling residents to take part in community activities. The home is well equipped and suitable to accommodate those that live there. There is off road parking to the front of the home and a large garden at the rear. A copy of the homes Statement of Purpose and Service User Guide is available up on request. Fees are calculated on an individual basis based upon peoples financial circumstances and individualised care package. Care Homes for Adults (18-65 years) Page 5 of 32 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: three star excellent 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 32 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 3 star Excellent. This means the people who use this service would experience excellent quality outcomes. The report is written on behalf of the Care Quality Commission (CQC) therefore throughout the report the terms we and us are used when referring to the CQC or a representative working on their behalf. For reporting purposes the preferred term to be used for people living and receiving a service is resident. The registered manager was not available at the first site visit but was at the home on the second visit. We had the opportunity of meeting with residents and members of staff during the course of the inspection process. The inspection report is based on information and evidence gathered by the Care Quality Commission (CQC) since the last key inspection, which was completed in August 2007. In August 2008 we completed an Annual Service Review. We do an annual service review when there have been no major inspection ( we call this a key inspection) in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us Care Homes for Adults (18-65 years) Page 7 of 32 since the last key inspection or annual service review. This was a key inspection which included two site visits to the service. The site visits were unannounced which means the manager and staff were not told that we would be visiting. As part of the inspection process we gathered information from a number of people which included meeting with and seeking the views of residents. Prior to the site visits we also sent out surveys to residents, their relatives and members of staff. This gave them an opportunity to tell us in writing about their opinions on the services provided at the home. Some of the comments received are included within the report. We case tracked two service users which means we looked in depth at their records, observed them as they went about their daily routines and evaluated the support they received from members of staff. In July 2009 the registered manager completed a self assessment form, which is called an Annual Quality Assessment Audit(AQAA).This document should tell us in detail what they and the registered provider have done since the last key inspection to meet and maintain the National Minimum Standards. It should also tell us what they felt they were doing well, how they had improved within the past 12 months and plans to develop in the next 12 months. The AQAA received was completed to an excellent standard. Care Homes for Adults (18-65 years) Page 8 of 32 The concise information told us everything we needed to know about the service. We also gathered information from general contact with the home through their reporting procedures which are called Notifications and information we may have received from other people, such as the general public and professional visitors. We have not received any complaints or safeguarding alerts about this service within the previous 12 months, This report is a public document and should be on display within the home and can be made available for reading upon request. What the care home does well Residents live in a home which is well maintained and homely. Residents have lived there for a long time and it was clearly evident that the registered manager and members of staff respect that they are in the residents home and have attempted to minimise any effects of institutionalisation. The registered manager has been able to retain a stable work force with no staff vacancies within the last 12 months. This means that residents receive care and support from people they know, trust and who care about them. Without exception Care Homes for Adults (18-65 years) Page 9 of 32 all members of staff and the registered manager demonstrated their commitment to supporting people with profound disabilities in a manner which promoted their self worth and independence. From residents surveys we can tell that they are happy living in their own home and with the support provided. Staffing surveys indicated that staff feel well supported, are happy in their job and feel that they work well as a staff team for the benefit of residents. What has got better from the last inspection Since the last inspection the acting manager was promoted to become the manager of the home, she then went on to successfully complete the registration process with us to become the registered manager of the home. She has also achieved a National Vocational Qualification at level 4 and achieved the leadership and management award. New equipment has been provided for residents. New flooring, lighting, and pictures have been provided and redecoration has also been completed. Fixture and fittings are homely and indicate that thought and consideration has been given to making all areas personal and homely. Care Homes for Adults (18-65 years) Page 10 of 32 Many aspects of administration have been improved since we last inspected, these include new care plans,policies and leaflets for use by residents. These come in various formats enabling residents to know about policies which are there for their protection. To ensure that residents have structured and planned activities which they have chosen to do, activity planners have been introduced. This means residents have something to look forward to each day. What the care home could do better There are no parts of this service which fall below the required standard. We think that the registered manager has demonstrated her ability to review how the home is run and her commitment to its continued development. As a consequence we do not feel the need to make any good practice recommendation. Care Homes for Adults (18-65 years) Page 11 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Sylvia Brown 3rd Floor Unit 1 Tustin Court Port Way Preston Lancashire PR2 2YQ 01772730100 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 12 of 32 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 13 of 32 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. Residents 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 staff team all about them and the support they need. Evidence: There have been no new admissions to the home for a number of years therefore we were not able to assess the current pre admission procedures which have been developed. The registered manager informed us that changes to old procedures have taken place and that the process is more service user led, taking into account their individual direct need for support alongside