Care Home: 190 Townsend Avenue

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What the care home does well People who live at the home told us good things about their support. Each person who lives at the home has a care plan. These have a lot of information in which tells the staff what they need to do to support the person. People living at the home are supported to use their independent skills and to learn new skills. We were told that staff support some people to go to college. People are supported to go out for a meal, go to the pub, go to the gym, go shopping, and follow other interests they have. Every week people living at the home have a meeting with staff so that they can have their say about the service. Staff support people living at the home to visit their doctor, dentist, nurse, optician and other important appointments on a regular basis. Other professional people visit the home on a regular basis to provide support to the people who live there. Staff are good at taking care of medication and support people well with their medication. The staff team are well trained and are confident that they can support people well. The home is comfortable, well presented, safe and clean. The home has lots of space. There are two main lounges, two quiet lounges, and a games / activity room. Each person has their own bedroom and these are fitted with a lock for their privacy. The home is well managed and is run in the best interests of the people who live there. What has improved since the last inspection? This was the first inspection since the home was registered with us in April 2009. We have visited the home on one occasion since it was opened. This was because the manager had told us of a serious incident. When we visited we found that the home needed to improve how new people were admitted and some parts of care planning and risk assessments. A senior person from Voyage is looking into this. The manager has told us of some improvements to the service since it became registered. These include; A guide for service users which includes pictures and an audio (taped) version has been made. Staff training has improved. Good links with GPs, dentist and other health professionals have been made. Activities have increased for people living at the home. What the care home could do better: When a new person is admitted to the home an assessment of their needs is carried out by a senior member of staff. However, we found that assessment information is not being attained from the agency referring the person. This is particularly important given the nature of the needs of the people living at the home. Before a new person moves into the home the manager should get information on the person`s needs from a social worker or other professional person. This is so that the manager knows what the new persons needs are and can decide if their needs can be met at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 190 Townsend Avenue 190 Townsend Avenue Norris Green Liverpool L11 8NB     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: Debbie Corcoran     Date: 3 0 1 0 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: 190 Townsend Avenue 190 Townsend Avenue Norris Green Liverpool L11 8NB . Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Voyagecare.com Voyage Ltd Name of registered manager (if applicable) Mr Noel Davies Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia physical disability Additional conditions: The registered person may provide the following categories of service only: Care home only - Code PC. To people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Learning disability Code LD; Physical Disability - Code PD; Mental Disorder - Code MD. (The service provides up to 8 places for people who have an acquired brain injury whose needs may not easily fall within the service user categories above). The maximum number of people who can be accommodated is: 16. Date of last inspection Brief description of the care home 190 Townsend is registered to provide accomodation and support to sixteen people who may have a learning disability, a difficulty with their mental state or a physical Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 0 16 16 16 Brief description of the care home disability. The service provider is Voyage Ltd. This is a privately owned company which has a number of services around the country. The home is currently divided into two seperate areas. These are referred to as Tate Lodge and Walker Lodge. It is intended that Tate Lodge will accomodate eight people who have a learning disability and Walker Lodge will accomodate eight people who have an acquired brain injury. The home is purpose built and and has been designed to high standard. The home is located on a busy road. It is close to local shops and has good publice transport links. The range of fees for residing at the home are between £1,825 and £2,250 per week. The manager did inform us that the fees will depend on the individual needs of the person and may therefore fall outside of this range. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The visit to the home was not announced beforehand. During the visit the majority of the people living at the home were met and a number were spoken with on a one to one basis or on a small group basis. We looked at a sample of records relating to the people living at the home. We also looked at other records including medication administration records, staff files, staff training records and health and safety records. These help to show us how peoples health and wellbeing are being promoted and whether staff have the skills and training needed to support people appropriately. Care Homes for Adults (18-65 years) Page 6 of 30 We sent surveys to people living at the home and to members of staff and some of the information in these has been used to inform the findings of the inspection. A tour of the home was carried out which included all communal areas. We talked to staff including the deputy manager, a member of care staff and a Clinical Psychologist who is based at the service. The manager returned a self assessment of the service prior to this visit. The self assessment enables the service provider to inform us of what they do well, where they have improved and where they can improve in the future. It also includes information on how they promote equality and diversity, how they seek the views of people living at the home and includes data on staffing and health and safety. The self assessment is referred to as an Annual Quality Assurance Assessment (AQAA). Some of the information in this has been used to inform the findings of the inspection and we have made reference to the contents of this throughout the report. 