Care Home: 118-120 Dudley Street

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What the care home does well The service continues to provide people with a good environment in which to live. Aids and adaptations are provided as required. The service continues to be run by a qualified and experienced manager. People are consulted on, and participate in, the day-to-day running of the home. They are supported by a qualified and trained staff team. People`s best interests are protected by the service`s induction programmes for new staff. Care plans are produced and regularly reviewed to ensure people`s needs and personal preferences are met. Risk assessments are undertaken and strategies identified to keep people safe from harm. They are supported to make their own decisions, maintain contact with family and friends and provided with opportunities to participate in a range of activities. A choice of meals is provided that meets people`s dietary needs and personal preferences. Mealtimes are flexible. The manager is aware of areas need improvement and plans are produced for these to be addressed. What has improved since the last inspection? The service has addressed the requirements identified in the previous key inspection report. These include better support for people to access community-based activities on a regular basis, improved recordings of action taken to address issues raised informally or through the service`s complaint procedure and ensuring all staff receive regular fire safety training and participate in drills at least once every six months. What the care home could do better: The service carries out regularly checks on the premises and maintenance issues are generally addressed in a timely manner. However, the need for repairs to be carried out on the garden path has been reported on in the maintenance records several times, but not yet been addressed. Plans should be made for this work to be undertaken to ensure people who wish to spend time in the garden can do so safely. Staff recruitment files kept by the service should include dates when references have been received and seen by manager. This will demonstrate more fully that robust recruitment procedures are being followed at all times to ensure the well being of the people living in the home is protected. Caring for people with diabetes should be included in the service`s training programme and when refresher courses arranged. This will ensure these people`s needs are being met by a confident and competent staff team who are up to date with current practice. Key inspection report Care homes for adults (18-65 years) Name: Address: 118-120 Dudley Street 118-120 Dudley Street West Bromwich West Midlands B70 9AJ     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: Linda Elsaleh     Date: 1 1 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 118-120 Dudley Street 118-120 Dudley Street West Bromwich West Midlands B70 9AJ 01215802573 01215256257 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: enquiries@lonsdale-midlands-limited.co.uk Lonsdale (Midlands) Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 8 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 (LD) 8, Physical disability (PD) 8 Date of last inspection Brief description of the care home 118-120 Dudley Street is an 8-bedded nursing home for older adults with learning and physical disabilities. The home is situated close to local shops and amenities, near to West Bromwich town centre, and is accessible by public transport. The premises consist of a communal lounge, dining area and assisted bathing facilities. There is a domestic style laundry and kitchen, and a garden/patio area to the rear. A lift services the first floor. A range of services are available including assistance to access healthcare facilities, various in -house and external recreational pursuits, and community inclusion. The home has its own transport. For up date information about fees charged the reader is advised to contact the service. Care Homes for Adults (18-65 years) Page 4 of 30 8 8 Over 65 0 0 Brief description of the care home 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: We looked at information we have received about the service since our last visit and responses to surveys received from people who live in the home, their relatives and health and social care professionals. Comments were positive about the service and have been included in this report. The service is required to complete an Annual Quality Assurance Assessment (AQAA). This provides us with information about what has happened in the home during the last 12 months. This was returned to us when requested and contained the information we asked for. This unannounced visit was carried out by one inspector on 11th November 2009 by one inspector. The service did not receive prior notice about when we would visit. We spoke to the manager, staff and some of the people live in the home. We looked at the care files for two people and files for two staff in detail as well as other records and Care Homes for Adults (18-65 years) Page 6 of 30 documents kept by the service. This was to help us to assess the quality of life for people who live in the home and the services performance against the national minimum standards. The atmosphere in the home was relaxed and friendly and the people we met appeared healthy and well looked after. Care Homes for Adults (18-65 years) Page 7 of 30 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 on page 4. Care Homes for Adults (18-65 years) Page 8 of 30 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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. People are provided with the information they need to make an informed choice about where to live. These are provided in written and pictorial formats. The service continues to review its assessment procedure to ensure it can meet the needs and aspirations of people who wish to move in. This means people can be confident their needs will be met in the manner in which they prefer. Evidence: Information about the service is provided in its Statement of Purpose and Service User Guide. These are available at the home in written and pictorial. The documents are regularly reviewed to ensure information is kept up to date. The eight people who live at the home have done so for over 12 months. Hence, there have been no new admissions during this period. We looked at two peoples files in detail and both contained information