Care Home: 27 Larchwood Close

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What the care home does well The service provides a homely, welcoming and inclusive atmosphere. During this visit staff were observed to be attentive, caring and supportive toward people. Some people living in the service told us that staff respect their privacy. One person said, "They are very good at doing this". People have person centered care plans, which people living in the service have been involved in making, which are reviewed regularly using accessible formats. People are supported to attend a range of appropriate recreational and leisure activities which meet their cultural, diverse, social and religious needs. Comments received from people included, "I go to church", "I have been on holiday to the Isle of Wight", "I go out for lunch" and "I go shopping to buy my meals". People have their own menus and purchase their shopping. A person using the service said that they like their meals and being able to choose what they like to eat. People living in the service benefit from a stable staff team that know their needs well and they receive regular training. What has improved since the last inspection? Since our previous visit the home have reviewed peoples care plans, which reflect their current needs and goals. The home now maintains a list of all homely remedy medication, which has been authorised by the General Practitioner Some improvement was seen in ensuring that people or their representative`s sign their care plans to confirm their agreement. Staff recruitment recruit records were now available for to us see to that all the required information has been obtained to ensure people`s safety and welfare. What the care home could do better: Some people`s bedrooms on the second floor did not have window restrictors on them. It was required that a risk assessment is completed ensuring the well being and safety of people living in the service. Since our visit the service has confirmed to us that this matter has been completed. The cupboard containing cleaning substances was left unlocked, which was brought to the attention of staff who took immediate action to ensure people`s safety. It is recommended that the service obtains the most recent local authority safeguarding vulnerable adults from abuse procedure. Key inspection report Care homes for adults (18-65 years) Name: Address: 27 Larchwood Close 27 Larchwood Close Banstead Surrey SM7 1HE     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: Lisa Johnson     Date: 3 0 0 6 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 27 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 27 Information about the care home Name of care home: Address: 27 Larchwood Close 27 Larchwood Close Banstead Surrey SM7 1HE 01737370115 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.mencap.org.uk Royal Mencap Society care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies 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 categories: Learning disability (LD). Date of last inspection Brief description of the care home Larchwood (27) is a large detached property located in a residential area in Banstead, Surrey and is registered with the Commission for Social Care Inspection as a care home providing personal care for six people with a learning disability. Accommodation is on two floors accessed by stairs and comprises of six single bedrooms, a lounge, dining area, kitchen, utility room, office, shower rooms and a bathroom. The home has a large garden to the rear of the property, which is easily accessible, and private parking is available to the front of the property. The weekly fees range from £400700 7 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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 site visit was carried out as part of a key inspection. The visit was unannounced. We arrived at 10:10am and left at 4.15 pm. The last key inspection was carried out 10th July 2009. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which was clear and detailed and gave us all the information that we asked for. Reference is made to this assessment throughout this report. We also looked at other information that we have recieved since out last visit to the service. We sent two surveys to people living in the service and one was returned to us. Three people receiving the service were involved in this inspection. We met with the Care Homes for Adults (18-65 years) Page 5 of 27 registered Manager Mr. D shattell and three members of staff. During this visit we looked at staff recruitment, and training records, We looked at three peoples care plans, risk assessments, menus, quality assurance systems, medication administration policies, health and safety records and policies and procedures were sampled. Care Homes for Adults (18-65 years) Page 6 of 27 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 27 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 8 of 27 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 27 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. People are provided with accessible information about the home so that they can make an informed choice about the service and their needs are assessed prior to admission to the home. Evidence: During this visit we looked at the information provided to people who use the service to see whether it is able to supply detailed information about everything that people or their representatives need to know about the service. There is a statement of purpose and service guide, which is also produced in alternative formats. The AQAA states that this information would be provided to people before they moved in, which was also confirmed by a person surveyed. There have been no recent admissions in the home and some people have lived there for a number of years. However the service has a clear admissions procedure, which includes an assessment process, which involves gathering information from the person, their representatives, care management assessments and any relevant health professionals. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a plan of care that they have been involved in making. People are encouraged to make decisions about their lives and they are supported to take risks as part of an independent lifestyle. Evidence: Since our previous visit the service has developed accessible person centered plans. During this visit we viewed three peoples plans which identified peoples individual goals. Care plans are reviewed every six months and each person meets with their key worker every two weeks to review their goals. Information seen demonstrated that these meetings take place. Two people spoken with said that they are invited to their meetings and one person said that they keep a copy of their care plan. Some people or there representative had not signed their care plan to confirm their agreement, which was brought to the attention of the manager. People are supported to make decisions and choices about their lives. The service holds regular meetings for people to be able to raise their views. People are supported Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: to manage their finances with support if this is required and policies and procedures are in place, which support this. Two people told us that they have keys for their bedroom and the front door and information supplied in the AQAA states that people are involved in staff recruitment.A person living in the service decided recently that they did not wish to continue with their employment, which has now ceased. People are supported to take risks as part of an independent lifestyle. During this visit we sampled some of the risk assessments for three people, which included, managing finances, domestic tasks, using electrical appliances using transport independently, self medication, bathing and showering. All risk plans had been reviewed and are up to date, which are discussed with people and staff. Care Homes for Adults (18-65 years) Page 12 of 27 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 living in the service are supported to take part in culturally appropriate activities and they are part of the local community. People maintain links with their family and friends and their rights and responsibilities are respected and they are offered varied and well balanced meals,which meet their preferences. Evidence: Each person has an individualised weekly activity schedule, which meets with their needs and preferences. On arrival at the home a number of people were attending day services. Two people who were present in the home at this time went out shopping and for lunch with staff. The needs of one person has changed and funding has been obtained for them to receive support on a one to basis to provide them with moe individualised activities, which meets with their preference. Records were maintained of activities that they were participating in. This person told us I have been shopping Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: and bought lots of things and I go out for lunch on Saturdays. A person surveyed said that they can choose what they want to do at during the day, evening and weekends. A person spoken with said they attend work action and that they had been to the Isle of Wight on holiday. Another person told us about the day service that they attend. Peoples interests are supported and one person like to play darts and a dart board is available supported by a risk assessment. People are able to choose their holidays. People maintain links with the local community and use facilities including, shops, visiting the cinema, going to the pub and one person goes to a health and fitness club Peoples religious needs are supported and a person told us that they go to church on Sundays. People maintain links with their family and friends. A person told us I go home at the weekend and a phone is available for people to use to maintain contact. The organisation has a families charter, which guides staff in supporting people to maintain and strengthen relationships. People and staff were interacting through out this visit who were attentive and respectful. A member of staff was observed giving out peoples mail to them to open, which had arrived while they had been away from the home. People were observed to enter the kitchen on their return from activities making themselves drinks. People are supported to participate in household activities, which are recorded in their care plan. This includes cleaning, washing, shopping and preparation of meals. During this visit a person was observed laying the table for tea. Information in the AQAA states that the home welcomes pets. The home has a cat called Lucy, which people said they help look after. Each person now has their own individualised menu, which were seen on display in the dining room. People shop for their own food and each have their own cupboard in the kitchen for storing their supplies, which contained a photograph to assist identification. A variety of picture menus are used to assist people in choosing their meals. Menus were varied and well balanced and a person spoken with said that they liked having the opportunity to shop and choose their preferred meals. In the evening people were seen being assisted to prepare their meal. Healthy eating is encouraged and fruit was seen in the dining room for people to help themselves to. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support from staff in the way they prefer and want and their physical and emotional needs are met. The home supports people with their medication in a safe way. Evidence: Three peoples care plans that were sampled included information about their likes, dislikes, preferences and routines. One persons plan identified that their preference is to take showers and their preferred times for receiving was documented. Information seen during this visit demonstrated that peoples preferred name of address and their preferred gender of staff to provide their personal support is respected. Each persons file contained information about their health and emotional needs and the support that they receive from health care professionals. One persons care plan stated that they require support with attending regular orthotic clinics. Outcomes of these consultations were recorded in their records. Another person