their personal preferences for how they would like to live and be supported. Previous inspections have identified that the current residents pre assessment and admissions procedures were completed to a good standard. We have confidence that new procedures will, when used, demonstrate how this aspect of the service has developed. Care Homes for Adults (18-65 years) Page 14 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are involved in decisions about their lives, and play an active role in planning the care and support they receive. This means they receive the care and support they want and need. Evidence: Although the residents living at Spennithorne Road have profound disabilities, and complex health care needs, the registered manager has systems in place which has made sure they are in control of their lives and direct the support they receive. From talking to and observing staff members practice we could see that they were fully committed in supporting residents to lead purposeful and fulfilled lives and everyday experiences. We saw one resident being asked if they would like to go with staff to hang out the residents clothes after being laundered. Although the residnet had limited mobility they chose to go into the garden and watch the process. Another resident who has seveer restrictions in movement was asked if they would like to move to the kitchen area to oin a member of staff as they completed the residents laundry tasks. Throughout all these observations we heard members of staff holding Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: everyday meaningful and thoughtful conversations with the residents. We looked at two of the four residents care files in depth and one other in part. We could tell that residents were consulted about their needs and had contributed to the making of their care plans. The care plans we looked at were very detailed and informative, summary versions were in an easy read format which residents had seen. They were personalised and appeared reflective of the residents wishes for daily living. Staff surveys all stated that members of staff were given enough information and support to enable them to carry out their role and responsibilities when supporting residents. When asked what does the service do well staff members commented provides competent staff who know the client group and all their needs very well and meet and attend to all the residents healthcare needs. During the inspection members of staff appeared highly competent and knowledgeable about residents conditions and their individual requirements for support including health,social care and any risks associated with their conditions. Because of the complex needs of residents, risk assessments were carried out for all essential areas for their daily living requirements. This ensures that members of staff know what risks are likely when supporting a resident. Where specialised equipment was required, information about its safe use and maintenance was recorded and used for reference purposes. We observed an agency member of staff taking time to read care plans and risk assessments before they took a resident out. We also observed that regular members of staff talked with them to assure themselves that the agency staff member had understood how the resident was to be supported and of any special considerations which were required. We were informed that the agency member of staff had worked previously at the home and knew of the resident they were supporting. Residents have some restrictions placed on them due to their disability, for instance one resident cannot go out for long periods of time because community facilities are ill equipped when personal care is required. Not withstanding this the staff team work around restrictions to ensure residents choices are met as far as possible met. The risk assessment process helps them to do this. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: Care Homes for Adults (18-65 years) Page 17 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident is treated as an individual needs and requirements. They are able to keep in touch with family and friends and they are as independent as they can be, lead their chosen life style and have the opportunity to make the most of their abilities. Residents have nutritious and attractive meals and snacks at a time and place to suit them. Evidence: The registered manager has, over a period of years shown us her commitment to developing the services provided to people with profound disability. She has created a strong ethos within the home that she and staff members know they are guests in the residents home and that their role and function is to promote and support residents to live meaningful lives. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: During our inspection we saw that residents care files contained activity records that identified what the they like to do to occupy themselves. These were detailed records which showed residents choices for everyday living and preferred routines. Activity planners were also in place which supported residents to have structured days which they can plan for and look forward to. One resident was supported to prepare for going out,they were given the opportunity for choosing where they wanted to go. On this occasion they decided on visiting a cafe and going to the cinema. Supporting members of staff were observed referring to care support notes to make sure they had all the information they required such as photo symbol cards which were to be used by the resident when choosing their meal whilst out. Another resident was observed being asked by one staff member about the planned activity, but it was made clear through non verbal responses that the resident did not want to do what was planned. Alternative options were discussed with the resident who decided to listen to music. The three residents surveys stated that they felt they were able to make decisions about what they did each day,that staff always treated them well and that members of staff always listened and acted on what they said. All residents are to have a holiday period away from the home this year and special holidays are in the process of being planned for next year in order to acknowledge and celebrate two special birthdays. The home continues to have access to a minibus to support residents getting out to local centres and events. Residents are able to chose activities which are suitable for them, for instance they attend concerts, go to the cinema, go to restaurants,visit places within the community and have holidays. The registered manager told us that within the next twelve months she is going to improve residents involvement within their local community. Residents are able to receive visitors when they want and most have a regular visit from their family and or friends. The registered manager told us that in the last year improvements had been made regarding meals at the home. She said healthy eating had now been put in place and that residents had been involved in menu planning. Photo symbol cards