Care Home: 267 Old Shoreham Road

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What the care home does well Residents who live at 267 Old Shoreham Road benefit from the support of a professional, enthusiastic and dedicated team of staff. Throughout the inspection, all the staff on duty demonstrated their personal and collective commitment to providing residents with a high level of care in a respectful and dignified way. Each resident has a comprehensive plan of care that identifies their needs and enables these to be met in a consistent and considered way. There is evidence of of a culture whereby things are "done with", rather than "done to" the people who live at the home. Residents have choice over the things they do and each person has an activity programme which is individually meaningful to them. There are lots of opportunities to go out, including for one person three holidays in the last twelve months. Despite management changes, the home continues to be run efficiently and effectively and both management and staff are good advocates for the people they support. What has improved since the last inspection? Since the last inspection the home has been completely redecorated and this has served to provide the people who live there with both personal and communal spaces that are pleasant, well maintained and which meet their needs. An ongoing compatibility issue between two of the people who live at the service is near to resolution, with a named social worker now identified for one individual who is now actively supporting her client to find a placement that more appropriately meets her needs. The skills and professionalism of the staff team have further developed with staff being more dynamic and open minded in their approach to complex needs and situations and there was evidence of a real drive to support individuals in a way that is in their best interests. What the care home could do better: The home needs to build on the work that they have started, especially in respect of the support and opportunities available to those individuals with very complex needs and behaviours. With the support of other professionals, the home needs to keep placements under formal review and ensure that people are constantly moving forwards in their lives. Access to staff training needs to be improved and in particular staff must have the opportunity to undertake the mandatory and specialist training they need to do their job in a timely way. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 267 Old Shoreham Road 267 Old Shoreham Road Portslade East Sussex BN41 1XF     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: Lucy Green     Date: 2 4 0 6 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 31 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 31 Information about the care home Name of care home: Address: 267 Old Shoreham Road 267 Old Shoreham Road Portslade East Sussex BN41 1XF 01273295477 01273295478 Lou.Aish@brighton-hove.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Brighton & Hove City Council care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home 267 Old Shoreham Road is a three storey, semi-detached property situated on a main road in Portslade. The home can accommodate up to 3 people with learning disabilities who are physically able. Each person has access to a single bedroom and shared communal space, including a lounge, kitchen/dining room and two bathroom facilities. More detailed information about the services provided at 267 Old Shoreham Road can be found in the homes Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the Provider. Care Homes for Adults (18-65 years) Page 4 of 31 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term service user to describe those living in care home settings. For the purpose of this report, those living at 267 Old Shoreham Road are referred to as residents. This report reflects a key inspection based on the collation of information received since the last inspection, a site visit and a review of the homes Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The AQAA was completed by the Registered Manager and returned when we asked for it. Care Homes for Adults (18-65 years) Page 6 of 31 The site visit was carried out over six hours between the times of 10:40am and 4:40pm on Wednesday 24th June 2009. We had a look around the home and examined some care, medication and staffing records. We observed the interaction between staff and residents throughout the day. During the visit we met with two of the three people currently living at the home and one of these people spent time talking with us and showing us their person centred plan and photos. The management arrangements have recently changed at the home and as such we spent time with the person who has been seconded to manage the service. Two senior carer officers and seven care officers were also met with during the visit, and the Inspector spent additional time talking with two of them individually. 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 following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite the ongoing commitment of the service to identify and assess peoples needs, residents do not have timely and sufficient formal opportunities to choose where and with whom they wish to live. Evidence: The AQQA stated that there have been no new admissions to the home since the last inspection and this was confirmed to be the case. The same three people are therefore living at the home and as such the ongoing compatibility issues that have been discussed in previous reports are still relevant. That being said there was evidence provided by the person appointed to manage the service which indicates that the person currently most affected by compatibility issues has now been allocated a named social worker, who on the basis of a re assessment, is actively seeking a more appropriate placement for their client. Through discussion with staff and a review of care plans, it was identified that whilst Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: the service has worked hard to appropriately support individuals, their ability to fully review their placements and ultimately choose where to live, has been impacted by the absence of social workers at reviews. Two of the three people living at 267 Old Shoreham Road have not had their social care assessment reviewed for two years. Given the complex needs of these people and the behavioural support required especially for one person, this situation is unacceptable. The home were able to provide evidence of their attempts to establish formal reviews, but a situation which is beyond their control is negatively impacting on the lives