Care Home: 27a Old Kenton Lane

What the care home does well When asked what the service does well residents told us that it generally provides good care. They told us that "tender loving care with good concern for the well being" was provided and that the home cared for residents as individuals. Members of staff told us that the home is kept clean and tidy, there is respect for residents and colleagues and the home provides good meals to the residents. Health or social care professionals tell us that "they respond effectively to peoples` requests and manage medication well" and that they support residents to attend out patient appointments. People using the service benefit from a small home with a very personal approach, which feels more like a family home than a care home. What has improved since the last inspection? The home has met all previous requirements, this was assessed during our compliance visit in January 2010. Information of this visit can be obtained from the Care Quality Commission on request. We included an extract of the inspectors findings in this report. "Nineteen statutory requirements had been identified during the key inspection on the 24th September 2009. These were in respect of staff training, residents` finances, review meetings, access to files, risk assessments, the complaints procedure, staff recruitment and health and safety within the home. The timescales for compliance had all expired prior to this random inspection. Following the key inspection a statutory requirement notice had been issued in respect of health and safety, residents` finances, staff recruitment and staff training. The timescale for compliance had also expired prior to this random inspection. The purpose of this random inspection was to check that compliance with the statutory requirements identified during the key inspection and compliance with the statutory requirement notice had been achieved. To check compliance the manager made residents` case files, staff personnel files, staff training records, residents` financial records, health and safety records and a copy of the complaints procedure available for inspection. We noted that compliance had been achieved. There was evidence that members of staff had attended a medication training course organised by Boots and that they have attended training in safe guarding adults and in respect of infection control. A member of staff that is employed as a domestic/carer has received training in the areas necessary to enable them to carry out their duties. Residents` financial records are more detailed and there are now systems in place for auditing both on an internal and an external basis. Records were up to date and included a record of charges (fees and extras) in the monthly accounts. We were satisfied that residents had access to investment bonds to enhance their savings. Residents` case files also contained evidence that review meetings were taking place and that the manager was following through with the local authority if these became overdue. We noted that risk assessments had been completed for key aspects of a resident`s life and that circumstances or situations that might act as `triggers` were included. Risk assessments were subject to review. Staff personnel files now contain the documents listed in Schedule 2. Although new recruitment has not taken place the manager said that he is aware of the need for recruitment practices that promote and protect the safety and welfare of the residents and will ensure that new members of staff are recruited in accordance with Regulation 19. The complaints procedure has now been updated and it contains the correct contact details for the CQC. There was evidence that the portable electrical appliances had been tested. The service has achieved compliance with the statutory requirements identified during the key inspection report of September 2009 and with the statutory requirement notice. . During the inspection we spoke with the manager about the home`s practice of purchasing items on behalf of the resident and the claiming back of this money being subject to a delay. We advised the manager to encourage residents to keep a small petty cash float so that purchases can be made with the resident using their own money, at the time". What the care home could do better: We have made two requirements during this key inspection. The home must ensure that only information relevant to the person is included in individual care plan folders as this ensures their individuality and confidentiality. An up to date signatory list of staff competent in the administration of medication must be provided, which would reassure people using the service that medication is safely administered. Key inspection report Care homes for adults (18-65 years) Name: Address: 27a Old Kenton Lane 27a Old Kenton Lane Kingsbury London NW9 9ND     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: Andreas Schwarz     Date: 0 7 0 5 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 27a Old Kenton Lane 27a Old Kenton Lane Kingsbury London NW9 9ND 02089593965 02082010213 unuwatte@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Integrated Care Services Limted Name of registered manager (if applicable) Godwin Percy Bamunuwatte Type of registration: Number of places registered: care home 4 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: 4 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 27a Old Kenton Lane is a registered home. The registered manager is Mr Percy Bamunuwatte. Mr Bamunuwatte and his wife jointly run the Integrated Care Services company. They provide a similar service at one other local home. The home is located in a residential area of Kingsbury. The property is detached. There is one bedroom, a