and menus were in place, this makes sure that residents are able to make their own choices each day. Records of residents weights , food intake and meals taken outside of the home were maintained, all of which would assist a medical professional to make an assessment on the nutritional intake of residents if required. Care Homes for Adults (18-65 years) Page 19 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual health and personal care needs are recorded, recognised and met as they require and desire. They receive their medication as prescribed and in a safe manner by members of staff who are trained and competent. Evidence: All residents have an full and detailed person centred care files and health action plans that highlight their specific health care needs and how they should be met. During the inspection we saw one residents behaviour pattern had been monitored,the outcome of which gave clear indicators about pending seizures. Another residents health condition was being monitored in respect of the ageing process and the possible effects that may be having on their general health and wellbeing. Epilepsy care files were in place as were feeding regimes for two residents who require enteral feeding (PEG). Choking assessments were in place for all residents and all staff have received training in dysphasia. The care files we looked at demonstrated that appropriate health care assessments were in place and kept under review. Consultation with numerous healthcare specialists and advisors were evident and general health care checks and routine appointments were Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: carried out. Residents have their own doctors and are registered with dentists and opticians. Staff training records identified that they have received the specialised training they required in order to support residents with complex care needs. Training in the management and administration of medication is thorough with members of staff attending one full days training followed by the completion of a work book within one month of attending the training. Spot checks are completed by the registered manager to assure herself that members of staff remain competent and two yearly refresher training is manditory. Records about the homes routines for administering medications were well maintained. Care Homes for Adults (18-65 years) Page 21 of 32 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. If residents have a concern with their care, they or people close to them know how to complain on their behalf. Any concerns are looked into and action taken to put things right. The registered manager has systems in place which safeguard and protect residents from abuse and neglect. Evidence: The home has written complaints and adult protection procedures in place both of which are in formats suitable for service users. We have not received any concerns,complaints or safeguarding alerts about this service. There has been one complaint made to the home which was investigated by the registered manager. We found that the action taken followed procedures and was managed well. Members of staff are trained to a good standard and have extensive communication skills to enable them to communicate with residents. Residents surveys identified that they have someone they know,trust and who they are able to communicate with should they have any concerns about their care or how they are being treated. During the course of the inspection we saw how members of staff interacted with residents and found it both respectful and professional. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Members of staff confirmed that they were recruited correctly and that a Criminal Records Bureau(CRB)checks were applied for and received before they were offered a position of employment. This means that residents are safeguarded as far as possible from being care for by someone who may do them harm. The manager said that the new framework for implementing the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA DOLS) had been discussed with staff and at the time of our visit no one living at the home was subject to an application being made under these requirements Care Homes for Adults (18-65 years) Page 23 of 32 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. Residents live in a home which feels like their home , is comfortable and safe. The registered manager makes sure the residents have the right specialist equipment to support them and maintain their independence. Evidence: Residents live in a warm caring well maintained home which was clean and free from odours.Residents surveys infomed us they the home was always fresh and clean. Though there are only four residents who live at the home, because of their complex needs they require additional space. The lounge is of an adequate size but residents would benefit from additional space. We are told that consideration is being given by the landlord about the provision of a conservatory or extension which would provide residents with more communal space. Since the last inspection the lounge and all bedrooms have been redecorated with new fixtures and fittings being provided within the lounge. The outcome is that the home feels and appears to provide a homely environment for the residents who have lived there for many years. Bedroom layout, decoration and furniture was individualised according to residents own tastes,needs and requirements. Time has been spent making sure that residents have Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: been consulted about colour schemes and new fittings so they have bedrooms they like. Aids and adaptations have been provided to support residents. Servicing records were in place which confirmed that the registered manager took the required action to make sure all equipment was safe and fit for purpose. There is no dedicated separate office available for the registered manager which means space used by residents is compromised. Office work and meetings have to be arranged within the lounge or dining room or in residents bedrooms with their permission. Meetings are also arranged outside of the home. Paperwork is stored within the dining area which could be used by residents if appropriate office space was found or made. Consideration should be given to developing new office space to enable the running of the home to be completed away from residents and ensure all meetings and discussions take place in private. The rear garden is spacious and well maintained. Weather permitting, it was evident that residents liked to access the gardens. Laundry facilities were clean and of sufficient size to meet the requirements of residents. Washing machines had sluicing facilities which ensured that soiled items are appropriately disinfected and clean, all of which reduces the risk of cross infection. Staff training records identified that staff have completed training in infection control procedures. The registered manager could demonstrate through the keeping of records that refrigerator temperatures were monitored, water temperatures