had management guidelines in place for staff to be able to support them with their emotional needs. Through assessment one persons needs have changed and the service has obtained extra funding to support this person. One person dislikes leaving the home to attend Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: appointments and arrangements have been made for the General Practitioner to visit the home. A person living in the service said that staff respect their privacy, which was also confirmed by two people spoken with during this visit. One person said, Staff do this very well. Detailed records were maintained for all health care consultations including visits to the general practitioner, dentist, chiropodist and any hospital appointments. Staff receive training which supports the needs of people currently living in the service including, diabetes, epilepsy and all staff have attended pain awareness training. Although the service has implemented accessible health action plans we were informed by the registered manager that these are currently being reviewed and some of the sections in the current format as are not applicable for everybody . During this visit we viewed the homes medication administration practices. Medication was stored appropriately. The quantities of medication received by the home were recorded. Medication is dispensed by a local chemist using the monitored dose system (MDS). Staff receive medication training and undertake annual observational assessments. A list was maintained of all staff with their signatures that are trained and authorised to administer medication. A medication profile was in place for each person and medication administration records sampled during this visit were appropriately recorded. Homely remedy medication administered by the home has been authorised by the General Practitioner. One person is currently being supported to self administer their medication. Risk assessments are in place and lockable cabinets have been provided in peoples bedrooms. The service is intending to support other people to self medicate where this appropriate. Care Homes for Adults (18-65 years) Page 16 of 27 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. If people have concerns the know how to complain and their concerns will be listened to . The home safeguards people. Evidence: We looked at information provided to people, which tells people about how they can make complaints. During this visit we saw a copy of the homes complaints procedure, which was seen on display in the hallway. The service demonstrated that this information had been adapted and was provided with pictures to make it accessible for people living in the service. Since our previous visit the service has not received any complaints. The organisations complaints procedure is clear and includes timescales and all complaints are expected to be recorded. Complaints are audited part of the services quality assurance framework. Two people spoken with during this visit told us they knew who they would speak to if they had any concerns and that staff would listen to their concerns. Three people spoken with said that they were happy living i the home and one person said, The staff are nice. The service has safeguarding vulnerable adults from abuse procedures in place, although it was recommended that the registered manager obtains the most recent local authority procedure as this was not available. Financial procedures are in place and during this visit peoples monies were stored securely and we also sampled the Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: finance records for two people which were maintained appropriately. Two members of staff spoken with during this visit told us that were aware of the procedures, that they had attended training and were clear about their responsibilities should they witness or be made aware of any incident where the safety of a person is compromised. The registered manager has attended the local authority safeguarding vulnerable adults from abuse training and we sampled three members of staff training records, which also confirmed that they have received safeguarding training. Since our previous visit one referral was made following the local authority safeguarding vulnerable adults from abuse procedure, which the service brought to the attention of the Commission. Care Homes for Adults (18-65 years) Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further improvement was identified to ensure that the home is safe. People live in a comfortable, well maintained home that is homely, clean comfortable and hygienic Evidence: The service provides a homely atmosphere, which is accessible to people living in the service. There is a large, open plan dining room and a comfortable sitting room. The environment is maintained by a housing provider and through the homes continuous improvement plan they have identified that the carpet needs replacing with appropriate flooring in the dining area, the kitchen ceiling needs addressing and sofas need replacing in the sitting room. There is a well maintained accessible garden to the rear of the property. During this visit the staff had finished carrying out cleaning tasks and it was observed that the cupboard containing cleaning materials had not been locked, despite a sign on the door reminding staff that this should be kept locked. This matter was brought to their attention and prompt action and prompt action was taken to make this safe. It was observed that some of the upstairs bedroom windows did not have window restrictors on them, which were wide open. While viewing the homes health and safety records this matter had been identified by the environmental health department when Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: they visited over a year ago. The manager told us that this matter had been referred to their housing provider, although the requirement made by the environmental health department has not been complied with. This places peoples safety at risk. Therefore an immediate requirement was made that risk assessments are completed as these had not been carried out ensuring peoples welfare and safety. Since our