bathroom, a toilet, a lounge/diner, an office, and kitchen on the ground floor. Three more bedrooms, and a bathroom with toilet can be found on the Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 4 1 9 0 1 2 0 1 0 Brief description of the care home first floor. The home has a self-contained back garden of medium size. There is parking space for two cars in the homes own drive and free kerbside parking on a road around the home. There are a few shops in walking distance. More shopping facilities are in Wembley or Harrow, which can be reached through public transport. The home is registered for four residents and is currently fully occupied. Fees for the home depend on the assessed needs of the prospective resident and information about current levels of fees can be obtained, on request, from the manager of the home. The service user guide and a copy of the most recent inspection report can be obtained from the owner of the home. The inspection report is also available on the internet at the CQC website. Care Homes for Adults (18-65 years) Page 5 of 26 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 key inspection took place in May 2010 and lasted four hours. The registered manager was available throughout this inspection. We spoke to three people using the service and two staff members. The home forwarded a detailed Annual Quality Assurance Assessment (AQAA), within the given timescale. We undertook a compliance visits in January 2010 and information from this visit is included in this report. We have received three health care questionnaires, comments from these surveys are included in the report. We assessed one care plan, two staffing records and various other records enabling us to make a sound judgement in regards to quality outcomes and the quality of care provided by the home. We would like to thank the registered manager, people using the service and staff contributing positively during this key inspection. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? The home has met all previous requirements, this was assessed during our compliance visit in January 2010. Information of this visit can be obtained from the Care Quality Commission on request. We included an extract of the inspectors findings in this report. Nineteen statutory requirements had been identified during the key inspection on the 24th September 2009. These were in respect of staff training, residents finances, review meetings, access to files, risk assessments, the complaints procedure, staff recruitment and health and safety within the home. The timescales for compliance had all expired prior to this random inspection. Following the key inspection a statutory requirement notice had been issued in respect of health and safety, residents finances, staff recruitment and staff training. The timescale for compliance had also expired prior to this random inspection. The purpose of this random inspection was to check that compliance with the statutory requirements identified during the key inspection and compliance with the statutory requirement notice had been achieved. To check compliance the manager made residents case files, staff personnel files, staff training records, residents financial records, health and safety records and a copy of the complaints procedure available for inspection. We noted that compliance had been achieved. There was evidence that members of staff had attended a medication training course organised by Boots and that they have attended training in safe guarding adults and in respect of infection control. A member of staff that is employed as a domestic/carer has received training in the areas necessary to enable them to carry out their duties. Residents financial records are more detailed and there are now systems in place for auditing both on an internal and an external basis. Records were up to date and included a record of charges (fees and extras) in the monthly accounts. We were satisfied that residents had access to investment bonds to enhance their savings. Residents case files also contained evidence that review meetings were taking place and that the manager was following through with the local authority if these became overdue. We noted that risk assessments had been completed for key aspects of a residents life and that circumstances or situations that might act as triggers were included. Risk assessments were subject to review. Staff personnel files now contain the documents listed in Schedule 2. Although new recruitment has not taken place the manager said that he is aware of the need for recruitment practices that promote and protect the safety and welfare of the residents and will ensure that new members of staff are recruited in accordance with Regulation 19. The complaints procedure has now been updated and it contains the correct contact details for the CQC. There was evidence that the portable electrical appliances had been tested. The service has Care Homes for Adults (18-65 years) Page 7 of 26 achieved compliance with the statutory requirements identified during the key inspection report of September 2009 and with the statutory requirement notice. Care Homes for Adults (18-65 years) Page 5 of 8. During the inspection we spoke with the manager about the homes practice of purchasing items on behalf of the resident and the claiming back of this money being subject to a delay. We advised the manager to encourage residents to keep a small petty cash float so that purchases can be made with the resident using their own money, at the time. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 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 26 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. A thorough pre-admission process assures residents that they are admitted to the home on the basis of their assessed needs and the ability of the home to provide them with the appropriate care to meet these. Evidence: The service has already told us as part of an annual quality assurance assessment (AQAA) that Our home carries out a thorough and complete needs assessment of the service user, prior to admission, by a qualified and experienced member of staff and we always confirm in writing whether we can or can not meet the prospective residents assessed needs. The AQAA also confirmed that new residents are provided with detailed information about the services and facilities available at the home before they are admitted. The registered manager told us that the last person was admitted in 2007, assessment procedures have been assessed in previous key inspections as compliant with National Minimum Standards. Care Homes for Adults (18-65 years) Page 10 of 26 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. Comprehensive care plans, that are subject to regular review, and risk assessments assure residents that their needs are identified and addressed. Staff work with people using the service sensitively and enable them to make choices about their life. Evidence: We looked at one care plan during this inspection. The care plan was of good standard and person centred principles are used to ensure that the person is involved in the assessment process. Care plans are reviewed regularly and the most recent review was undertaken in March 2010. During the compliance visit on the 19/01/2010 the regulation inspector found similar evidence by assessing additional care plans and a statutory requirement notice issued in November 2009 regarding the lack of regular care planning was found to be met. We found the care plan folder to be very disorganised and health records, risk assessments and documents relating to the persons care were not in order. To make it easier in accessing service users care plan folders it is recommended to re-organise the folders to make them easier accessible for people using the service, staff, social workers and the regulator. In addition to this Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: we found in the care plan folder information relating to a different person living in the home, to ensure peoples individuality and confidentiality these must be removed and put into the relevant folder. During our compliance visit in January 2010 the inspector made the following comments about care plans. Residents case files also contained evidence that review meetings were taking place and that the manager was following through with the local authority if these became overdue. People using the service confirmed that the have used the postal voting system during the General Election. We observed people using the service to move freely around the home and helping themselves to snacks and drinks. We observed staff interacting with people using the service professionally and staff were seen listening to people choices of visiting people in another service run by the organisation. The manager is the appointee for 3 of the 4 residents living in the home. Comments regarding residents finances are included in Standard 23. We viewed risk assessments in the care plan folder assessed. We found fall assessments and behaviour risk assessments, these are detailed and comprehensive and a robust management plan to minimise the risk is in place. During the compliance visit in January 2010 the inspector made the following comments about risk assessments. We noted that risk assessments had been completed for key aspects of a residents life and that circumstances or situations that might act as triggers were included. Risk assessments were subject to review. Care Homes for Adults (18-65 years) Page 12 of 26 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. Taking part in activities and using community resources gives residents the opportunity to enjoy an interesting lifestyle. By maintaining contact with their family and friends the residents need for company and fellowship is met. Residents are encouraged to become more independent by taking part in the daily routines of the home. A varied and balanced diet assures residents that their dietary needs are met. Evidence: Only 1 of the 4 residents attends a day centre. They do so for 5 days per week. The remaining residents had a daily activity programme included in their case file. We discussed with the registered manager issues relating to college access and day centre access for one of the people living at the home. It was clear during the discussion that the home had considerable difficulties in finding suitable activities for the person, this may be to the lack of accessible places available and due to involvement of people significant to the person. We discussed ways of tackling these difficulties by Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: implementing multi disciplinary risk assessments, which allows the home to safely manage the risk and get the significant others on board. We observed people using the service accessing the community with staff support during this inspection. Previous inspections judged peoples lifestyle as good. People using the service are registered to vote and informed us that they have taken part in the General Election. The home is encouraging people to access the community and activity plans confirmed that people using the service help with the weekly shopping, go to the pub, restaurants, libraries, walks in local parks and further afield, shopping trips to Brent X, etc. The home supports people using the service to maintain relationships with their families and friends. One person told us that he is visiting his girlfriend later during the