of the residents concerned. The management and staff team of this service were able to evidence how their own efforts have had a positive influence on the lives of the three people they support, but the Commission cannot ignore the fact that there has been a considerable delay for one person and their continues to be a delay for another, in exploring the different placement options available to meet their diverse needs. The outcome of this situation is ultimately affecting the privacy and dignity of one individual and the right to feel calm and safe at home for others. In the meantime, the service continues to support people well and through the careful planning and structuring of each day, the difficult task of balancing individual and collective needs is maintained. The home has been asked to use the person centred process to explore choice of home and identify future goals and aspirations. The Commission will take this wider issue of ensuring individuals have access to regular social care assessment reviews and genuine opportunities to live in a home that fully meets all of their needs and expectations forward with Brighton & Hove Council as an organisation which both provides and commissions care. Following on from a wider Council project to improve the Service User Guide and Statement of Purpose generally, 267 Old Shoreham Road have now produced this information in a format that is more accessible to the people who live at the home. The person now appointed to manage the service showed us the draft version which is soon to be circulated to the people living at the service. Once completed, this will provide individuals with the relevant information to enable them to understand the rights and responsibilities attached to their placement. 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. Care plans include comprehensive information and guidelines to support individuals in a respectful and consistent way. Outcomes could be further improved if person centred plans were more strategically used to formulate life goals and choices. Evidence: Through discussion with staff and observation of their practices, it was demonstrated that they have positive relationships with the people they support and a very good understanding of their needs. The Inspector tracked the care for two residents, which included a partial examination of their care plans, activity schedules and a discussion with the staff on duty. The Inspector also met with both of these individuals during the course of the inspection and one of the residents showed the Inspector their person centred plan. Both care plans viewed contained very detailed support guidelines about daily care routines, health care, behaviour and communication needs. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Care plans are regularly reviewed, with a formal in house review of care needs every six months. As documented in the Choice of Home section of this report, the home have had difficulty in securing social workers to attend these reviews and as such this has prevented key actions from being fully explored in a timely way. Care plans contain a range of risk assessments for each resident and there is evidence that the approach to risk assessing has become more enabling and as such the number of restrictions in place has reduced. Evidence gathered from documentation and observation of staff supporting residents during the inspection, highlights that the home provides a service where residents are encouraged and supported to lead their lives with flexibility and choice. In order to further improve outcomes in this area, the home must develop the person centred process to support residents to more strategically identify and formulate life goals which develop their skills, experiences and independence. In particular, the staff spoke of the benefits for at least two of the residents living in single person services and as such theses should be fully explored through the person centred process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the opportunities to spend time as they choose and to participate in activities that are meaningful to them. Residents are supported to maintain relationships with their relatives and receive a range of balanced and wholesome food. Evidence: At the time of the visit, one resident was on holiday and therefore away from the service. The other two residents were supported to follow their own individual routines which for one person included a trip to Lewes and picnic and for the other a local walk and time at a nearby park. Discussion with both residents both before and after their days activities evidenced that they were involved in doing things that they enjoyed. The activity timetables viewed for two residents demonstrated that they have access Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: to a choice of various outings and activities which are meaningful to them. Due to the current needs and wishes of these two people, attendance at college courses and other formal services have not been successful. Discussion with staff identified that goals for both these people included developing contact with peers and attending external classes of interest. For one person staff are researching voluntary employment opportunities. Evidence gathered from staff discussions and records demonstrated that staff are creative and flexible in their thought processes in enabling residents to expand their opportunities and lifestyles. One of the residents showed the Inspector their person centred plan and other photographs of activities they had taken part in, which provided evidence that people have the opportunity to take part in things they like and are genuinely interested in. Annual holidays for individuals were reported by both staff and residents to be a huge success. One resident demonstrated to the Inspector that they were very clear about the type of holiday they wanted to go on this year and staff confirmed that they were in the process of facilitating this. The home has a positive approach to enabling residents to maintain contact and relationships with families. There was evidence in the care plans that the home supports residents to meet with and receive visits from their relatives. Resident reviews include the opportunity for residents representatives to attend if the resident wishes. Meals at 267 Old Shoreham Road are prepared according to a menu that is drawn up in consultation with residents to reflect the meals they wish to have. The menu is also reflective of individual likes and dislikes and specialist diets, therefore on some days different meals are prepared for different residents. Activity schedules include time for residents to