Care Home: 165 Point Clear Rd

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What the care home does well Listens to people and helps them to do things that they wish to do.Supports people to stay in contact with their families and friends.Supports people to live in an environment that is comfortable and safe.Looks after people`s health and welfare and cares for them well.Helps people to take part in activities that they enjoy. What has improved since the last inspection? Improved the way in which the views of people who use the service and those who have an interest are sought and listened to.Representatives of the organisation now visit the home on a monthly basis to make their own assessment of how care is being provided, this visit includes spending time speaking with people who are using the service. What the care home could do better: No requirements or recommendation for practice were made as a result of this inspection visit. The manager and the staff team should continue to build and develop on their sound foundation of good practice. Key inspection report Care homes for adults (18-65 years) Name: Address: 165 Point Clear Rd St Osyth Clacton on Sea Essex CO16 8JB The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Neal Cranmer Date: 1 5 0 1 2 0 1 0 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 31 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: 165 Point Clear Rd St Osyth Clacton on Sea Essex CO16 8JB 01255823172 01787479406 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) : TLC Care Homes Limited care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The maximum number of service users who can be accomodated is: 4 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 Date of last inspection 2 0 0 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home 165 point Clear Road is a chalet style bungalow situated in the pleasant village of Point Clear, just outside of St Osyth. The home offers service users spacious accommodation. All have their own bedrooms with ensuite facilities. Communal living areas are also large and spacious and offer service users space to go off and spend time in isolation if they choose. The home has a large garden area to the rear of the property, with a patio area whwere service users may chose to sit during good weather. The home is situated on a bus route, which provides easy access to either Clacton-On-sea, the nearest seaside resort or the historic town of Colchester some twelve miles away. Care Homes for Adults (18-65 years) Page 5 of 31 Care Homes for Adults (18-65 years) Page 6 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 31 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on the 15th of January 2010. We spent time looking around the home and spoke to people living in the home and the staff caring for them. We looked to see if people were happy living in the home and with what goes on in the home. To help us write this report we looked at a lot of different evidence, this included paperwork like care plans, staff files and menus. To help us further the manager sent us information in a document called an Annual Quality Assurance Assessment or AQAA. This gave us information about how they run the home and look after people. Care Homes for Adults (18-65 years) Page 8 of 31 What the care home does well Listens to people and helps them to do things that they wish to do. Supports people to stay in contact with their families and friends. Supports people to live in an environment that is comfortable and safe. Looks after peoples health and welfare and cares for them well. Care Homes for Adults (18-65 years) Page 9 of 31 Helps people to take part in activities that they enjoy. What has got better from the last inspection Improved the way in which the views of people who use the service and those who have an interest are sought and listened to. Representatives of the organisation now visit the home on a monthly basis to make their own assessment of how care is being provided, this visit includes spending time speaking with people who are using the service. Care Homes for Adults (18-65 years) Page 10 of 31 What the care home could do better 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 Neal Cranmer The Belgrave Centre Stanley Place Talbot Street Nottingham NG1 5GG 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 11 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives are provided with the necessary information to enable them to make an informed decision about the homes ability to meet their assessed needs. Evidence: The manager told us in the AQAA, We provide prospective service users with a comprehensive Statement of Purpose and Service users Guide On the day of the inspection we sampled both the Statement of Purpose and Service Users Guide. Combined both documents provided prospective service users or their representatives with the necessary information to enable them to make an informed choice about the services ability to meet their assessed needs. This information included details about the provider and registered managers experience and qualifications, also included was information about the admission process, accommodation provided and how to go about raising a concern or complaint. The statement of Purpose also included details about the fees charged and what was and was not included/covered by the fees. There had been one new admission made to the home, which occurred in late 2009. The Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: manager told us in the AQAA, Transition plans are put into place for service users moving into the home, so that they are given the opportunity to test drive the service. Through discussion the manager was able to demonstrate a solid knowledge of the importance of having a robust assessment process in place because of the complex needs of the people using the service. The manager explained the admission process from the point of receiving the initial referral through to admission. She stressed the importance placed on looking at compatibility with other people living in the home. The manager provided us with evidence to show that transitional arrangements were put in place based upon each persons individual need. Following admission into the home a six week review is held before the admission becomes permanent. We examined the assessment tool used by the manager to assess peoples needs. The document was found to be comprehensive and covered a wide range of areas including: self care, dressing/undressing, domestic skills within the home, budgeting skills, physical health, mental well-being, communication skills, eating and drinking, diet, clothing, social interactions and activities. Due to the complex needs of the people