of assessments carried out by relevant health and social care agencies and the services Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: own assessments. People we spoke to told us suitable arrangements were made for them to visit the home before they move in. Records of these visits are kept available in their files. We discussed the admission process with the registered manager who demonstrated that she understood her responsibilities in relation to assessing the needs of individuals who may wish to live at the home and their compatibility with the people already living here. She told us of plans to include comments about what life is like at the home from people receiving a service in the Service User Guide. This will provide people who may wish to come with current residents perspectives. Care Homes for Adults (18-65 years) Page 12 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. People are involved in the planning of their own care, supported to make their own decisions and are consulted on, and participate in, all aspects of life in the home. The service carries out risk assessments and identifies strategies for keeping people safe from harm. Evidence: The care plans we looked at includes the personal, health and social care needs of each person. These are produced in easy read formats with information about their individual likes/dislikes and how they wish support to be provided to them. Plans are reviewed on a monthly basis by staff and, where applicable, risk assessments are in place which supports the contents of each plan. Since our last visit the manager and deputy have attended training in person-centred planning and care plans have been revised to reflect this. The manager told us this learning has been cascaded down to all staff and arrangements made for them to Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: attend a similar course. The practices we observed and discussions with staff show us the principles of person centred planning are practiced within the home. Staff told us each person is encouraged to live the lives they choose and are supported to make their own decisions. Discussions with staff show they are familiar with peoples plans and how their needs are to be met. For example one staff member told us, the plans provide me with information about what the person can and cant do and how they like me to support them. Information provided by the manager shows plans have been introduced for staff to receive more training in client-centred issues, such as epilepsy and sensory impairment. This is to ensure the staff team is confident and competent meeting peoples needs. As stated above, individual risk assessments are in place, where applicable, to support the contents of peoples individual care plans. This ensures strategies are put in place to reduce the risk of harm, but not restrict people from living the life they choose. Generic risk assessments, those not based on an individuals needs and capabilities, are available for staff in the general health and safety risk assessment folder. Staff showed us they understand risk management and commented strategies identified in the risk assessment process show us how to keep people safe and enable them to continue to do things for themselves. 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. People are able to follow their own routines and have opportunities to participate in a range of activities. They are supported to maintain contact with their families and to develop new friendships. People are offered a choice of meals that meet their dietary needs and personal preferences. Suitable arrangements are made for them to enjoy mealtimes. Evidence: The manager and staff told us they continue to work with local colleges in an effort to identify suitable courses that may be of interest to people who live in the home. The records show a college course was explored for one person, however s/he declined to attend an induction day and expressed no further interest. The manager has undertaken a review of how the service supports people to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: participate in activities. A weekly activity programme is produced with each person and arrangements are agreed about how people will be supported in accessing community-based activities. The rotas show sufficient staff are on duty to ensure people are able to participate in the activities they wish to. For example; during this visit people were accompanied to go shopping and others to go on a trip to the bowling alley. The files we sampled show daily records are kept of the activities individuals have participated in. These are included in the regular in-house reviews to ensure people continue to be provided with activities of choice. One person told us they enjoyed their bowling trip especially as they had won. Other outings include going to the cinema and local concerts that included seeing popular tribute acts. Activities and outings are discussed at house meetings and the minutes show three people, who said they would like to go to see Crufts earlier in the year, were supported to do so. Recent minutes also include discussions about possible holiday destinations for next summer. People enjoy weekly visits from external entertainers who provide exercise to music and progressive mobility classes. Celebratory events and parties are also organised and people invite their relatives and friends, such as to parties to celebrate birthdays and to entertainment evenings. This year has included a sing-a-long band and a small animal act that people were able to touch and ask questions about. Staff and people living at the home told us Christmas is the main focus for events at present. Plans have already been made to attend the local churchs celebrations, a party at a local hotel and a trip to the pantomime. The staff told us people are encouraged and supported to maintain contact with family and friends. The files we sampled include details of people who are important to the individual and how contact is to be maintained. There is an pen visiting policy for welcoming relatives and friends at any reasonable time. Visitors receive a warm welcome from staff and other people who live here. The following comments have been made by visitors homely environment, made to feel welcome, staff are friendly and kind and the manager and staff are approachable. People are able to receive visitors in the privacy of their own rooms if they wish. We observed people following their preferred routines. They choose the clothes they want to wear, but told us they often consult staff on the suitability of their choice in respect of the weather. There is unrestricted access to communal areas, however people are supervised and/or supported in high risk areas, such as the kitchen, in accordance with their individual plans and risk assessments. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: The Gold Award for food hygiene was issued by the Environmental Food Agency on its last visit to the service. The service continues to offer people a choice of meals based on their individual dietary needs and likes/dislikes. Snacks and hot/cold drinks are available throughout the day. Mealtimes are flexible, and can be changed to meet peoples individual lifestyles or preferred eating times. Records are kept of meals taken by individuals. People are involved in meal planning and shopping for food items. They are encouraged to carry out tasks for themselves according to their ability for example; one person likes to make her/his own breakfast and enjoys sitting in the kitchen chatting to staff while making toast. Most people are able to enjoy their meals unaided. Training in assisting people with eating and drinking has been attended by some staff. The manager told us plans are being made for all staff to receive this training. Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service meets the personal, emotional and healthcare needs of people living in the home and in the manner they prefer. There are suitable procedures in place for the safe handling and administering of medication and is managed on peoples behalf by staff trained to do so. Evidence: As reported on at previous inspections, staff are aware of peoples individual personal care needs. Observations made during this visit tell us the principles of respect, dignity and privacy are put into practice by staff. We saw staff knocking on doors before entering, using the individuals preferred term of address and speaking to them in a respectful and friendly manner. Peoples personal care needs and the support they required are detailed in their care plans. Rotas seen show appropriate staffing levels are maintained to ensure their needs can be met at all times. Discussions held with staff show us they are familiar with peoples plans and gave us examples of the support they provide to individuals. Mental Capacity assessments have been carried out to ensure peoples right to make Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: their own decisions are respected. Reading materials on this matter is available in the home and training arranged for all staff is almost complete. People have access to community-based health care services such as; general practitioners, district nurses, occupational therapists and chiropodists. The service continues to work closely with health care facilitators, based at GP surgeries, for which health action plans have been produced for each person. Records kept on peoples files show they are supported by staff to attend health care appointments. Reports of reviews carried out by peoples specialist consultants are also available on their files. A most pro-active, efficient and friendly home was a comment that was made by a community nurse who visits the home regularly. Staff we spoke to told us they had recently attended training in caring for people with epilepsy. The training matrix show staff have or are about to attend training in epilepsy and dementia care. They commented that it had been some time since they had attended training in caring for people with diabetes. This training was not identified on the training matrix. The manager is advised to include diabetic care in its training programme. This will ensure people with diabetes are being fully supported by staff that are fully confident and competent to do so. None of the people living at the home manage their own medication. During this visit we observed the nurse on duty following good procedures for booking in and administering medication. Specimen signatures and initials of nursing staff are kept in the medication folder to aid the monitoring of records. All nurses in the home are responsible for managing and administering medication and attend regular training courses. The services medication procedures were last reviewed in January 2009. These have been signed by staff to confirm they have read and understand the contents. For occasions when bank or agency nursing staff may be called upon to deal with medication the service keeps folder containing up date information peoples medication for them to refer to. Care Homes for Adults (18-65 years) Page 19 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. The service has systems to ensure that the views of the people who live here are listened to and acted upon, giving assurance that people are protected from abuse and have their rights are respected. Evidence: The service has a complaint procedure available in a pictorial format and was last reviewed in January 2009. Systems are now in place for recording the nature of the complaint, details of the investigation carried out and outcome. Information provided by the service show two complaints have been received by them within the last 12 months and satisfactorily dealt with in accordance with its procedures. No complaints about the service have been reported to us, the Quality Care Commission (CQC). People we spoke to, and those who responded to our survey, tell us they know who to speak to if they are unhappy or concerned about anything. The staff team regularly consults with people on an individual and group basis. This enables any issues or concerns to be dealt with promptly. Records of these are kept on the persons file and/or included in the house and staff meeting minutes. Adult protection policies and procedures are available in the home and safeguarding training has been provided to staff. The service follows procedures for reporting any concerns and works with the local authority and other agencies to ensure people are protected. Staff we spoke to told us they had received training in adult protection and Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: were confident any issues raised would be appropriately dealt with by the manager and provider. No safeguarding concerns were raised during this visit. The minutes of a recent house meeting show discussions have been held with people