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: When a new person is admitted to the home an assessment of their needs is carried out by a senior member of staff. However, we found that assessment information is not being attained from the agency referring the person. This is particularly important Care Homes for Adults (18-65 years) Page 8 of 30 given the nature of the needs of the people living at the home. Before a new person moves into the home the manager should get information on the persons needs from a social worker or other professional person. This is so that the manager knows what the new persons needs are and can decide if their needs can be met at the home. 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. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions procedure needs to be developed to ensure all relevant information on a persons needs is attained before the person moves to the home. This is to ensure the persons needs can be appropriatly met. Evidence: We looked at the statement of purpose and service user guide for the service. These are documents which provide information on the services and facilities provided at Townsend. They include information on the philosophy of care, process for assessing peoples needs, care planning, staffing, meeting peoples needs and terms and conditions of residency. We saw that the service user guide had been written in plain language and included pictures to illustrate some of the main points. We were told that the statement of purpose for the home had also been produced in an audio version. People who are thinking of moving into Townsend can use these in order to aid their decision. People living at the home told us in surveys that they were asked if they wanted to move to the home. They also told us that they had receive enough information about Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: the home before moving in so that they decide if it was the right place for them. We case tracked two people using the service. By this we mean that we looked in more detail at their needs, the type of support they were receiving and their care plans. We saw that an initial assessment of needs had been carried out with these two people before they moved to the home. The assessments cover the persons strengths and needs. The outcome of an assessment will determine whether or not a person will be admitted to the home and this is based on the homes capacity to meet the assessed needs of the person. The manager told us that the referring agency, for example Social Services, are asked for assessment information when a new person is referred to the home. However we did not see this information in relation to the two people we looked at. We also noted this following a previous visit to the home. Following the inspection the manager informed us that these were attained for one of the people concerned but had been kept in another record. It is important to attain this assessment information as it may contain significant information which may otherwise be unknown to staff at the home. Following the assessments a pen picture is devised and this includes information in relation to the daily support needs and choices of the person concerned. We were told that prospective service user are invited to visit the home and spend time there before deciding whether or not to move in. We saw in one persons records that a transition plan had been drawn up which detailed how the person would be supported with a planned and phased move to the home. 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. Each of the people using the service has an individual support plan which provides staff with guidance on what the persons needs are and how these should be met. Evidence: Each of the people living at the home has a care plan. We case tracked two people using the service. By this we mean that we looked in more detail at their needs, the type of support they were receiving and their care plans. The level of information in care plans was very good. Care plans included information on how to meet the needs of the person in areas such as their physical health, communication, personal care, mobility, social skills, finances, relationships, activities and holidays, living skills, behaviour, cultural and spiritual expression, medication, decision making, age and illness and death, mental health. Each section of the care plan explained the persons assessed need, followed by short and long term goals to meet this, followed by information on how to deliver the support required. Risk assessments are carried out where a person living at the home is thought to be Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: at risk of harm. We found that each area of the persons care plan was followed up with a risk assessment relating to that particular aspect of their support. The risk assessments looked at were comprehensive and detailed how to keep people safe. We found that care plans included information on how to support a person with equality and diversity issues. We saw that staff are required to sign as having read and understood all areas of the persons care plan and risk assessments. We found the system for assessment, care planning and risk assessment was thorough, auditable and there were clear links between identifying an assessed need, ensuring that information on how to meet this was reflected in the persons care plan and alongside this there was clear and comprehensive risk assessment information. During discussions with people who live at the home they were very positive about all aspects of their support and appeared confident that staff were meeting their needs and providing good care and support. People said that they are making their own decisions as to their daily support and their routines within the home and they confirmed that staff support them to use and develop their independent living skills. People living at the home have the opportunity to attend regular meetings whereby they can discuss the running of the home with staff on a more formal basis. The manager has informed us in the providers self assessment (AQAA) that To ensure that the views of people using the service are heard we will hold regular resident meetings and We also will have regular key worker meetings which will include activities planning. People using the service are also actively encouraged to give views on how they think the service could improve. We have a letting us know what you think policy in various formats which will be given to service users when they move into the service. 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 living at the home are supported to develop their independent living skills and to be involved in their local community. People choose their meals and are supported to use and develop their skills as appropriate. Evidence: Care plans for people living at the home included a good level of information on how to support the person with using and developing their independent living skills. From discussions with people it was clear that they are supported to develop their independent living skills as appropriate to their individual needs. For example one person confirmed that they prepare meals with support from staff, another person told us that they have discussed their long term aims with staff and are working to meet these. Care plans also include information on personal networks, likes and dislikes, preferred routines and interests / hobbies. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: People living at the home gave good feedback on their support with pursuing social activities. They reported going out and using community resources with support from staff. Discussions with people and records indicated that they are being supported in activities such as attending places of interest, going to the gym, going for a meal, going to a pub, shopping, trips out. We also saw that people have the opportunity for therapeutic activities for example drama therapy, physiotherapy and occupational therapy. One person told us that they have set new goals for themselves since moving into the home and they are receiving therapeutic advice and support to achieve these. We also noted that people are supported to think about their educational and vocational needs and goals and a number of people are being supported to attend college and one person has started a vocational course. People living at the home are encouraged to make choices about the running of the home and their care. People have the opportunity to attend meetings on a regular basis. People confirmed that they are making choices as to their daily routine and how to spend their day. Each person has the opportunity to plan the week ahead or this may be done on a daily basis depending on the needs of the person. People are supported to manage their own affairs when possible, for example one person manages their own money. People living at the home are encouraged and supported to prepare and cook some of their own meals. The home does have a designated cook. The menu was varied and appeared appetising and all feedback on the food and meals was positive. In addition to the main kitchen people living at the home have a small kitchen where they can make their own food and drinks. One person living at the home told us in surveys that they make decisions about what to do each day and the home provides Good food, good entertainment, good outside activities, good holidays, good money management. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported with their personal, emotional and physical healthcare needs and medication is well managed. Evidence: Each of the people living at the home has a care plan and these include a good level of information on how to support the person with their emotional and physical health and well being. Records showed that people living at the home are well supported to remain healthy and to attend health related appointments. For example they are supported to see a GP, dentist, etc on a regular basis. People are also supported to see other health professionals as appropriate to their needs. People are being supported with their emotional and psychological needs. The home has a full time Clinical Psychologist in post. During discussions with the psychologist they informed us that they carry out an assessment with each of the people living at the home and develop a therapeutic programme in line with this. We were also told that the home uses the services of a drama therapist on a regular basis and a behavioural therapist on a weekly basis. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We looked at how medication is being managed. As part of this we looked at a sample of medication administration records and medication in stock. This showed that medication is recorded and administered appropriately and is well managed. Medication is administered by senior members of staff who have been provided with training in administering medication and staff also undergo an assessment of their competency in administering medication. Medication stock and medication practices are audited on a regular basis. Care plans include a section for recording the persons strengths and needs with medication. We found that information on particular medications had been sought and this was provided to staff for reference purposes. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies, procedures and practices are in place for dealing with complaints and for aiming to protect service users against abuse or neglect. Evidence: The home has a complaints policy and procedure which is time scaled appropriately and includes contact details for the Commission. We asked people in surveys if there was someone they can speak to informally if they were not happy or if they knew how to make a complaint and the response was that they did. Information on how to make a complaint is provided to people in the service user guide. This has been written in plain language and includes the use of pictures to illustrate some of the main points of the process. We were told that there have been no complaints made directly to the home since it was registered. An adult protection policy and procedure was in place. This outlines responsibilities for responding to an allegation of abuse and any subsequent investigations. We found that a further adult protection procedure had also been written in plain language and included pictures and this was provided to people living at the home. Staff recruitment procedures include a check against the Protection of Vulnerable Adults register and attaining a criminal records bureau check for new members off staff. Staff are reported to be provided with adult protection training in their induction Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: and some staff training records showed us staff have been provided with adult protection training. During discussions with one member of staff they were able to explain how what they would do in the event of an allegation of abuse being made. Accidents and incidents are appropriately recorded and audited. The record of accidents was looked at and this showed no particular areas of concern. We were told that incidents are monitored and analysed in an attempt to identify triggers to peoples behaviour and to review how the person is being support. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 a clean, safe, well maintained and comfortable home environment which is presented to a high standard. Evidence: The home was recently purpose built and it therefore meets required standards in relation to size and facilities. It is a two storey building situated in well maintained accessible grounds. The home has an enclosed rear garden for the safe use of people living at the home. The home is furnished and presented to a high standard. The home is divided into two separate areas, these are referred to as Tate Lodge and Walker Lodge. Tate Lodge accommodates people who have a learning disability and Walker Lodge accommodates people who have an acquired brain injury. Each area has a main lounge, a quiet lounge, games room, dinning room and one main kitchen and a training kitchen. A sample of bedrooms were looked at during a previous visit to the home when we noted that they had been furnished and presented to a high standard. Every bedroom has en suite facilities. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home is clean, well maintained and well presented. The presentation, safety and maintenance of the home is checked on a regular basis as part of the quality assurance process. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported by staff who are appropriately recruited, trained and well supported. Evidence: There is a manager and or deputy manager and senior staff on duty throughout the day. Staff roles and lines of accountability are clear. This means that staff know their responsibilities and know when to refer to a senior person for advice or support. People living at the home gave good feedback on the staff team. One person commented theyre great and another person said the staff are nice. Discussions with people living at the home also indicated that staff are supporting the aims and objectives of the home in encouraging people to make choices, develop their independent living skills, and use their local community. At the time of the visit there were 4 people living on each side of the home. The staffing levels on each side of the home were; 3 care staff and 1 senior member of care staff. A deputy manager and a clinical psychologist were also on duty. The home has domestic and maintenance staff in addition to care staff. Staffing levels at the time of the visit mean that people living at the home were receiving one to one support. We looked at staff rosters to assess usual staffing levels and found these to Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: be as found on the day of the visit. We looked at a sample of staff files to assess recruitment and selection practices and ensure these were in line with protecting people. These showed that relevant pre employment checks, for example, attaining references had been made prior to starting new members of staff. We did not see evidence of criminal records disclosures at the time of the visit. The manager has confirmed since the inspection visit that these are held at the head office of Voyage as per prior agreement with the Commission. These practices aim to safeguard people living at the home. New staff are reported to undergo an induction programme and this includes core health and safety related training. New staff were reported have three weeks training before they start supporting people. We looked at a sample of training records. These showed us that staff have been provided with training in topics such as health and safety, fire safety, moving and handling, medication, adult protection. Additional training noted on some staff records included training in topics such as supporting people who have epilepsy, values, attitude and equality and diversity, deprivation of liberty, mental capacity, sexuality and brain injury, forensic awareness, support planning, sensory impairment, substance misuse, and supporting people who have challenging behaviour. This level of training tells us that the staff team should be able to promote and safeguard the wellbeing of people living at the home. The manager reported that 15 out of the 21 care staff have attained a relevant National Vocational Qualification (N.V.Q) in Health and Social Care and the remaining 6 are enrolling to commence a qualification in the near future. We sent surveys to staff and a number of these were returned. The surveys asked question such as; did your employer carry out checks such as your CRB and references before you started work, did your induction cover everything you needed to know to do the job when you started, are you being given training which is relevant to your role, does your manager meet with you to give you support and discuss how you are working, do you feel you have the right support experience and knowledge to meet the different needs of people who use services. All responses were positive and there were no areas of concern raised. Comments from staff included I have nothing but praise for the company starting from training to actually working at the home, everything is positive. They do a great deal with and for the service users and Provides great services and a homely clean environment for service user. Management also liaise with the staff well to make sure were working to a high Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: standard. 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. People live in a home which is well managed and run in their best interests. Peoples health and welfare is safeguarded by appropriate procedures and practices. Evidence: The manager of the home was not available at the time of the inspection. A deputy manager therefore provided information as required. The home is well organised and all required information was readily at hand. The home is well managed and staff roles and lines of accountability are clear. The manager has attained a relevant qualification and in previous dealings with the manager he presents as committed to providing a good quality service. Voyage has a quality assurance process which includes monthly visits to the service by a senior person from within the organisation. The service is regularly audited and these cover all aspects of the service provided from care planning and medication to maintaining a safe environment and safe working practices. Further checks and audits are in place to ensure that the service is meeting the required standards. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: People living at the home have been surveyed as to the quality of the service and their feedback will be used to contribute to the development of the service. The process for supporting people with managing their personal monies was looked at for a sample of people. This was presented as a straight forward and accountable process which includes regular audits. Staff records showed us that staff are provided with regular supervision meetings. Staff team meetings are also taking place on a regular basis. Both of these forums give staff the opportunity to review their practice, share good practice, develop their skills and knowledge, develop as workers, contribute to decision making and shaping the service and to share important information on the needs of the people they support and on the service in general. Health and safety policies, procedures and practice are in place to safeguard the well being of people living at the home, staff and visitors. A safe working practice risk assessment has been carried out. This identifies potential areas of risk and includes information on how these are being managed. 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 2 The manager should ensure that an assessment of needs is attained from the referring agency before admitting a new person to the home. This is to ensure all relevant information on the needs of the person have been sought. 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. 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). 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