were checked and monitored and good cleaning routines were carried out. Care Homes for Adults (18-65 years) Page 25 of 32 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. Residents have safe and appropriate support as there are enough competent staff on duty at all times. They have their needs met and are cared for by members of staff who get the relevant training and support from their manager. Evidence: No staff have ceased employment at the home since we last inspected, therfore there have been no new members of staff recruited within the past twelve months. The service has a good history of compliance regarding the recruiting and selecting of members of staff. All mandatory checks and employment forms are completed as are face to face interviews before successful applicants are offered staffing positions. Following recruitment, new members of staff complete common induction procedures which are lengthy and thorough. They are supernumerary and shadow more experienced staff whilst on induction. They have to complete extensive induction workbooks within the first six weeks of employment which are monitored by the registered manager. Additional workbooks leading to an Induction Award are also required to be completed which are service specific. All members of staff have staffing files within which information about their continued learning is kept. The service places a strong emphasis on training and all staff have completed infection control, food hygiene,CPR and fire training within the past 12 Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: months, plans were in place for them to do their yearly updates on manual handling. Since the last inspection training plans have been increased to include such training as the protection of vulnerable adults,equality and diversity, care of people with a physical disability and dysphasia which many members of the staff team have already completed. Staffing surveys told us that staff members thought they received good support and training from the organisation. The staff team is long standing with all staff being employed at the home for more than twelve months. This means residents receive care and support from people they know and trust. On occasions when agency staff are employed, checks are made to make sure that they have worked at the home previously and are known to the residents as far as possible. We looked at the rota of hours worked and can confirm the managers statement that they are devised to meet the needs of the residents. We checked the rota against the activity planners for residents and could not see any activity that had been cancelled due to shortages of staff. As stated within the report earlier, we had the opportunity of observing members of staff as they supported residents. We found thef to be polite and respectful. They demonstrated various communication skills and were knowledgeable when questioned about residents complex needs and how they should be supported. Records confirmed that they receive regular supervision and have their practice monitored by the registered manager. Annual appraisal systems were in place as were performance development records. Care Homes for Adults (18-65 years) Page 27 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. The home has effective quality assurance systems developed by a qualified, competent manager. This means residents and their families have confidence in the service because it is led and managed well and in the best interest of those living at the home. Evidence: Since we last inspected there has been a change in the management structure in that the acting manager has successfully completed the registration process with us to become the registered manager at the home. She has also completed training at NVQ level 4 and achieved her certificate in Leadership and management. The registered manager has a strong leadership style and is committed to raising standards for people with a profound physical disability. She is an NVQ assessor and undertakes to train others within the organisation. From our discussions with the registered manager, she demonstrated a sound understanding in respect of continuous service improvement and person centred thinking was clearly evident. The AQAA stated that the registered manager is supported to run the home by a service Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: manager, who visits the home to make sure standards are maintained and continued development is identified. The registered manager stated that there is an excellent relationship between the registered manager, staff and relatives all of which has positive outcomes for residents. The registered manager told us that in May 2009 the responsible individual of the organisation spent a week working alongside members of staff at the home as a support worker. This means they met with residents and gained an understanding of their needs and how they were supported, gained direct experience of everyday life at the home and obtained insight into the role and responsibility of support workers. Each resident has a key worker and regular house meetings and user forums mean that issues arising within the home are openly discussed. The service manager visits the home monthly to complete Regulation 26 visits. These visits include talking with the residents, looking around the building to make sure various standards are met , talking with members of staff and if available meet with the registered manager. The organisation has policies and procedures in place regarding the health , safety and wellbeing of residents and members of staff as well as for the running of the business. Many have been adapted into formats which can be used by residents such as easy read and audio tapes. Although we have quoted parts of the AQAA within the report, we feel that further comment is warranted. The AQAA contained excellent information and identified that the registered manager has a high level of understanding about the importance of equality and diversity and listening to and acting on behalf of people with complex needs. There was good evidence to show that the registered manager was self aware and recognised where further opportunities remain to develop the service further for the benefit and enjoyment of residents. A sample of Health and safety records were looked at and we found that all appropriate service checks were completed routinely ensuring equipment was fit for purpose and safe. Quality assurance procedures have been completed which included consultation with residents, relatives and visitors to the home. All returned surveys were positive with such comments as welcoming and friendly friendly staff open to discuss any problems clean and friendly environment and clients well cared for. Care Homes for Adults (18-65 years) Page 29 of 32 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 32 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 Care Homes for Adults (18-65 years) Page 31 of 32 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. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!