living in the service we were unable to obtain their views of how their assessment was for them. However from discussion with the registered manager and from sampling of records we judged that the assessments carried out were sufficiently detailed to enable the manager to develop a plan of care based upon the persons assessed care needs. Care Homes for Adults (18-65 years) Page 14 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to make decisions about their lives, and are encouraged to play an active role in planning the care and support that they receive. Evidence: The manager told us in the AQAA, We provide comprehensive service user care plans using a person centered format which is user friendly. We sampled care plans for two people living in the home, including that of the person most recently admitted to the home. Each care plan examined started with a profile containing relevant information such as the persons next of kin, date of birth, and people involved in the care of the person. For each person there was a range of individual care plans in place covering Personal Care, Communication, Management of Behavior, Eating and Drinking, Independent Living Skills and Daily Activities. The format of the care plans identified the aim/objective, and the skills the person had. The care plans gave details of what staff needed to do and what the person was able to do for themselves. The care plans contained a good level of detail so that staff were able to provide support consistently in the way that the person wished. One care plan stated X bath water Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: temperature needs to be checked to ensure that they have not run it to hot and X needs to be reminded by their key worker to purchase their preferred toiletries when needed. Some discussion took place around decision making. Most of the people living in 165 Point Clear Road have very complex needs making it difficult or not possible for them to make informed decisions. Individual records examined contained Mental Capacity Act Assessments. Staff working in the home know people well and have used this knowledge combined with input from relatives and health care professionals to enable them to get to know people very well and build positive rapports which assist them to support people positively when they become stressed or anxious. There was information in the care plans examined that showed peoples preferred ways of communicating. Staff spoken with were able to demonstrate that they were familiar with peoples complex needs. During the course of our inspection we observed staff dealing with difficult situations supportively and sensitively, thereby helping people to manage situations without becoming to anxious. Peoples likes and dislikes were documented in their care plans. Care plans were evaluated regularly or as peoples needs changed and each key worker completes a monthly report. This ensures that people continue to receive appropriate care to meet their changing needs. Comments in surveys completed by relatives for the home indicated that relatives felt that they were kept well informed about their relatives by key workers. Each person has a comprehensive range of risk assessments in place that described the identified risk and the agreed response to reduce the risk. Care Homes for Adults (18-65 years) Page 16 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service are supported to make choices about their life styles, and are supported to maintain and develop their life skills. Evidence: The home does not have a structured activities plan. The manager explained that activities are based upon each individuals likes and dislikes. Activities tend to take place on an ad hoc basis due to the complex needs of the service users, staff have over time found that it is best not to be prescriptive about activities. As a result activities tend to be chosen by the service users on a day to day basis. However records showed that there were a range of in-house activities provided including, listening to music, chatting with staff, drives out and going for walks. On the day of our visit we observed service users being supported to go out for walks and to go out on shopping trips. The manager told us in the AQAA, Service users are encouraged to help with the daily routines for their home, and to make choices about their daily lives and to participate in the day to day running of the home. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: During the course of our inspection visit we heard and observed service users being supported to make decisions about how they wished to spend their day. We also observed service users taking an active role in some aspects of the day to day running of the home including organising washing and assisting with the preparation of refreshments and snacks with support as required. The manager and staff actively encourage family contact; the homes visitors book showed that relatives regularly visited the home. Discussion with the manager and staff indicated that service users were supported to maintain links with their family members by their key workers. The care plans we examined contained the contact details of the people who were important in the lives of the service users. The manager told us in the AQAA, Service users are encouraged and supported in the preparation of well balanced menus, which encourage personal choices, preferences and healthy eating. The home operates a four weekly rotational menu, sampling of which indicated that it was varied and nutritious. Discussion with the registered manager indicated that service users are consulted with on a weekly basis about the menu. On the day of the inspection we overheard service users confirming with staff what they were going to have to eat. Other records we examined showed that service users were involved in shopping for food stores, and as stated above on the day of our visit we observed service users going out shopping with staff. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based upon their individual needs, and the principles of respect, dignity and privacy are put into practice. Evidence: The manager told us in the AQAA, All service users have individualised personal support care plans which detail how they prefer their personal support to be provided. Care plans examined contained sufficient information about the way in which people wished to have their personal care carried out to ensure that staff provide their care consistently. Observations on the day of the inspection showed that staff provided care considerately and discretely. The manager told us in the AQAA, Service users are supported to access all therapeutic and health care services that are required as per their care plan. Each of the care plans examined contained a Health Action Plan and there was ample evidence that peoples health care needs were given a high priority. The manager and staff spoken with were all able to demonstrate a good awareness of peoples individual needs around health and well being. Records examined contained evidence of appointments with a range of health care professional including; General practitioners, Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Practice Nurses, Chiropodists, Dentists, Community Nurses, and Psychologists. Records of peoples weights was also being maintained and these were current and up to date. Discussion took place with the registered manager about the homes practice around the administration of medicines. The manager was able to demonstrate a thorough understanding of their responsibilities around the storage and recording of medicines. All medication is stored in a locked metal cabinet situated on the wall in the office. Medication is dispensed via a Measured Dosage System (MDS) or individually named containers. A list of all staff authorised to administer medicines is maintained including a list of initials. The medication records were examined for all of the service users living in the home and were found to be in order with no evidence of any gaps or omissions. All staff before being allowed to dispense medications complete a workbook, they are then assessed by senior staff on a further six occasions. Discussion with staff indicated that they are reassessed if there are significant changes to peoples medication or if they move homes within the organisation. We were unable to observe a medication round, as service users were only prescribed medication first thing in the morning and in the late evening, however from our observation we judged that the homes practice around the administration of medicine was sufficiently robust enough to keep people safe. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to express their concerns, and have access to an robust, effective complaints procedure. Evidence: The manager told us in the AQAA, We take all concerns, complaints and protection issues extremely seriously and ensure all staff, service users and families are informed of organisational policies and procedures relating to these areas. The home had a complaints policy and procedure in place, which was clearly set out and openly available to service users, visitors and staff. A copy of the complaints procedure was on display in the hallway of the home, this version of the procedure was displayed in a pictorial format to assist and enable people with comprehension difficulties to understand its content. A record was held to show that all staff had signed to confirm that they had read and understood the policy. The AQAA provided by the manager and received by us on the 3/12/2009 stated that no complaints had been received by the service since the last key inspection and our records confirmed this to be the case. On the day of our visit we observed a service user raising a concern directly with the registered manager, this concern was received sensitively and assurances were given to the service user that their concern would be looked into. Safeguarding policies and procedures were in place for staff guidance and were available to service users to access. Staff spoken with and records examined indicated that staff had received training around safeguarding and keeping people safe. Discussion with the Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: manager and staff indicated that they understood their responsibilities regarding keeping people safe. Since our last key inspection of the service one safeguarding referral had been made to the appropriate authority, this referral was investigated and was found to be unfounded. Care Homes for Adults (18-65 years) Page 22 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in an environment that is safe and well-maintained, and in which people can develop their independence. Evidence: The manager told us in the AQAA, We provide the highest quality environment, which we believe exceeds the minimum standards. The home has a very large lounge which houses a snooker table for all residents to freely use. All the bedrooms have their own bathrooms and all are decorated and furnished as to service users liking. The home is designed to meet the individual needs and life styles of the people living there. On the day of the inspection it was found to be clean, well furnished, comfortable and fit for its stated purpose. The home provided service users with a good sized garden which was enclosed and safe for them to access either independently or with support as required. People also had access to a patio area where they could sit and spend time during the summer months. The home is situated on a main bus route and is quite close to the local seaside. Service users rooms that we visited were pleasantly decorated and we saw evidence of people having their personal possessions around them, items we observed included ornaments and family photographs. We observed service users sitting in the lounge listening and watching television with staff and they appeared relaxed and at ease in their Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: environment. The atmosphere in the home was good and there was a positive rapport going on between the staff and the service users. The laundry facility in the home was domestic in nature, being equipped with a washing machine and tumble dryer. Cleaning materials were locked away securely in a cupboard. The manager provided us with documents to show that monthly health and safety audits were being undertaken including Control of Substances Hazardous to Health (COSHH). The last audit undertaken was carried out in November 2009. COSHH data sheets relevant to substances held in the home were maintained, and all relevant safety assessments had been carried out. Staff spoken with said that they had access to Personal Protective Equipment (PPEs) e.g. gloves and aprons, and records showed that staff had received training in infection control. It was however noted during the course of the inspection that the clinical waste bin situated at the front of the premises was overflowing, this was however noticed by a visiting senior manager who pointed this out to the registered manager, and provision was then made for a collection. Care Homes for Adults (18-65 years) Page 24 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident they are cared for by a competent staff team who can meet their needs and who have been employed following a thorough recruitment process. Evidence: The manager told us in the AQAA, We have high staffing levels, and excellent