be involved in daily household tasks, including cooking and cleaning. At the time of the visit, staff were observed to be actively involving residents in the planning of their days and for one person this included helping to prepare their own packed lunch. Due to the high support needs of residents, especially when accessing the community, access to activities is dependent on high staffing levels being maintained. The Inspector observed the staff handover at the beginning of the late shift, where it was highlighted by senior staff that activities for the rest of the day would need to be in house due to there being three staff on duty. Whilst both individuals had already been out during the earlier part of the day, it did mean that they could not have total choice and control about when to go out. Care Homes for Adults (18-65 years) Page 16 of 31 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. Residents benefit from the considered and flexible way in which their personal and health care needs are met and are protected by the robust systems in place to manage medication. Evidence: A review of two care plans and health action plans provide documentary evidence that people receive appropriate support to meet their health and personal care needs. It was evident that referrals are made to external professionals, including GPs, opticians and speech and language therapists as required. As a service which accommodates people with complex behaviours, the home works closely alongside other specialist professionals including the behavioural support team. There was evidence that the intensive behavioural support programme for one individual has had a positive impact on their physical and emotional well being. For this person, there is still much to be done to improve their quality of life, but the staff team remain positive and open to trying new ways of working to try and achieve this. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: Personal care was observed to be being provided in a sensitive and respectful way during the course of the inspection. Interaction between staff and residents as support was being provided was noted to be positive and relaxed. The boundaries between staff and residents are clear and professional and the focused way in which staff work is a major strength in the running of this service. Systems are in place to ensure medication is managed appropriately and one staff member has been delegated responsibility to oversee the management of medication at the home. No residents manage their own medication at the current time, although there was documentary evidence that demonstrated this area was regularly explored and the staff member who takes the leads on managing medication at the home confirmed that wherever possible residents are involved in the process. Staff receive appropriate training in the management of medication and are currently in the process of completing in house competency assessments. It is highlighted in the Staffing section of this report that there is a delay in staff being able to access training in a timely way. It was highlighted that one of the courses for which some staff have had to wait for is supporting people with epilepsy. The Manager confirmed that the effect of delays in this training meant that some staff are not able to support those residents with epilepsy outside the home and as such this can impact on access to leisure opportunities. It is required that staff have access to the training they need to fulfil their roles effectively. Medication records were found to be clear and it was possible to audit medication coming into and leaving the home. We are confident that the systems in place should ensure residents are receiving the right medication at the right time. Due to recent changes in legislation, a requirement has been made in respect of making provision for the safekeeping of any controlled medication that may be brought into the home. 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. Residents and visitors to the home benefit from and are protected by, the open culture at 267 Old Shoreham Road. Evidence: The home has a complaints procedure in place and an accessible copy is available for residents and visitors to access. The appointed Manager showed the Inspector her plans to further improve the accessible version which will soon be in place. The home has not received any complaints about its service since the last inspection. The home seeks to operate an open culture where issues are openly discussed and opinions shared. Positive interaction was observed between residents and staff during the inspection. Residents are encouraged and supported to voice their opinions about the things they like and dislike. Discussion with both staff and management identified that they understand their own advocacy roles in supporting peoples complaints to be recognised. The home has a number of systems in place to protect residents from abuse. New staff are employed subject to appropriate recruitment procedures and the necessary checks being undertaken. There are systems for supporting residents with their finances, which ensure that money held on behalf of residents is regularly audited and checked. Further improvements to residents access to their money were identified through Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: individual bank accounts, but the Inspector acknowledges that these issues are currently beyond the control of the service. The training files viewed for two staff identified they had received training in the safeguarding of vulnerable adults. 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. Residents benefit from a homely, safe and comfortable environment that meets their diverse and complex needs. Evidence: A senior staff member showed the Inspector around the home, including two residents bedrooms and the communal areas. There was evidence that residents, are supported, where they choose, to decorate and furnish their bedrooms in a way that reflects their individual interests and choices. By choice, one resident keeps their bedroom very basic with limited furniture and no soft furnishings. It was evident throughout the day, that this individual is able to access their belongings as and when they choose. Risk assessments and guidelines in this persons care plan were reflective of how they keep their personal space. Communal areas include a large kitchen/dining area, separate lounge and two bathrooms. There is a secure and accessible garden to the rear of the property and residents were observed enjoying this space at the time of the Inspectors visit. There is evidence of an ongoing programme of maintenance with most of the house having Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: been recently redecorated. The home was found to be clean, tidy and hygienic at the time of the inspection. 