Care Home: 25-27 Haymill Close

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well Information about the services the home provides is clear and gives people a good picture of the home. Prospective residents are fully assessed and given the opportunity to visit the home prior to admission, to ensure the home is right to meet their needs. There is also a settling in period to give new residents the opportunity of getting to know their fellow residents plus the staff, and be sure this is the right home for them. The service user plan documentation is clear and comprehensive, providing a good picture of the resident and their needs and how these are to be met. Risk assessments are in place for all identified risks, to show how these are best managed for each individual. Residents are encouraged to make individual choices about what they do and do not wish to do and to maintain their independence to the best level they can. There are individual activities programmes to meet persons interests, abilities and needs. The home has an open visiting policy and visiting is encouraged. Staff care for residents in a gentle, friendly and professional manner, respecting their privacy and dignity, and promoting good communication. The food provision at the home is good and varied, and residents choices, to include cultural and religious dietary needs, are recorded and respected. The heathcare needs of the residents are identified and met, to maintain their well-being to the optimum level. Staff communicate effectively with residents and there was a good atmosphere throughout the home. Overall medications are being well managed and the one shortfall identified should be easy to address. Clear procedures are in place for the management of complaints and safeguarding adults issues, and these are adhered to, thus protecting the residents. There is evidence of redecoration and refurbishment of areas of the home, to maintain a homely environment for residents to live in. Infection control procedures are in place and are being adhered to. The home is being appropriately staffed to meet the needs of the residents. Staff vetting and recruitment procedures are robust and are followed, thus safeguarding residents. The manager has the skills and experience to manage the home effectively and knows what needs to be done to further improve communication and standards within the home. Systems are in place for quality assurance and residents are encouraged to express their opinions. What has improved since the last inspection? Daily fridge and freezer temperatures are now being checked and recorded, with some further work in progress to ensure the fridge thermometers are fully accurate. There is evidence that the required employment checks are carried out prior to new staff working at the home. Documentation in respect of legionella assessment and testing was being awaited by the home, but the manager confirmed that there had been no issues identified. Fire drills are being held regularly to include all staff. Risk assessments for equipment and safe working practices are now being reviewed and updated annually and whenever there is a significant change. What the care home could do better: Ensure that staff are aware of any specialist instructions for a particular medication to be administered. There would appear to be an issue with the landlords carrying out work that is within their remit in a timely manner, and this could place residents, staff and visitors at risk and needs to be addressed without delay. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 25-27 Haymill Close 25-27 Haymill Close Greenford Middlesex UB6 8HL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Clare Henderson-Roe     Date: 3 0 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: 25-27 Haymill Close 25-27 Haymill Close Greenford Middlesex UB6 8HL 02089988856 02088109531 hm2527haymill@ealing.org.uk www.supportforliving.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Velichka Ilieva Colman Mr Peter Lee Type of registration: Number of places registered: Support for Living care home 9 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: 9 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 25-27 Haymill Close was registered in 2004. It had been formally registered as Perivale Supported Housing and had comprised of four houses linked by an administration block. The service is for nine adults who have learning disabilities. One Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Brief description of the care home house, number 25 is for four female service users and the other house, number 27 is for five male service users. A small office connects the houses. There is some parking to the front of the home and a communal garden that is shared with another registered home. This is mainly a lawn with a patio area. All bedrooms are single and are situateed on the ground and first floor. Both houses have good communal space and are very homely. The staff team consists of one Manager for the two houses and one deputy manager for each house and support workers. Number 25 & 27 Haymill Close is situated on a housing estate near to the Ealing Consortium Activities Resource Centre. Several service users attend this local resource centre where they take part in sessions such as Drama therapy. The houses are near to a main road into London and a short walk to a main road where there are buses into the towns of Ealing Broadway or Greenford. Ealing Broadway has good rail links for both in and out of London. The current fees charged range from £286.48 to £817.43 per week. 