Care Home: 248 Lidgett Lane

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What the care home does well People said they were happy living at the home. One person said, "I am very happy here thank you". Another said, "Settling in nicely, I like it here". Staff were familiar with what was written in people`s care plans and could talk confidently about the support they give. One staff member said, " Everything we need is in the care plans and risk assessments". They had very good knowledge of people`s individual support needs and could describe people`s routines well. Staff said they like to encourage people to be as independent as they can be. Records showed that people experience a wide variety of activity. Activity on offer to people includes, swimming, various clubs, college courses, quiz nights, bingo evenings, going out for meals, church or synagogue attendance and visiting friends and family. People said they were never fed up or bored and that there was always something to do. People are given excellent support to observe their Jewish culture. A communal Shabbat meal is arranged every Friday evening in a traditional Jewish style. People are offerred the opportunity of attending a synagogue of their choice on the Sabbath day and encouraged to follow Jewish home life by relaxing and resting on the Sabbath day. People are also suppported to follow other faiths. One person has made connections with people at a local church and can now attend with support of the people from church. This has given the person some independence they enjoy. Staff said that they felt they had enough staff to support people with their activities. One said, "Oh yes, plenty of staff and extras can always be arranged to take people places if necessary". Another said, "They have a good life, lots to do and plenty of choice". Also there was plenty of social interaction between the staff and people who use the service. It was clear that staff and people who use the service get on well. People said they liked their new home. One person said, "I like the quiet of my own room" and "There is plenty of space". People who live at the home said they liked staff and got on well with them. One person said, "I like them all, they are all nice". Staff said their induction had been good and prepared them well for their job. Comments included: "Very good induction and it remains on-going" "Very thorough induction" "Plenty of time given to go through things". Staff also spoke highly of their on-going training. Comments included: "Training here is very good" "Good opportunities and readily available". Staff spoke highly of the support and leadership they get from the manager. Their comments included: "He listens to us" "He is very approachable" "Absolutely fantastic manager, can ask him anything" "Great manager, he gets things done" "Works alongside us to train us". People who use the service said, "He`s very nice" or smiled when asked if they got on well with him. What has improved since the last inspection? This is the first inspection of this service. What the care home could do better: Pre-admission assessments should be carried out thoroughly. This will make sure that people`s needs are properly identified and they are not missed or overlooked. The practice of staff carrying out health screening checks for people who live at the home must stop as they have not been trained to do this. The practice must also be reviewed with a health practitioner and any screening must be agreed with the people using the service. This will make sure that people`s health needs are not missed or overlooked. Handwritten entries on MAR (Medication Administration Record) sheets should be checked and countersigned by a second person to make sure the information is correct and people receive the right medication. The whistleblowing policy should include the contact details for agencies to contact outside of the organisation if staff wish to report concerns. Key inspection report Care homes for adults (18-65 years) Name: Address: 248 Lidgett Lane 248 Lidgett Lane Leeds West Yorkshire LS17 6QA     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: Dawn Navesey     Date: 1 3 0 7 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 31 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 31 Information about the care home Name of care home: Address: 248 Lidgett Lane 248 Lidgett Lane Leeds West Yorkshire LS17 6QA 01132681542 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leeds Jewish Welfare Board Name of registered manager (if applicable) Keith Robinson 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 maximum number of service users who can be accommodated is: 5. 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 neds on admission to the home are within the following category: Learning disability: Code LD. Date of last inspection Brief description of the care home 248 Lidgett Lane is a newly built, six bedroomed property providing 24 hour care and support to five adults with learning disabilities. The home operates in accordance with Jewish cultural requirements, but can also cater for the needs of people from other faiths. The house is situated in a residential part of the Leeds 17 area close to many local amenities such as shops, doctors dentists, churches and Synagogues. Bus services are within a short walking distance and the people who live at the home have access to a number of vehicles within the organisation. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 5 Brief description of the care home The home has facilities to meet the needs of people with physical disabilities. One bedroom is situated on the ground floor and there is a lift to the first floor. All bedrooms have en-suite facilities and a telephone point to enable people to have private telephone conversations. Other facilities within the home include a communal dining room, lounge and utilty rooms. There is a domestic style kitchen that provides people with opportunity to develop their cooking skills. There is also an enclosed garden to the rear of the property, providing an attractive space to sit out in. Car parking is available at the front of the house. The home has 24 hour staffing with a sleep in night care worker. The charges at the home are 1785 pounds per week. Care Homes for Adults (18-65 years) Page 5 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 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 Care Quality Commission (CQC) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 9:40am to 5:00pm on the 13 July 2009. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people living there. Before the inspection Care Homes for Adults (18-65 years) Page 6 of 31 evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. This was well completed and gave us all the information we asked for. Survey forms were sent out to people using the service, staff and health care professionals. None of these have been returned at the time of writing this report. During the visit a number of documents and records were looked at and some areas of the home used by the people living at the home were visited. Some time was spent with the people who use the service, talking to them and interacting with them. Time was also spent talking to staff and the manager. Feedback at the end of the visit was given to the manager. This is the first inspection of this service. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: People said they were happy living at the home. One person said, I am very happy here thank you. Another said, Settling in nicely, I like it here. Staff were familiar with what was written in peoples care plans and could talk confidently about the support they give. One staff member said, Everything we need is in the care plans and risk assessments. They had very good knowledge of peoples individual support needs and could describe peoples routines well. Staff said they like to encourage people to be as independent as they can be. Records showed that people experience a wide variety of activity. Activity on offer to people includes, swimming, various clubs, college courses, quiz nights, bingo evenings, going out for meals, church or synagogue attendance and visiting friends and family. People said they were never fed up or bored and that there was always something to do. People are given excellent support to observe their Jewish culture. A communal Shabbat meal is arranged every Friday evening in a traditional Jewish style. People are offerred the opportunity of attending a synagogue of their choice on the Sabbath day and encouraged to follow Jewish home life by relaxing and resting on the Sabbath day. People are also suppported to follow other faiths. One person has made connections with people at a local church and can now attend with support of the people from church. This has given the person some independence they enjoy. Staff said that they felt they had enough staff to support people with their activities. One said, Oh yes, plenty of staff and extras can always be arranged to take people places if necessary. Another said, They have a good life, lots to do and plenty of choice. Also there was plenty of social interaction between the staff and people who use the service. It was clear that staff and people who use the service get on well. People said they liked their new home. One person said, I like the quiet of my own room and There is plenty of space. People who live at the home said they liked staff and got on well with them. One person said, I like them all, they are all nice. Staff said their induction had been good and prepared them well for their job. Comments included: Very good induction and it remains on-going Very thorough induction Plenty of time given to go through things. Staff also spoke highly of their on-going training. Comments included: Training here is very good Good opportunities and readily available. Staff spoke highly of the support and leadership they get from the manager. Their comments included: Care Homes for Adults (18-65 years) Page 8 of 31 He listens to us He is very approachable Absolutely fantastic manager, can ask him anything Great manager, he gets things done Works alongside us to train us. People who use the service said, Hes very nice or smiled when asked if they got on well with him. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. 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 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 10 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. In the main, people are provided with a standard of pre-admission assesment which makes sure the service can meet their needs. Evidence: In the AQAA, the manager said, We have a comprehensive Statement of Purpose, Service User Guide and Licence to Occupy which is specific to the people who live in the home. This means that people have information on what the home can provide available to them. He also said, All new service users receive a comprehensive needs assessment before admission and they are involved in that process. Independent Care Managers complete the initial assessment of need and we are involved in this process. People said they were happy living at the home. One person said, I am very happy here thank you. Another said, Settling in nicely, I like it here. We looked at pre-admission assessment information for someone recently admitted to Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: the home. We found there had not been any formal assessment by the home and staff were relying on information gained in the previous placements. This could lead to some needs being missed or overlooked. Staff did however tell us that this person had visited regularly before moving in and had been assessed by staff during this time. They said notes had been made at the time of the visits and that they would now be working with the person to develop support plans based on their needs. Pre-admission assessments should be carried out thoroughly and recorded. This will make sure that peoples needs are properly identified and they are not missed or overlooked. Care Homes for Adults (18-65 years) Page 12 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 are encouraged to make decisions about their lives and are involved in planning their care and support. Evidence: In the AQAA, the manager said, Our service delivery is based upon a person centred approach to ensure that all individuals are given opportunities to lead fulfilling lives. Individuals are involved in their own care planning process. This involves completing their care plans with support from the key worker. The people who live at the home are encouraged to take risks and appropriate risk assessments are in place. We looked at care plan and risk assessment records for some people who live at the home. We found them to be person centred and individual to each person. Support plans and risk management plans had clear and detailed instruction on how the needs Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: of people who use the service are to be met. Staff were familiar with what was written in peoples care plans and could talk confidently about the support they give. One staff member said, Everything we need is in the care plans and risk assessments. They had very good knowledge of peoples individual support needs and could describe peoples routines well. Staff said they like to encourage people to be as independent as they can be. Care plans are reviewed and evaluated regularly to make sure they are still relevant for people. Key workers do this on a monthly basis with people who live at the home; this makes sure they are still meeting peoples needs properly. The manager also checks the plans regularly and then discusses them in supervision meetings with staff. This makes sure peoples needs are well met. People are encouraged to make choices and decisions about what they do. Staff said they encourage people to make choices in their every day lives such as what to do, what to eat, what to wear and where to go on holiday. We saw people being offerred choices throughout the visit. Staff also responded well to requests for anything from the people living at the home, for example, drinks, food or wanting to go out. People who live at the home also have regular meetings where they discuss, holidays, staffing matters, food, activities and responses to anyone new moving into the home. Staff said that it was through one of these meetings that they now have satellite television and are now looking into getting Internet access for everyone. Care Homes for Adults (18-65 years) Page 14 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 excellent 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 able to make choices about their lifestyle. Social, educational, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: In the AQAA, the manager said, The people who live in the home are supported in observing Judaism, if they wish to do so. During the year there is a programme of cultural events and activities which they are invited to participate in. We have established links with local Jewish Organisations and individuals are supported to attend Synagogue, should they wish to do so. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Some of the people who live in the home attend social activities arranged by other service providers in the City. We provide programmes of leisure and recreational activities such as art, music and other pursuits through our weekly social club. Records showed that people experience a wide variety of activity. Activity on offer to people includes, swimming, various clubs, college courses, quiz nights, bingo evenings, going out for meals, church or synagogue attendance and visiting friends and family. People said they were never fed up or bored and that there was always something to do. On the day of the visit, there was a variety of outings for people, including a luncheon club meeting run by the organisation. People told us they had been on holiday recently and how much they had enjoyed it. One person said, We had nice days, nice food and steady walks, really enjoyed it. The manager and staff work hard to make sure people are offerred plenty of opportunities for leisure and educational activity such as college courses. They make sure they are well informed on what is available for people and assist them to access or enrol. Staff said they always respect peoples choices though if they choose not to do something or change their mind on a college course. People are given excellent support to observe their Jewish culture. A communal Shabbat meal is arranged every Friday evening in a traditional Jewish style. People are offerred the opportunity of attending a synagogue of their choice on the Sabbath day and encouraged to follow Jewish home life by relaxing and resting on the Sabbath day. People are also suppported to follow other faiths. One person has made connections with people at a local church and can now attend with support of the people from church. This has given the person some independence they enjoy. Staff said that they felt they had enough staff to support people with their activities. One said, Oh yes, plenty of staff and extras can always be arranged to take people places if necessary. Another said, They have a good life, lots to do and plenty of choice. Also there was plenty of social interaction between the staff and people who use the service. It was clear that staff and people who use the service get on well. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: In the AQAA, the manager told us, Meals are very well balanced and cater for the dietary and cultural needs of the people who live in the home. However, we encourage choices when preparing the menu. Mealtimes are always flexible. We looked at menus at the home. These are planned around peoples likes and dislikes. Staff support the people who live at the home to develop the weekly menu and shop for it. Staff said they try to encourage healthy eating but make sure people have plenty of treats. Kashrus (Kosher) must be observed at all times and staff are given advice on this through their staff handbook, Jewish Home Life. People said they enjoyed the food in the home, especially roast dinners for Shabbat. People, who do not use verbal communication, smiled and looked content when we asked if they liked the food and whether staff were good cooks. Care Homes for Adults (18-65 years) Page 17 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. Overall, peoples general healthcare needs are well met and based upon their individual needs. Evidence: In the AQAA, the manager said, We provide flexible and sensitive support to the people who live in the home in a way that enhances their dignity, privacy and independence. Adequate staffing levels are in place to ensure that personal care is delivered in a manner that complies with the underpinning philosophy of our service. Each individual has a health action plan. Each person has a Health Booklet which details past medical history. Medical appointments and all information appertaining to this is recorded on each individual persons file. Referrals to other health care professionals are made as required. Staff had good knowledge of peoples personal support needs. Staff were courteous, polite and respectful of peoples dignity when attending to any personal care needs. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: People looked well dressed and groomed and said they had the support they needed. Good records are kept of health appointments and their outcomes. Staff make sure that people are given support to attend appointments to meet their health needs. Staff are prompt in supporting people at the home to get health checks and referrals as their needs arise. Staff have received some training on meeting the specific health needs of people who live at the home. They said they had completed training in epilepsy, medication and behaviour management. However, staff have been undertaking some health screening checks for people at the home. This practice must stop as staff have not been trained to do this and it could lead to health needs being missed. The practice must be reviewed with a health practitioner and any screening must be agreed with the people using the service. The home uses a monitored dosage pre-packed system for medicines. There are good ordering and checking systems in place. We checked some medication administration records (MAR) sheets. These were found to be in reasonable order. We did however, notice that some entries on the MAR sheets had been handwritten. It is good practice to make sure these entries are checked and countersigned by a second person to make sure the information is correct and people receive the right medication. Care Homes for Adults (18-65 years) Page 19 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 able to express their concerns and are protected from abuse. Evidence: In the AQAA, the manager said, Each person who lives in the home has been issued with a booklet on how to complain. The service welcomes suggestions and complaints about our care practice and we use the information to provide a learning curve. The complaints procedure that the individuals use is in a format that enable them to understand the process. We spoke to people in the home and they told us that if they were unhappy about anything they would talk to staff or the manager. It was clear from staffs interactions with people that the people who live at the home seemed confident to raise their wishes or concerns. The service has not received any complaints, but has systems in place to record and investigate any that should be made. The manager said he would also record any compliments the service receives. The manager also told us in the AQAA, We have a Safeguarding Adults Policy in place. The people who live in the home are made aware of what abuse is and we explain to Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: them that the polices and procedures are there for their protection. Ensure that all staff undertake training in respect of Safeguarding Adults. All staff have attended a training session regarding the Organisations Whistle Blowing policy. Staff have received training in safeguarding adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. They were familiar with the whistle blowing procedure and said they would have no hesitation in using it if they thought they needed to raise concerns outside of the home or organisation. However, the homes safeguarding adults policy does not contain the contact numbers to enable staff to do this. We reccommend this is included so that staff can report concerns if they needed to. People who use the service are also given training on keeping safe and reporting concerns. The manager and area manager are currently looking at the effects of the deprivation of liberty act. They have been on training and are now looking at the training needs of the staff team. This will make sure peoples interests are properly protected. Records are kept of the finances of people who live at the home and their monies are kept safe. Care Homes for Adults (18-65 years) Page 21 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 environment is homely, comfortable and safe for people who live at the home. Evidence: In the AQAA, the manager said, We have recently moved into a brand new purpose built house and as with all new builds, we have a snagging period of 12 months. The home is located in the heart of the Jewish community and generates a very warm and positive atmosphere that is conducive to ordinary family life. All bedrooms are individually personalised, all have en suite bathrooms with showers. The home is close to the local amenities, public transport and places of worship. Each persons room has a television and facilities for SKY TV, if required. Each persons bedroom is lockable and everyone is provided with their own key. A tour of the home was carried out. Communal areas, bathrooms and bedrooms were visited. The home looked clean, homely and well maintained. All areas were nicely decorated and furnished. Bedrooms were spacious and individual to each person, Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: clearly showing their hobbies and interests. They also all have their own telephone point for if people want to install their own private phone or the Internet. The bathroom has an adapted bath and moving and handling equipment to suit people who need this help or may need it in the future. This bathroom would benefit from some decor such as pictures and plants to make it more homely looking. People said they liked their new home. One person said, I like the quiet of my own room and There is plenty of space. The lounge and dining area are very spacious and well set out. There is evidence of Jewish culture and home life around the home, such as pictures, calendars and the Shabbat candles. There is a reasonable sized attractive, enclosed garden, that has recently been landscaped. There is room to sit out and enjoy a BBQ in the summer months. People who live at the home have also been involved in the gardening. The communal areas of the home are cleaned by cleaning staff who come in to the home. To respect peoples privacy, staff assist the people who live at the home to clean their own bedrooms. Staff have received training in infection control as part of their induction and were able to say what other infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Care Homes for Adults (18-65 years) Page 23 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. Staff are trained, skilled and in sufficient numbers to support people who use the service. Evidence: In the AQAA the manager said, We have a functional team in place and work very well together and aim to provide excellent individual care for each person. We have a highly trained and skilled workforce. We undertake Mandatory staff training. The Project ensures that staff receive relevant on-going training that focuses on improving the quality of life of the people who live in the home. Staff receive regular supervisions by the Home Manager. The Home Manager undertakes a training skills audit of the staff team. People who live at the home said they liked staff and got on well with them. One person said, I like them all, they are all nice. Records showed that, in the main, there are two staff on duty throughout the day. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Occasionallly there are three staff. The manager is also available Monday to Friday 9am - 5pm but also does some shifts where he works alongside staff to monitor practice and supervise staff. All staff we spoke to said they had enough staff to make sure the needs of people who use the service were met well. We looked at recruitment records. These showed that recruitment is properly managed by the home; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. People who use the service are also involved in recruitment, enabling them to choose their own staff. The service has developed their own induction pack. Staff said their induction had been good and prepared them well for their job. Comments included: Very good induction and it remains on-going Very thorough induction Plenty of time given to go through things. We also looked at training records and these showed that most staffs training was up to date or if updates were needed, they were planned. The manager completes a monthly check on training to make sure nothing gets missed. Staff spoke highly of their training. Comments included: Training here is very good Good opportunities and readily available. As well as providing all the essential training, the manager makes sure that training is specific to the service and any specialist needs. For example, Jewish culture and customs, healthy eating, autism and dementia. There is a commitment from the organisation for staff to complete their NVQ (National Vocational Qualification) in care at level 2 or above. Over half of the staff team have now achieved an NVQ in care at level 2 or above. This means they are qualified to carry out their job. We looked at staffs supervision records and saw that regular one to one sessions are provided for staff to discuss their roles. Staff said, Supervisions are great, we get good guidance and We have regular supervision and you can request one any time if you need anything extra. Care Homes for Adults (18-65 years) Page 25 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 home is well managed, the interests of the people who use the service are seen as important to the manager and staff and are properly safeguarded. Evidence: In the AQAA, the manager said, The daily running of the home is influenced and structured around the specific needs of the people who live there. The Project places the highest priority on the improvement and maintenance of quality care. The Project works continuously to improve the service and provide an increased quality of life for the people who live in the home. The manager of the service has an NVQ level 4 qualification in care and has many years experience of managing a home. He also has the registered managers award making him suitably qualified to run and manage the home. Staff spoke highly of the support and leadership they get from the manager. Their comments included: Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: He listens to us He is very approachable Absolutely fantastic manager, can ask him anything Great manager, he gets things done Works alongside us to train us. People who use the service said, Hes very nice or smiled when asked if they got on well with him. Records we looked at showed that regular health and safety checks are carried out. In the AQAA the manager said relevant health and safety policies and procedures were in place, and reviewed. He also said equipment has been serviced or tested as recommended by the manufacturer or regulatory body. Records showed that certificates on gas and electrical safety were up to date. The organisation provides a comprehensive manual of policies and procedures for staff to refer to. We looked at accident reporting and spoke to staff about this. Staff were clear on their responsibilites and how to report and record accidents or incidents. We also looked at environmental risk assessments. The organisations community care manager conducts monthly provider reports with requirements for improvement. The organisation is also currently working on the development of a questionnaire to send out to people who use the service and their relatives. This will enable them to gain feedback on the service and how they can improve it. We recommend that this is extended to health and social care professionals too, giving the an opportinity to comment on the service. The AQAA was very well completed by the manager and gave us all of the information we asked for. It highlighted what the home could do better, how it had improved and what the plans are for further improvements. This shows the manager is always assessing how things could be improved for people who live at the home. Care Homes for Adults (18-65 years) Page 27 of 31 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 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 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 1 19 13 The practice of staff carrying 31/07/2009 out health screening checks for people who live at the home must stop as they have not been trained to do this. The practice must also be reviewed with a health practitioner and any screening must be agreed with the people using the service. This will make sure that peoples health needs are not missed or overlooked. 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 Pre-admission assessments should be carried out thoroughly and recorded. This will make sure that peoples needs are properly identified and they are not missed or overlooked. Page 29 of 31 Care Homes for Adults (18-65 years) 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 2 20 Handwritten entries on MAR sheets should be checked and countersigned by a second person to make sure the information is correct and people receive the right medication. The whistleblowing policy should include the contact details for agencies to contact outside of the organisation if staff wish to report concerns. 3 23 Care Homes for Adults (18-65 years) Page 30 of 31 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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