day. Families are encouraged to contribute and comment on the care provided. One survey stated that it would be beneficial to have regular access to drinking water in the service users room. The person was so kind to show us his room and we found a jug with fresh drinking water on his bedside table. We discussed how residents are encouraged to be independent and the manager gave examples of residents taking part in the daily routines in the home. Under supervision residents are supported to make a cup of tea or a snack. Residents may bring down their clothes to the laundry room, help with the shopping or set the table and clear their things away after eating. We saw a copy of the menu on display. It provides evidence of a varied and healthy programme of eating. It incorporated fresh fruit and vegetables. None of the residents have any special dietary needs although as 2 residents do not have any teeth some food items are cut into smaller pieces or mashed. When asked about choice the manager said that the menu is checked with the residents on the day to see is any changes are necessary. This was confirmed by one of the people we spoke to during this inspection. Care Homes for Adults (18-65 years) Page 14 of 26 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 receive assistance with or prompting with personal care in a manner, which respects their dignity and privacy. Residents health care needs are met through access to health care services in the community. Residents can be confident in staff being appropriately trained and regular medication training is provided. Evidence: If residents require assistance with personal care tasks this can be provided by a carer of the same gender. The rota is arranged so that there is a female member of staff on duty in the evening and in the morning to assist the female resident with dressing and bathing. Where assistance is provided in the form of prompting, this is done in a way that respects the dignity of the resident. We observed staff informing the manager that he has supported a service user during our visit to fresh up after an accident. When looking at case files we looked at records relating to access to health care facilities in the community. We noted, that there was evidence of regular appointments with the dentist and optician. Residents had regular appointments with the psychiatrist and there was mention in a letter of the home providing an escort when the resident attended outpatient appointments. It was evident when assessing care plan folders that people using the service are supported to visit doctors and Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: hospitals for outpatient appointments. We also noted that the manager is following up these appointments by contacting clinicians to get feedback of the outcome and any further actions to be taken to improve the persons health. We assessed medication records, which were judged to be of good standard, relevant information such they name of prescriber, known allergies, medication dosage, etc. is present on Medication Administration Sheets (MARS). MARS are of good standards and had no gaps, when people are on social leave this is clearly recorded. The home has three medication cupboards one of the cupboards was not fixed to the wall. This was however rectified during this inspection and a handy man fitted and fixed the cupboard safely to the wall. Five staff have recently taken part in medication training provided by a suitable trainings provider. We discussed with the manager the lack of an up to date signatory list of staff competent in the administration of medication. During the compliance visit in January 2010 the inspector made the following comments. There was evidence that members of staff had attended a medication training course organised by Boots. We have received three surveys from health care professionals one of the comments made. The home monitors medication administration efficiently and responds to service users concerns effectively. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are encouraged to raise satisfaction and dissatisfaction about the care and support provided. Robust procedures ensures that people using the service are protected from abuse. Evidence: The home did not receive any complaints since the last key inspection, people using the service told us that they would go to the manager if they have any problems. We have seen evidence that the home responded positively to concerns raised by family members in regards to the lack of fresh drinking water available for their relative. The complaints procedure is compliant and is accessible on the notice board and the service users guide. The home did not make a safeguarding referral since the last key inspection. The manager explained that no money is kept on the premises belonging to people using the service. One of the people using the service is providing £40.00 every months to contribute for expenses during weekend visits. The family is providing receipts and money is withdrawn from the service users account. On occasions relatives purchase items for people using the service and are reimbursed.We felt that finances are not transparent and informed the manager that he should look into ways improving the system to create more transparency. We sampled two staffing files and noted that staff is vetted by obtaining references and police checks prior to being offered employment. Care Homes for Adults (18-65 years) Page 17 of 26 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 enjoy a comfortable and homely environment with comfortable communal and private facilities in which to relax. Residents live in a home that is clean and tidy. Evidence: During the tour of the premises no issues relating