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: This was an unannounced inspection carried out as part of the regulatory process. A total of 6 hours was spent on the inspection process, which included a tour of the home and viewing records to include medication management, service user plan documentation, training records, quality assurance documentation, staff employment record information and maintenance and servicing records. The Annual Quality Assurance Assessment (AQAA) completed by the manager has also been used to inform this report. We spoke with 5 residents and 5 staff. No visitors were present at the time of inspection. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 7 of 29 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 home provides information for prospective residents and their representatives to give them a good picture of the home and the services it provides, helping them to make an informed choice. The pre-admission process is thorough and ensures the needs of the residents are fully identified in order that an appropriate placement can be made. Evidence: The home has developed an easy read version of the Service Users Guide and this is available to current and prospective residents and their families. It provides information about the home and the services it offers in a simple and clear format. Support For Living (SFL) has clear procedures on the process to be followed for assessment and admission. All prospective residents are fully assessed by a suitably qualified SFL Director and a member of the Community Team for People with Learning Disabilities (CTPLD) and the assessment is thorough, covering all identified needs and aspirations. Information is also gained from other key people such as family, plus input from professionals involved in the persons care. This ensures that the persons Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: health, social and personal care needs are identified and the appropriate placement can be considered with staff who have the knowledge and skills to meet their needs. Planned visits then take place and these lead onto a trial period living in the home, with assessments at 1 month and 3 months to review how the placement is progressing and address any issues that may become apparent. Care Homes for Adults (18-65 years) Page 11 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. Service user plan documentation is comprehensive and up to date, providing staff with a clear picture of each resident, their individual needs and how these are most effectively met. Residents are encouraged and supported to maintain as much independence as they are able, and their wishes are respected. Risk assessments are in place for all identified areas of risk, thus minimising the risk to each resident whilst respecting their right to independence. Evidence: Each resident has a person centred support plan. This is written in a manner that is user friendly and presents a very clear picture of each individual, their needs and the most effective way to meet these needs. In one service user plan viewed the way in which needs are to be met to respect the persons religious and cultural needs was clearly identified. There was also good information to help staff to understand the particular religion and associated customs and cultures. 6 monthly reviews are carried out with the resident and their key worker, with their representative, care manager and the home manager also being invited to attend. During the review they consider Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: whats working and whats not working and an action plan is put in place to address the issues identified. The people living at the home are encouraged to make choices about their daily lives and routines and to excercise independence where they are able to do so, with help and support from staff. Work has been done to improve communication between staff and residents, and 4 of the residents use non-verbal forms of communication, and do so very effectively. Notices and pictures are on display in the home to include a staff on duty identification board, with photos. Risk assessments were in place for each resident, identifying the particular risks to the individual and the action to be taken to minimise them. These are comprehensive and there is evidence that they are reviewed whenever there is a change, and new assessments are formulated for any newly identified risks. Care Homes for Adults (18-65 years) Page 13 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. Each resident has their own activity plan to include social, cultural and leisure activities, thus ensuring their needs are individually planned for. The home has an open visiting policy and visiting is encouraged, thus maintaining good links with family, friends and the community. Staff care for residents in a friendly, caring and professional manner, respecting their dignity and privacy. The food provision at the home provides variety and choice to meet each persons dietary needs, to include cultural preferences. Evidence: Some of the residents attend local day centres, and in addition there are several inhouse activities to include drama therapy, music therapy, aromatherapy, reflexology and other treatments carried out by qualified professionals. TV and music centres are available in the home and time is taken to ensure the residents particular likes in music and TV programmes are identified and provided for. Staff also ensure residents Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: are engaged in activities to include daily routines such as assisting with laundry and shopping, laying the table for meals and other supervised household activities. A picture of each persons daily routine and planned weekly activities is available in the support plan. It was clear that the manager, key workers and staff have a good knowledge of the likes and interests of each resident and work hard to help them to live