Care Home: 20 Swallow Street

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What the care home does well The registered manager and staff make sure that residents living within the home are able to lead the lives they want. We saw many examples where they were consulted and encouraged to make their own choices and decisions. Residents were able to rise when they wished which meant one person had a lie in on the day of the site visit. We saw that this was the preferred routine for the residents which we can confirm was recorded within their care plan. Residents continue to be part of the community and visit local places of interest and places important to them. Each resident has access to their own healthcare support services within the community and are supported to visit them when required, rather than the services being provided at the home. This means residents continue to have a say in who they receive support from and retain their independence regarding appointments. Residents are promised that Swallow Street is a home for life and it was good to see action taken for residents to remain at the home when they become over the age of sixty-five or ill. The staffing levels at the home were good and plans were underway to provide waking night care workers so that residents get the night care support they require as they become older and or their general needs increase. Residents receive one to one support from their key worker, who acts as an advocate for the residents when required. We saw a number of records which showed us that key workers spent time with the residents and acted in their best interest. Residents surveys stated that they felt members of staff listened to them and acted on what they said. One resident said members of staff " are my friends". When asked what does the home do well, residents told us the home " is beautiful" and " I like living here, I like the staff, the other residents and my own room." Members of staff are well supported with almost continuous access to the registered manager. Robust recruitment and selection procedures were in place and followed. Members of staff received induction training and followed the Learning Disability Award Framework (LDAF) for their continued training. They are encouraged to complete a National Vocational Qualification at Level 3. Staff receive supervision and an annual appraisal system is in operation. Members of staff told us they received enough training to enable them to support the residents as they required with one member of staff stating within their survey they they received " regular job consultations with the team leader to offer support and guidance." What has improved since the last inspection? This is the first inspection since registration in May 2009 What the care home could do better: The registered managers commitment to maintaining standards has meant that there are no areas where the service is failing. The registered manager has identified a number of areas within the AQAA where she felt service provision could be developed and improved within the next twelve months, therefore the number of good practice recommendations are minimal. We have recommended that improvements are made regarding the laundry area, ensuring that washing machines have the appropriate programmes to ensure infection control is managed effectively. Appropriate weighing scales should be provided to make sure that all residents weights can be accurately monitored. Key inspection report Care homes for adults (18-65 years) Name: Address: 20 Swallow Street 20 Swallow Street Manchester Lancs M12 4GH     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: Sylvia Brown     Date: 0 7 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 29 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 29 Information about the care home Name of care home: Address: 20 Swallow Street 20 Swallow Street Manchester Lancs M12 4GH 01612244552 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): North West Community Services (Greater Manchester) Ltd Name of registered manager (if applicable) Ms Jannette Storey Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC, to Service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Swallow Street offers support to five residents. The buglaow is of sufficent size to be able to meet their lving requirements. Lound, dining and kitchen communal provided residents with enough space to meet together. Each resident is provided with single bedroom accommodation which ensures their privacy is maintained. Residents have a garden area at the rear. There is no dedicated parking space for visitors to the home. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home Fees for care, support and accommodation are 898:98 per week and includes an allowance for annual holdays entitelments. Care Homes for Adults (18-65 years) Page 5 of 29 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 inspection report is based on information and evidence gathered by the Care Quality Commission (CQC). This is the first inspection of this service since registering with us in May 2009. This was a key inspection which included a site visit to the home and the registered offices of the service. The site visit was unannounced which means the registered manager and staff were not told that we would be visiting. For reporting purposes the preferred term to be used for people living and receiving a service at Swallow Street is resident. As part of the inspection process we gathered information from a number of people which included talking with and seeking the views of residents during the site visit. Prior to the site visit we also sent out surveys to residents, members of staff and professional visitors. This gave them an opportunity to tell us about their opinions on the services provided at the home. Comments received Care Homes for Adults (18-65 years) Page 6 of 29 are included within the report. At the time of the site visit three residents were living at the home, one of whom was away on holiday. As part of the inspection process we case tracked one resident, this means we looked in depth at their care support which included looking at their records in detail and observing them as they received support and went about their daily routines. We also obtained an overview of the care and support the remaining resident was receiving. In September the registered manager completed a self assessment form, which is called an Annual Quality Assessment Audit (AQAA). This document should tell us in detail what they and the registered provider have done to meet and maintain the National Minimum Standards. It should also tell us what the service is doing well, improvements made to develop the service and future developments planed for. The AQAA we received was completed well and gave us lots of clear information about the service. We also gathered information from general contact with the home through their reporting procedures which are called Notifications and information we may have received from other people, such as the general public and professional visitors. We have not received any complaints about this service or received any safeguarding alerts. This report is a public document and should be on display within the home and can be made available for reading upon request. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The registered managers commitment to maintaining standards has meant that there are no areas where the service is failing. The registered manager has identified a number of areas within the AQAA where she felt service provision could be developed and improved within the next twelve months, therefore the number of good practice recommendations are minimal. Care Homes for Adults (18-65 years) Page 8 of 29 We have recommended that improvements are made regarding the laundry area, ensuring that washing machines have the appropriate programmes to ensure infection control is managed effectively. Appropriate weighing scales should be provided to make sure that all residents weights can be accurately monitored. 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 29 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 29 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. The registered manager makes sure that prospective residents have individualised moving in programmes which they have been supported to make. They have been consulted about their needs and up to date assessments were in place. Evidence: The registered manager makes sure that prospective residents have moving in programmes which are individual to them. At the time of our site visit, two prospective residents were being supported by allocated key workers to make their moving in plans. Although the prospective residents had not visited the home, key workers had met with them three times in the residents current placement. The registered manager explained that this had given the residents time to get to know support staff and gain confidence in commencing introductory visits and meet with others who live at the home. Key workers had been able to read important information about the prospective residents,conduct their own assessments of the residents needs and obtain up to date information to aid the development of a new care plan. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The registered manager makes sure that pre admission programmes and visits are recorded. Current residents living at the home had been consulted about the prospect of new residents and were aware that new people were about to move into the home. We were told that the residents were already known to each other and had met previously at social events. Whilst the home has a statement of purpose the registered manager told us within the AQAA that she plans to adapt important information into a user friendly formats which will be more suitable for use by the current residents. She also stated those residents who do not have relatives should have an independent advocate to support them when moving into a new placement and plans to develop this aspect of the service within the next twelve months. Care Homes for Adults (18-65 years) Page 12 of 29 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. Residents are involved in making decisions about their lives and play an active role in planning the care and support they receive. This means they remain in control of their lives and are able to direct how support is provided. Evidence: Residents are involved in the development of their care plans. In addition to being consulted about the general assessments process, they are also consulted about their preferences for support and how they would like that completed. Staff understand the importance of residents being supported to take control of their own lives and were observed by us to be actively promoting this throughout the site visit. The records we looked at identified that individual residents had been encouraged to make their own decisions and plans for how they lived, this included risk taking. Care plans and associated information was well detailed and identified that the assessment process was continuous with all records containing up to date information. We were able to observe residents and talk with them as they went about their daily Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: routines. This meant we could see that the care plans were being followed as the residents wished and how the residents were encouraged to make everyday choices regarding their routines. Plans were written simply and were easy to read. The key worker system allows staff to work on a one-to-one basis with residents to make sure that their views and wishes are known and followed. Residents and their key workers meet once a month to review how the previous month has gone in respect of attending appointments and making sure any request made by the resident had been met. This specific one to one time is also used to plan for the future month in respect of appointments and desired activities. Records of joint meetings were kept. Residents surveys informed us that they feel able to talk with staff,that their views and wishes are understood and that staff follow their request. Systems within the home make sure residents have direct access to the registered manager as she works as part of the care team. In addition the registered manager makes sure she consults with residents regularly, their views are made known at residents meetings and key workers act on behalf of residents to make sure their views are heard. Residnets also have the opportunity of meeting with the service manager who visits the home each month to conduct statutory regaulation 26 visits. Care Homes for Adults (18-65 years) Page 14 of 29 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. Residents are treated as an individual and the care home is responsive to their needs. They continue to be part of the local community and are supported to follow their personal interests and activities. Evidence: The registered manager demonstrated a commitment to enabling residents to develop or maintain their skills, including emotional, social, communication and general living. They were supported to identify and set their own goals which were recorded and supported to achieve them. From the records we looked at, the direct observations we made and from what residents told us, we could see that residents of Swallow Street are able to have individual dreams and aspirations which they are supported to fulfil as far as possible. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The registered manager stated within the AQAA that accommodation is provided for life, because of this at least one person living at the home is over the age of sixty five. We observed the resident being supported to visit a local supermarket to assist a member of staff to buy everyday items of food for the home. Residents files and daily report diaries recorded in detail all activities undertaken by them. We were able to see that one resident went to a weekly day care centre which gave them the opportunity to mix with people of their own age. Residents spiritual needs were also recognised and supported. We were informed by the manager and read records that one resident had tried a number of local churches but had made the decision to return to the church they used to visit. Transport and staffing support was provided to make sure this took place each week as the resident desired. Swallow Street is a small home, because of this daily routines within the home are flexible and more reflective of an ordinary home. We saw that residents could get up when they wished. Records identified residents abilities to make their own drinks and snacks and we saw one resident helping themselves to fruit when they wished. Records confirmed that residents frequently visit a wide selection of places within their local community and are able to meet with people who do not have a disability. Similarly they have an opportunity of meeting with others who have a learning disability and who are accommodated within a residential setting. At the time of our visit one resident was on holiday. They had chosen to go on holiday with their friend from another service and were supported by staff from the home to do this. Meals within the home are planned on a weekly basis, however because of the small number of residents, meal changes can and do take place as the residents desire. Residents have the opportunity of visiting local cafes and restaurants all of which broaden their experiences and promote their enjoyment. Residents food likes and dislikes are recorded and staff have good communication skills to support residents to make meal choices when out in the community. Residents nutritional intake is recorded and concerns are identified in respect of excessive weight gain or loss. Residents weights are routinely recorded, however the stand on scales used by residents for this were not suitable to support people who have physical disability and who have degenerative conditions because of ageing. Because of this recorded weights may not be a true reflection of residents actual weight. Care Homes for Adults (18-65 years) Page 16 of 29 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. Residents personal and health care needs are met. They have care plans in place which they have been consulted about. Residents are supported to take their medication in a safe way. Residents approaching the end of their life are supported to remain at home as far as possibly and are assured they will be made comfortable and supported in a sensitive, respectful and dignified manner. Evidence: Residents receive personal and health care support which includes specialist medical support services when required. We can confirm through looking at residents records, talking to the registered manager and members of staff that residents have their own general practitioner within the local community which they visit. They also visit local opticians and chiropodists for treatments and routine checks. This means residents are able to make individual choices about who they receive healthcare support from. Records clearly identified residents last treatments for dental, optical and hearing tests. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: At the time of our visit all residents received support to take their medication. Medication administration records looked at were completed appropriately and in accordance with best practice. We observed one resident receiving their medication which identified that the member of staff administering the medication was familiar with the resident and knew correct procedures. The registered manager ensures that staff competency is assessed in respect of medication administration and staff training records confirmed that all staff with responsibility for administering medication had completed and passed an appropriate medication training course. The AQAA identified that that the registered manager has yet to fully develop seeking the views of residents about their last wishes and feelings. The registered manager told us that all residents receive support when visiting or staying in hospital and that staff are designated to visit them at such times. We were also informed by the manager that one resident who became ill and subsequently died was supported whilst they were in hospital by staff from the home. Comprehensive pictorial plans were put into place for each treatment the resident was to receive, this means that the residents was able to understand what was being done to assist them to get well. The resident was given the opportunity to die at home with an end of life plan being put into place. The registered manager stated that the resident was given the opportunity to end their days with people who they knew well and who cared about them. Care Homes for Adults (18-65 years) Page 18 of 29 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. Residents who use the service are protected from abuse by good safeguarding procedures which members of staff have been trained in. Residents know about and have access to a complaints procedure. They are encouraged to share their views on the service through good consultation processes. Evidence: Residents surveys confirmed that each person had someone they knew and trusted whom they could talk to if they were unhappy. Members of staff demonstrated at the visit and within their survey that they were skilled and competent at communicating well with residents through understanding and use of non verbal communication indicators used by residents. The service has comprehensive complaints and safeguarding policies in place which are there to protect residents from any forms of abuse and poor practice. We have not received any complaints about this service. The registered manager told us that any dissatisfaction would be dealt with immediately and any investigations would be conducted by an independent person from within the organisation. The registered manager informed us that one complaint had been received at the home which was investigated and upheld. Residents have regular opportunities to meet with the registered manager as she is Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: part of the support staff team. In addition residents have the opportunity of talking with someone from the service who visits the home each month to complete an assessment of how the home is maintaining compliance with standards. Also residents are able to share their collective opinions of the service when residents meetings are held. The registered manager has informed us that she intends to develop and make sure residents with minimal or no family contact have the opportunity of using an independent advocate who will support them to raise any dissatifactions they may have and act in their best interest. Staff training records confirmed that staff have or are planned to receive training in full adult protection procedures. At induction all new staff have their role and responsibilities highlighted in respect of protecting residents from any form of abuse either from within the home or when in the community. When we spoke with members of staff they had a good understanding of safeguarding procedures and what action take to report a suspicion or allegation of abuse. There have been no safeguarding alerts