to ensure they know what to do if they feel they are being bullied. The service continues to support people to access local advocate services. Care Homes for Adults (18-65 years) Page 21 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. People live in a safe, well-maintained and comfortable environment. Evidence: The premises are in keeping with the local community and a range of amenities are within easy access of the home. The service has its own transport which is available to people living in the home. It continues to provide people with a comfortable, well maintained and clean environment in which to live. Since our last visit the service has purchased a new television and settees for the lounge. Two bedrooms and a bathroom have been fitted with equipment enable better support to be provided to people who are less mobile. People living at the home have ramped access to all parts of the garden which has raised flowerbeds, fish pond and patio areas. The service undertakes monthly maintenance checks of the premises. During recent months the service has identified that some of the paving slabs on the ramped walkway are beginning to lift. Arrangements need to be made for this to be addressed to reduce the risk of people tripping. The laundry is well equipped and situated away from living areas. Laundry and cleaning products are kept locked away and information is provided on the control of Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: substances hazardous to health (COSHH). There is also policy for the prevention and control of infection within the home and training has been provided for staff. Good practice is being followed by staff for example; mops are washed after use and stored appropriately. Care Homes for Adults (18-65 years) Page 23 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. People are supported by adequate numbers of appropriately trained and competent staff so that their needs are met. They are protected by the services recruitment practices. Evidence: Since our last visit the service has revised its day time staffing levels to provide people with increased support in accessing amenities and activities within the community. During this visit we saw staff interacting with individuals and providing them with good care and support. People and staff were seen chatting about various subjects. The people we spoke to tell us they have a good relationship with all members of the staff team. The service continues to be committed to ensuring all staff obtain/hold a recognised training qualification. The National Vocation Qualification (NVQ) Level 2 is held by the majority of staff and some also hold NVQ Level 3. Staff we spoke to tell us they feel supported by the manager and senior staff in all aspects of their training. Complimentary comments from relatives about the care and support provided to their family member. However, an additional comment was made about the constant turnover of staff. The manager told us six staff members have been appointed during Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: the last twelve months. The manager is advised to look at staff retention as part of its performance review. We sampled the services recruitment records and found evidence that satisfactory recruitment procedures are being followed. Check lists are kept at the front of files to show when documentation, such as Criminal Record Bureau (CRB) checks, have been received. However, copies of references are not kept on these files. The manager told us these are kept available the companys head office. A record should be kept to confirm when references were received and seen by the manager. This will further demonstrate people are protected by the services recruitment procedures. Information provided to us by the service tells us people living in the home are encouraged to participate more in the recruitment process. Information provided by the service states all staff have received induction training to the required standards. A record of induction is kept on their files together with a record of their training. A training matrix is on display in the office and provides the manager with information about what training has yet to be attended by staff and dates when refresher courses are to be arranged. Care Homes for Adults (18-65 years) Page 25 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. The people who use this service benefit from a well run home where their views underpin self monitoring, review and development. Their health, safety and welfare is promoted and protected. Evidence: Discussions and observations confirm that the service is being managed appropriately. The Registered Manager is a registered nurse (learning disability) and is appropriately qualified and experienced for the post. She undertakes periodic training to update her own skills. During this visit she demonstrated awareness of areas within the service that need improvement and showed us her plans to address these. The service has systems in place for monitoring and assessing its own practice. As part of this quality assurance system, pictorial surveys for obtaining the views of people who use the service have recently been revised. The manager told us that surveys seeking the views of relatives and other stakeholders are also ready to be sent out. Once these have been returned and evaluated with the services assessment of its own performance, it will publish its findings and plans for developing the service. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Health and safety matters within the home are appropriately managed. The records sampled show staff have received fire safety training. Other records seen, such as portable appliances testing and gas safety certificate, show systems are in place for carrying out routine checks and servicing of appliances and equipment. 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 1 19 Caring for people with diabetes and refresher training should be included in training programmes. This will ensure these peoples needs are met by staff who are competent and up to date with current practice. Action for paving slabs in the garden that are beginning to lift should be taken to ensure people are fully protected from the risk of falls. Recruitment files should contain dates when references were received and seen by the manager. 2 24 3 34 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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