active, interesting and fulfilling lives. The following is a quote from the homes AQAA: Each person is treated as an individual and our service is responsive to their race, culture, religion, age, disability and gender. People are supported to take part in activities that are appropriate to their age and culture and are integrated to the local community by visiting local shops, Church, Gurdwara (Sikh Temple), Cafes, Cinema, Pubs, Gateway Club, Restaurants and bus routes into neighbouring towns such as Ealing Broadway and Greenford. We look into the local community where individuals can learn practical, everyday skills such as shopping, handling money, road safety awareness, social skills (by waiting in queue, taking turns, waiting for public transport, not pushing past people etc). Residents have the opportunity to go on holiday and these are planned taking into consideration their wishes and known preferences. The home has an open visiting policy and visiting is encouraged. Maintaining contact with family and friends is a very important part of life for the residents, and staff do what they are able to facilitate and encourage this. Residents can meet with visitors in one of the communal rooms or in the privacy of their own bedroom, as they so wish. Each resident has their own bedroom and staff respect this and knock before entering the room. Residents were dressed to reflect individuality and bedrooms were also very personalised. There was good interaction between staff and residents and a very homely and friendly atmosphere throughout. The kitchens were viewed and were clean and tidy. One of the cookers was not working, however prompt action had been taken to call the engineer who attended on the day of inspection. Lists of residents food preferences and any special dietary instructions were available and the weekly menu is drawn up to reflect this. Residents are weighed each week, and where there is a marked change action is taken to refer them to the dietician via the GP. The residents are involved in the shopping trips as part of their weekly routines. We observed the lunchtime meal and this was a sociable occasion with staff available to assist and supervise residents as needed. Care Homes for Adults (18-65 years) Page 15 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. The wishes and preferences of each resident are recorded and respected by staff, thus promoting choice and treating people with dignity and respect. The healthcare needs of each resident are identified and met, to keep them at an optimum level of health. Medication management in the home is good, thus ensuring the residents medication needs are met. The one shortfall should be easy to address. The wishes of residents and their families in respect of their care with regard to health deterioration and end of life care needs are ascertained and recorded, so that they can be respected. Evidence: Plans are in place to meet residents religious and cultural needs, and it was clear that there is ongoing work taking place to make visits to places of worship more meaningful for the residents concerned. The staff team reflects the cultural diversity of the residents, and staff are available to assist with specific communication needs of individuals. The gender care preferences of each resident is ascertained and recorded, and this is respected. Residents looked well cared for and content, and those that were able to expressed their satisfaction with the care provided at the home. Each resident has a key worker and they are carefully matched so that there is effective communication between them and the key worker understands the overall needs of Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: the resident. The following information was provided in the AQAA: Each service user has an easy read format of a Health Action Plan using pictures and words which is comprehensive, identifying all their health care needs. We monitor service users health, weight, diet, dental and vision needs. Each individual is registered with GPs and they are supported to attend any appointments. We record the summary of all medical appointments and any medical concerns are reported by staff promptly. We seek and record support from GPs, District nurse, Psychologist, Memory Clinic, Therapists, Speech and language team, wheelchair assessments, Dieticians, Physiotherapists, Hydro-therapy sessions. We have developed easy read version of Hospital Passports. This document helps hospital staff (in case of service users hospital admission) to support people effectively. We have referred to use of picture board, symbols, object of reference in order to communicate with people in their preferred way which aims to promote effective communication. We viewed the documentation for 2 residents and it was comprehensive and provided a clear picture of each persons healthcare needs and how these are met. We viewed the medication management and sampled the records. A list of staff specimen signatures and initials was available. Receipts had been recorded and there was evidence that stock balances had been carried forward where necessary. The home uses a monitored dosage system (MDS) with the majority of tablets being supplied in 28 day blister packs. Some of the packs were viewed and the stock balances tallied with the number of medications signed for when administered. In one instance a medication with specialist administration instructions had been prescribed, however staff were not sure about the instructions. The medication information leaflet, which contains the instructions, was placed with the medication administration record (MAR) at the time of inspection and the manager said she would ensure all staff were made aware of the instructions to be followed. We also discussed the