sent to us and no suspicions of abuse have been raised at the service. The registered manager said that the new framework for implementing the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA DOLS) had been discussed with staff and at the time of our visit no one living at the home was subject to an application being made under these requirements Care Homes for Adults (18-65 years) Page 20 of 29 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. Swallow Street is a clean, bright and well maintained home. Residents have been consulted about decoration, fixtures and fittings, which means they all have individualised personal living space suitable to meet their needs. Evidence: During the course of our site visit we had the opportunity of looking around the home to see how standards were being maintained. We found that residents live in a clean and well maintained home which has within the last six months been significantly upgraded to provide a light airy environment. The lounge area is modern and reflective of a family lounge. Comfortable seating, with appropriate fixtures and fittings makes it a nice place for residents to gather together to relax and socialise. The kitchen dining room is also reflective of an ordinary home with additional comfortable seating which is used by residents both at meal times and when they want to sit and watch members of staff when meal preparation is underway. We feel that the medication cabinet and items relating to the running of the home should be removed from this area and placed away from view. This would mean residents have additional space within the dining area and further promote the family home Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: environment the registered manager has attempted to create. Whilst bathing and toileting areas are of sufficient size, additional work is required to make them less institutionalised, for instance storing plastic aprons, gloves and continence products from view would support this. The laundry area is very small and we have questioned if it is of sufficient size to meet the demands of the service. It was unclear if the two domestic style washing machines had the appropriate programmes to deal with infection control particularly as a number of current and known prospective residents have continence issues. Residents bedrooms were varied in the decoration and colour. It was evident that residents had been supported to furnish and decorate their rooms as they desired. We were told by the registered manager that the rooms allocated for prospective residents were being prepared and once introductory visits commence residents would be encouraged to choose their own colour schemes and plan how they would like their room. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have support from staff who have completed robust recruitment and selection procedures, who have been trained and who receive supervision. This means residents have confidence that those who support them will keep them safe. Evidence: Thorough recruitment and selection procedures are carried out by the organisation for all people working at the home. The staff files we looked at contained extensive information including application forms, training assessments, induction procedures and records relating to members of staffs probationary periods. Statutory checks are completed before staff are offered a position within the organisation including a Criminal Records Bureau check. The AQAA identified that four of the seven staff members have a National Vocational Qualification (NVQ) 2 specifically relating to supporting people with a learning disability, with a further three members of staff progressing on to NVQ 3. As part of the inspection process we spent time at the organisations main office and spoke with the director of the organisation and who is registered with us as the responsible individual for the service, about recruitment and training procedures. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Training records identified that the service has good auditing procedures in place which ensures that all levels of staff receive the training they require and routine updates. Staff records identified that they have annual appraisals with their manager and a review their practice against job descriptions and agreed development plans is undertaken. Members of staff also receive one to one supervision and support from their manager and have the opportunity of receiving support from her as she works alongside them when providing direct support. Care Homes for Adults (18-65 years) Page 24 of 29 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 residents of Swallow Street have confidence that the care home is run in their best interest and managed appropriately. Evidence: The registered manager has the required qualification and experience, is highly competent to run the service and meet its stated aims and objectives. She was able to demonstrate that she had a clear understanding of best practice and the way the home was run showed that she had a good understanding of residents needs in respect of diversity including gender, age, religion or belief and disability. The service has quality assurance procedures in place which are recognised by a National body. In 2008 the service achieved the Investors in people award. The service has extensive policies and procedures in place which are kept under review. The AQAA identified the dates of the last review. When we spoke with the director of the service we were informed of the process for continuous development of the service ensures policies and procedures were amended as legislation and best Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: practice changes occurred. Through feedback from members of staff, looking at staff meetings minutes and supervision records we identified that members of staff are informed of any relevant changes to policies and procedures. To make sure that members of staff are following procedures, spot checks of staff practices are carried out by the registered manager, in addition a service manager also monitors staffs practice and consults with them during the statutory regulation 26 visits. Health and safety records identified that servicing of equipment and checks are carried out by appropriately appointed professionals and that systems were in place for the routine monitoring of health and safety matters within the home. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 17 To make sure residents weights are accurately evaluated, appropriate scales should be used which are suitable for those who have a physical disability and associated conditions relating to age. Systems should be in place to store items used for personal care away from view. An assessment of laundry equipment should be undertaken to make sure the area is a suitable size and that washing machines have the appropriate disinfectant programme required for managing soiled items. 2 3 27 30 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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. 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