outstanding maintenance work were noted. The home has access to a person for small repairs. The manager explained to us that he is planning to repaint the inside and the outside of the home during this year. Each of the 4 residents has their own single bedroom and 2 of the bedrooms have en suite facilities. There are bedrooms on both the ground and first floors and toilet and bathing facilities on each level. There is a pleasant garden at the rear of the property. The premises were bright and airy. When we visited all parts of the home were clean and tidy and that the rooms were free of any offensive odours. Laundry facilities are in a room that is off the ground floor bathroom and the laundry facilities consist of a domestic washing machine and tumble drier. The home has an infection control policy. Care Homes for Adults (18-65 years) Page 18 of 26 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 using the service can be confident that staff are safe to work with this vulnerable client group and are supported by appropriately trained staff. Evidence: We assessed the homes rota, which demonstrates that staffing provided is sufficient to meet the need of the residents. This was also observed during this inspection when people using the service asked to go out and staff were able to respond to this request without delay and accompanied people to their chosen activity. The home informed us in their Annual Quality Assurance Assessment (AQAA), that all staff hold or work towards National Qualifications in Care, this was confirmed by the manager during our discussions. We viewed two staffing files which included evidence of appropriate qualifications. We checked two staffing files, which included all relevant information such as CRB checks, two references, application form, contract, right to work in the UK and proof of identification in form of a copy of a current passport. The files however were very untidy and disorganised and it is recommended to re-organise these files to make them more accessible. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: We viewed two staff files and it was evident that staff have attended a variety of training over the past year. Training attended was Fire safety, Medication, Health and Safety, Adult protection and Manual Handling. Staff spoke to confirmed that they have attended training and told us that they are very happy working at the home and feel supported by the manager. This is an improvement from what we found during our previous key inspection, which lead to enforcement actions in form of a Statutory Requirement Notice (SRN). Care Homes for Adults (18-65 years) Page 20 of 26 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. People using the service can be confident that the home is lead by a strong manager, who ensures that their views are taken into consideration when making decisions about the home. Peoples health and safety is paramount and appropriate procedures are in place to protect people using the service. Evidence: There have been no changes in management since the last key inspection. The inspector made the following comments in regards the management of the home during our key inspection in September 2009. We discussed the managers experience and qualifications. He told us that he has worked for approximately 9 years in a care setting in a management role. He is an Registered Mental Health Nurse (RMN), has NVQ level 4 and an RMA qualification. He is also a certified accountant. Since the last key inspection he has attended short training course on the Mental Capacity Act and has attended training seminars organised by the local authority. The manager told us that he has undertaken a quality assurance assessment in April 2010. Information was obtained from people using the service and significant other Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: through surveys. Staff have the opportunity to meet regularly to discuss issues about the home and contribute positively to the care and support. People using the service are encouraged to meet every three months to discuss the care and support and any other issues relevant to their lives. During the tour of the premises we checked all the four fire alarms, which were all in good working order. The home informed us in their AQAA that Health and Safety certificates such as Portable Appliances Test (PAT) and Landlord Gas Certificates are all up to date. Care Homes for Adults (18-65 years) Page 22 of 26 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 23 of 26 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 6 17 The responsible person must 01/06/2010 ensure that only information relevant to the person is kept in their individual care plan folders. This ensures that peoples individuality and confidentiality is maintained. 2 20 13 The responsible person must 01/06/2010 ensure that an up to date signatory list of staff competent in the administration of medication is in place. This ensures that people using the service can be confident in staff safely supporting them around the administration of medication. Care Homes for Adults (18-65 years) Page 24 of 26 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 6 To make it easier in accessing service users care plan folders it is recommended to re-organise the folders to make them more accessible for people using the service, staff, social workers and the regulator. The responsible person should redesign the financial records to provide more transparency. The home should re-organise the staffing files to make them more accessible and easier to use. 2 3 23 34 Care Homes for Adults (18-65 years) Page 25 of 26 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. 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