importance of ensuring all staff administering medications read and understand the information supplied with any new medications that are prescribed in future. There were 2 types of lancing device available for blood glucose testing, one of which is an approved device. The manager said that the others were not being used and would be returned to the chemist. Any medications for return to the chemist for disposal are listed and signed for. There are some controlled drugs available in the home for use in specific situations, for example, seizures, and clear instructions for the administration of such medication were available. There are 3 metal storage cupboards for the medication, and at the time of inspection the controlled drugs being stored were moved to one of the more secure metal cabinets. Policies and procedures for the administration of medications are available in the home and all staff who administer medications receive Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: training and are supervised prior to commencing medication administration. Overall medications are being well managed in the home. SFL has an End of Life plan and this is being completed for all residents at the home, with input from their families and representatives. This provides a clear picture of the wishes of the resident and their families in respect of the action to be taken should the residents health deteriorate, and ultimately their wishes in respect of end of life care and care after death. This is a sensitive topic to address and SFL are to be commended on their proactive approach. 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. There are clear procedures in place for the management of complaints and safeguarding adults, and these are followed, thus protecting residents. Evidence: We saw the complaints procedure on display in the home and it was clear that staff know the residents well and can observe for any signs of concern or distress so that this can be addressed. The home encourages residents and their families to raise any matters of concern so that they can be addressed promptly. SFL have clear policies and procedures in place for safeguarding adults, and also follow the Ealing Safeguarding Adults protocols. Staff spoken with were clear to report any concerns. We viewed the personal monies records for 2 residents. These were clear and up to date, and receipts are available for income and expenditure. There are robust procedures in place for the management of residents personal monies and these include checks of all personal monies at each handover and a monthly audit and reconciliation is also carried out. Care Homes for Adults (18-65 years) Page 19 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. The home is being maintained to provide residents with a homely environment to live in. Infection control procedures are in place and are adhered to, thus minimising any risks. Evidence: We carried out a tour of the home. There was evidence of areas of refurbishment and redecoration to include sofas, carpets and blinds, plus new cookers and dishwashers. The home has overhead hoists available in the bathrooms and where needed to meet specific residents care needs, and they have obtained a mobile hoist, awaiting construction, plus there is a list of homes in the nearby vicinity where mobile hoists can be borrowed from in the event of an emergency, for example, a power-cut that stops the home being able to use the overhead hoists. In the kitchens the ceramic tiles used as pot stands were both cracked and in need of replacement. A requirement is made under Standard 42. The communal areas were well furnished and were decorated in a pleasant and homely way, adding to the good atmosphere. Bedrooms are personalised and residents are encouraged to make choices as to what they would like in their rooms and the decor. There is a communal garden and this looked quite well maintained, and had garden furniture and an adult size swing for the residents to use. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The home has policies and procedures in place for infection control. Protective clothing to include gloves and aprons are available in the home. The laundry has a washing machine with a sluice programme for soiled items and there are clear laundering instructions for infection control purposes. Care Homes for Adults (18-65 years) Page 21 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. The home is staffed with appropriately trained staff in such numbers as to ensure that the needs of the residents are understood and met. Systems for vetting and recruitment are in place and are adhered to, thus protecting residents. There is a programme of training to provide staff with up to date skills and knowledge to enable them to care for the residents effectively. Evidence: At the time of inspection the home was being appropriately staffed to meet the needs of the residents and the home in general. The information provided in the AQAA shows that over 50 of staff are qualified to NVQ in care level 2 or 3, with more staff working towards these qualifications. There is evidence that staff undertake recognised training for working with people with learning disabilities, and staff were very able to work with and care for the residents effectively. SFL hold all the staff employment information at head office, and provide the home with an employment profile, which lists the all the pre-employment checks carried out in line with Schedule 2 of the Care Homes Regulations 2001. We viewed 2 of these documents that had been completed, and copies of the documents for other staff were emailed through at the time of inspection, and evidenced that all the required checks had been completed. The manager said that residents from some