staff retention, with good staff morale and a low usage of agency staff. From discussion with the manager, staff and sampling of records we were able to determine that the staff levels provided in the home were appropriate to meet peoples needs. We found that the home provides three care staff in the home on each shift, and night time support is provided for by two care staff. The manager has three days designated as supernumerary to enable them to carry out their management role, on their other two working days they work alongside the care staff. Through discussion the manager and staff were able to demonstrate a commitment to achieving National Vocational Qualifications (NVQ). All but three of the current staff team have either completed an NVQ award or are in the process of completing an NVQ at level 2 or 3. Out of a total of twelve care staff employed in the home 9 are NVQ qualified with the remaining 3 being in the process of completing an award. The registered manager is also in the process of completing the level 4 award in care. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: On the day of the inspection we observed members of staff carrying out their duties confidently and professionally. Staff spoken with said that information and knowledge is shared through a good handover process. A sample of two personnel files were examined and found to be well organised. They contained all of the documentation required by regulation including photographs, application forms, written references, Criminal Record Bureau (CRB) enhanced disclosures, PovaFirst checks and appropriate proofs of identity. The manager told us in the AQAA, We provide an excellent and ongoing staff training programme which includes a comprehensive induction for new staff. Personnel records examined as well as discussion with the manager confirmed that new staff employed in the home received a comprehensive induction. Part of the induction the manager explained was to assess staffs knowledge and previous experience. All staff as part of their induction receive training on health and safety, first aid, fire awareness, safeguarding, food hygiene, infection control, and mental capacity act. The organisation employs their own training officer who provides a large portion of the homes training. To enable staffs training needs to be tracked a training matrix is held centrally, which is ueful for the training officer to identify training that staff have received and when updates or refresher training maybe required. In addition to the homes mandatory training that the organisation provides as part of its induction other training can and is accessed when relevant to the needs of the service users this training included epilepsy, autism, communication, makaton, insulin awareness, nutrition and well-being, and NVQ. In addition to this the home is also registered as an ICE site (Inclusive Communication in Essex) Staff spoken with during the course of the inspection said that access to staff training provided was good. From the sampling of records we noted that staff training was a standard agenda item on all supervisions that staff received. Staff that we spoke with during the inspection as well as records we examined indicated that staff were receiving formal supervision sessions every six to eight weekly. From our discussions with staff we were able to form a judgment that staff were well supported and supervised. Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, and there are systems in place for reviewing the homes quality assurance processes. Evidence: The manager told us in the AQAA, There is a team leader and assistant team leader on every shift, and the majority of the staff team have NVQ 2 or 3 or are working towards the award. I am the registered manager and I am supported by an assistant manager. The manager has been the registered manager for the home for over two years and has significant previous experience of supporting people with a learning disability. She has responsibility for three homes all of which are based close to one another, and is supported in the running of each home by a home manager and a team leader. At the time of our inspection visit the manager was in the process of completing the National Vocational Qualification (NVQ) level 4 in care. During discussion with the manager and from our observations we were able to determine that the manager was able to demonstrate a good level of awareness and knowledge of the needs of the people living in the home. Staff spoken with said that the manager was open and always Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: accessible and provided them with a clear sense of leadership and direction. The registered manager stated that they were well supported by their line manager and the provider, and went on to say that the management team always recognised when she had done things well, and she was actively involved in the development of the company. The manager provided evidence that the home has a robust Quality Assurance System in place. They seek the opinions of staff, relatives and any other interested parties. There are a number of ways of getting this information including questionnaires sent to relatives. We sampled some of the surveys that had recently been returned by relatives, some of the question asked included Do you have any concerns over the daily running of the home? the response was It seems to be very well run In your opinion, how is the standard of care and support you relative receives? The response was The standard of care x receives is excellent Are you happy with the level of contact you have with your relatives key worker? The response was Yes Please comment on the quality of the environment? The response was Very good. Team meetings are held six weekly, and minutes of these meetings were being taken and kept. The provider or a representative of the organisation carries out monthly Regulation 26 visits (these are visits that the provider or a representative of the organisation are required to undertake under regulations) and copies of the reports following these visits are provided to the home. Sampling of Regulation 26 visit reports showed that people living in the home were spoken and consulted with as part of these visits. A range of Health and Safety documents examined were all found to be in order and up to date. Health and Safety certificates examined included the Landlords Gas Safety Certificate, the emergency lighting test and electrical installation test certificate. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation 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 30 of 31 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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