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. Residents benefit from a highly motivated and competent team of staff and are protected by the recruitment procedures. Further improvements could be achieved by the service ensuring that staff have access to timely training to enable them to fully carry out their roles. Evidence: Due to the complex needs of the people living at 267 Old Shoreham Road, the ratio of staff to residents is required to be high. As such at the time of the Inspectors visit there were more staff than residents at home. It was however observed that staff arrange themselves discreetly to ensure that they do not dominate the environment. The atmosphere was observed to be friendly and relaxed and the positive relationships between staff and residents were obvious. Discussion with the person appointed to manage the service, a senior care officer and a support worker confirmed that minimum staffing levels in the house are three staff. The aim however is to allocate at least 4 staff on shift during the day, in order to facilitate the higher support needs of people when accessing the community. A review of the rota reflected that staffing levels ranged between three and four care staff per shift, with other staff being allocated administration days to undertake specific non Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: care duties. On the afternoon of the inspection there were only three staff on duty and despite there only being two residents at home on that day, it was stated during the handover session that there were not sufficient staff to support either of the two residents to go out. This was not a real issue on the day, as both individuals had had the opportunity to go out earlier in the day, but it does affect personal choice and flexibility and highlights the disadvantages of people with complex behavioural needs living together in a group. An examination of the staff files for the two newest staff members provided evidence of a robust system of recruitment being in place, with all the correct documentation and checks being in situ. There is documentary evidence that whilst new staff members complete an appropriate induction programme, this is not always completed within the first six months of employment. Discussion with the people involved in managing the home and the examination of two staff files identified that staff training is ongoing and that key training for this client group such as positive behavioural support and Makaton have been completed by all permanent staff. The Inspector noted a number of training gaps for other courses and a discussion with the person appointed to manage the service identified that whilst the home is proactive in identifying training needs and nominating staff for updates, the Council training department cannot always meet these requests. It was highlighted that the delay in staff accessing training such as epilepsy has a direct impact on staff ability to support residents and as such poses an additional burden on those scheduling shifts. It is therefore a requirement of this inspection that the service explore other ways of ensuring all staff receive the training they need to fulfil their roles in a timely way. The Inspector saw evidence of regular staff meetings and individual supervision sessions being conducted with minutes recorded. The impression from meeting staff, observing their practice and reviewing documentation is that staff are professional in their approach and highly dedicated to their work. 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. Residents benefit from living in a safe and well run home that is effectively managed in their best interests. Evidence: Since the last inspection the Registered Manager has been seconded to work at another service and a member of the staff team has been appointed as Acting Resource Officer to oversee the management of the service. This person confirmed that she will now be submitting an application to the Commission to become the Registered Manager of the 267 Old Shoreham Road.. During the inspection, it was observed that the new Manager has an excellent relationship with both staff and residents and it was evident that both found her approachable and supportive. She has continued to manage this service both efficiently and effectively. The home has a system of quality monitoring in place with a Council representative Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: conducting regular visits in accordance with Regulation 26. There is also evidence that annual satisfaction surveys are sent out to stakeholders, although at the current time the results of these have not been formally collated and published. The feedback from one of the relatives surveys this year stated everyone is so cheerful and helpful and obviously love [residents name]. The home has various systems in place to ensure the health and safety of the home are maintained. One member of staff is delegated the responsibility of managing the control of substances hazardous to health (COSHH) and this individual demonstrated to the Inspector her system for ensuring these chemicals are appropriately stored and risk assessed. The Inspector viewed some of the other records in respect of health and safety as such concluded that the home has satisfactory recording and monitoring systems in place. 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 3 14 Regulation 14(1) & 14(2): The Registered Person shall keep the assessed needs of service users under formal review. To ensure that the Registered Person does not provide accommodation to people whose needs cannot be met and that all placements are in the best interests of the service user. 01/09/2009 2 20 13 Regulation 13(2): The 01/10/2009 Registered person must ensure that medication is stored in accordance with current regulations and guidance issued by the Royal Pharmaceutical Society of Great Britain. The Registered Person must ensure the safekeeping of all medicines, including making provision for the safe storage of any controlled medication. Care Homes for Adults (18-65 years) Page 29 of 31 3 35 18 Regulation 18(1)(c)(i): The Registered Person must ensure that all care staff undertake all training relevant to the roles they perform. To ensure that staff have the specialist skills required to support people with complex needs. 01/10/2009 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 30 of 31 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. 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