of the SFL homes in Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: the area do sit in on the interview process and prospective staff are shown around and introduced to the residents. There is a training matrix maintained for all mandatory and essential training. We viewed this and it was up to date, and recorded where training sessions had taken place and those booked. The manager had audited the matrix and identified any gaps or overdue trainings due and there was evidence that she has brought this to the attention of the SFL training department so further training can be arranged. All new staff undertake a 6 week induction training programme and and complete a recognised learning disabilities training programme before completing their probationary period. Staff spoken with said that they do undertake training on a regular basis to keep their skills and knowledge up to date. Care Homes for Adults (18-65 years) Page 23 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 home is being effectively managed and the manager is approachable and leads the team well. Systems are in place for quality assurance, providing an ongoing process of practice review within the home. There are good systems in place for the management of health & safety, however delays in repairs could compromise the safety of residents, visitors and staff. Evidence: The home has a manager who is going through the process of registration with CQC. The manager is undertaking NVQ level 4 in health and social care and will also be doing the Leadership Qualification (formerly the Registered Managers Award). She has undertaken several trainings in topics relevant to her role and to the diagnoses and needs of the residents and has several years of management experience. There is also a deputy manager for each house and at the time of inspection we observed that this team works effectively to manage all aspects of the home. Staff spoken with were satisfied with the way the home was being managed and it was clear that work was being done to ensure that staff are given autonomy and opportunities to take the lead in areas of the home, for example, communications co-ordinator. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: SFL have a system in place for quality assurance. This includes key performance indicator assessments that audit various areas of the home and records any action to be taken taken to address any shortfalls identified. The 6 monthly resident reviews are thorough and an action plan is drawn up with timescales to address any issues identified. There are also quarterly health risk monitoring meetings with healthcare professionals to discuss each residents health status and any further action to be taken to maintain optimum well-being. Regulation 26 unannounced visits are carried out on behalf of the registered provider and reports from these visits are available. Staff meetings take place 1-2 weekly and minutes are kept. There is also a monthly meeting without the manager present, and a staff development day had also taken place, with evidence that any areas identified for improvement were being taken forward. We sampled the servicing and maintenance records and those viewed were up to date. Fire drills are carried out and clear records are kept. The training matrix shows what training each member of staff needs to undertake to keep up to date with health & safety training topics. Risk assessments are in place for equipment and safe working practices and these had been reviewed in May 2009. The risk assessment and testing for legionella had last taken place in February 2009 and the manager confirmed that no issues has been identified, however the home was still awaiting the official documentation. A new assisted bath was installed in number 27 in May 2009, however we were informed that there had been a delay from the Landlords, Notting Hill Housing Trust (NHHT), in carrying out the rewiring necessary for the bath to be commissioned. We were informed that the broken tiles in the kitchens mentioned under standard 24 have been brought to the attention of NHHT, however they do not consider this an urgent repair, so no action has as yet been taken. There is also an issue with a split in the flooring in one bathroom and again we were told that there has been a delay in action being taken to address this. The fire risk assessment was last reviewed in March 2009. The Fire Safety Officers last inspection on 24/03/09 had identified some shortfalls, and action has been taken to address these, however we were informed that there had been some delays in the landlords carrying out the required work. The latest servicing of all the fire equipment was on 09/06/09 and it was recommended that an emergency lighting battery be replaced, however this had not yet been actioned. Hot water temperatures are checked and recorded weekly, however no action had been taken to adjust any high or low temperature readings. the Fire drills are carried out and clear records are kept. It was clear from discussion with the staff at the home that jobs that do not require a referral to NHHT can be addressed promptly, however there are often delays in NHHT getting works completed for the home and this needs to be addressed so that any issues identified are promptly Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: addressed. 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 1 20 13 All medications must be administered in accordance with any specific administration instructions. To ensure that specific instructions are adhered to. 13/08/2009 2 42 23 That any works required in line with health and safety legislation and guidance are carried out without delay. To protect residents, visitors and staff. 01/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!