visit the service has promptly confirmed to us that this matter has been addressed and that liaison has taken place with the housing provider. During this visit a person living in the service invited us to se their bedroom, which was comfortable and personalised to their preference Information supplied in the AQAA states that specialist equipment is provided and it was observed that an accessible shower was provided in the downstairs bathroom. During this visit the home was seen to be cleaned to a good standard and was hygienic. Hand washing facilities were available throughout the building and separate laundry facilities are provided. Care Homes for Adults (18-65 years) Page 20 of 27 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. People are supported by appropriate numbers of staff that are competent, trained and qualified to meet their needs and they are protected by robust recruitment procedures. Evidence: At the time of this visit there were three members of staff on duty. The staff duty rota was viewed which reflected the named staff that were on duty. We were informed that those two members of staff are provided during the day. One person receives extra funding for one to one support as well, which was recorded. At night time people are supported by a sleep in member of staff. The home does not use any external agencies to cover any staff shortfalls but occasionally use bank staff employed by Mencap who know people living in the service and work there on a regular basis. A pictorial rota was seen on display , which assists people in identifying who is on duty. People benefit from a stable staff team who know peoples needs well and there has been no staff turnover. People are supported by a staff team that are of mixed gender and ethnicity. New staff receive induction following Skills for Care core induction standards and out of six carers employed three hold National Vocational Qualifications (level 2 or above). Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Each member of staff have personal development folders. During this visit we looked at the training records for three members of staff, which demonstrated that they receive up to date statutory training and specialist training including, epilepsy and dementia awareness, values, person centered approaches, which includes diversity, which ensures that peoples needs are met. The manager is intending to attend deprivation of liberty safeguards. Staff recruitment is based on equal opportunities. During this visit we sampled three members of staff personal files, which contained the required information including two written references and enhanced criminal records bureau check (CRB). We were informed that no staff are employed until this information is received. Information seen during this visit demonstrated that staff receive appraisals and regular formal one to one supervision with the manager or deputy, which was also confirmed by two members of staff that we spoke with. Information supplied in the AQAA states that a person living in the service has been involved in recent staff recruitment. Care Homes for Adults (18-65 years) Page 22 of 27 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 run and in the best interests of people living there. The health, safety and welfare of people is in the main protected. Evidence: There is a registered manager in post, who has experience of working with people with a learning disability and has obtained a National Vocational Qualification (level 4) in management. During this visit we looked at the homes certificate of registration, which was seen on display in the home. The details were correct and recorded the correct numbers and categories of people that are supported. The manager informed us that they are currently providing some support to another service within the organisation and that a deputy has now been appointed for this service. The manager was observed to give an open and inclusive approach and made themselves accessible to both people and staff throughout this visit. Two members of staff said that they felt supported by the manager and that they were approachable. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Regular team meetings are conducted and staff said that there was good team work and communication. Monthly quality monitoring visits are conducted by the registered provider (Mencap), which were available for viewing. The organisation has recently introduced electronic reports, which were detailed and demonstrated that feedback is obtained from people living in the service to gain their views. Annual quality assurance surveys have been carried out, but these need updating. We were informed that the organisation is currently undertaking a review of the way that information is gained from people and they are moving toward a more flexible process for facilitating and recording discussions with people. The organisation has a continuous improvement framework that sets out how the quality of the service meets the needs of people using the service. This involves regular auditing, action plans and annual reviews. The organisation (Mencap ) has a range of policies and procedures , which includes equality and diversity to ensure that this is promoted. The service has a range of health and safety procedures in place. Monthly health and safety audits care carried out and water temperature monitoring is conducted. Staff Information supplied in the AQAA and from records sampled during this visit confirm that regular servicing and maintenance of equipment takes place. Two matters were identified for improvement. Staff training records, which were sampled demonstrated that they receive statutory training including first aid, moving and handling and health and safety. The service maintains accident and incident records and keep the Commission informed of matters that we need to be told about. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 It is recommended that the registered person obtains the most recent local authority safeguarding vulnerable adults from abuse procedures. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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