Care Home: 295 Long Lane

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What the care home does well People at 295 Long Lane enjoy living there and were relaxed and happy. Everyone has very good support plans in place so that staff now how people like things done and what they like to do. Most staff at the home have worked there for some time. They know the people living there very well, and can look after them in the ways that they are familiar with and prefer. Staff at the home help people to lead interesting lives. People can take part in different activities and go out and about in the local community. People can stay in touch with their families and have visitors whenever they wish. The home is very well equipped so that people are cared for safely and comfortably. Staff at the home make sure that people`s health is looked after. They support people in seeing doctors or other professionals needed to help them. People`s medicines are kept safely and given as they should be to keep people well. The manager is experienced and makes sure that the home is run safely and well. What has improved since the last inspection? The home are trying to help residents to make their views and choices known more by using pictures and symbols. When we last went to the home the manager had only just started to work there. They have now been there for a while. They are working to make sure that the home keeps on getting better. The manager is trying to make sure that residents have a say in planning their care. They are trying to make sure that records that need to be kept about people and the home are up to date. The home has a new kitchen that is clean and bright. What the care home could do better: All the staff working at 295 Long Lane have worked there for a while. The home has to keep information about staff to show that they are safe to work with people, that they well trained, and are well supported to carry out their work. These records were not complete or well organised. Although staff are given basic training they should also know about different types of learning disability. As the people living at Long Lane are getting older staff should also know about ageing and some of the things that residents might experience. This will help to improve staff knowledge and skills in working with residents. Key inspection report Care homes for adults (18-65 years) Name: Address: 295 Long Lane 295 Long Lane Grays Essex RM16 2QD     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: Vicky Dutton     Date: 2 5 0 1 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 29 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 29 Information about the care home Name of care home: Address: 295 Long Lane 295 Long Lane Grays Essex RM16 2QD 01375387952 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jane.fox@familymosaic.co.uk www.familymosaic.co.uk Family Mosaic Name of registered manager (if applicable) Mrs Michelle Sibley 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: Date of last inspection Brief description of the care home 295 Long Lane is part of t he Family Mosaic. Up to four people can live at the home. People living there have a learning disability. 295 Long Lane is a large bungalow that has plenty of room for people. There is a lounge and separate dining room. People who live there all have their own bedroom. There is a garden for people to enjoy with places to sit, a sensory area and a fish pond. There is a small car parking area at the front of the building, and visitors can also park in the street nearby. 1 1 1 1 2 0 0 8 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The home is quite close to local shops in Grays, and a short journey from all the facilities at Lakeside shopping and leisure area. The home has their own minibus to help people to get out and about Information about the home is made available to people in the Statement of Purpose and Service Users Guide. The current monthly cost of a place at the home was stated to be £4,418.13 to £5,682.13 per month. Residents pay a contribution toward this each week. People pay for their own chiropody treatment, hairdressing, some transport costs and any individual therapies such as aromatherapy. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: When we went to 295 Long Lane we did not tell people that we were coming. This was so we could see the home as it usually is. Before we went we sent surveys to people living at the home, people involved with the home and staff so that they could tell us about what it is like there. Some people sent surveys back to us and this gave us good information. Also before we went, we asked the manager to tell us about the home. We asked them to fill in a form to tell us how the home make sure that they keep up good standards in looking after people, and make sure that the home is safe. When we went to 295 Long Lane we spent time with people living at the home. They were not able to tell us what it was like to live there, but we were able to see if people were relaxed and happy and got on well with staff. We also spoke to some staff and Care Homes for Adults (18-65 years) Page 6 of 29 the manager. We looked around the building to see if it was nice for people to live in. We spent some time in the office looking at different paperwork that would let us see how peoples care is arranged and how the home is managed. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 29 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People will be given every assistance to make sure that 295 Long Lane is the right place for them to move into. Evidence: We saw that the home had a Statement of Purpose and Service Users Guide in place. These would provide people with good information about the service. The Service Users Guide had pictorial elements to help people to understand what is provided at 295 Long Lane. The manager said that there are plans to develop this further and make the information more accessible for people. Everyone living at 295 Long Lane has lived there for a number of years. No one new has moved in. The manager said in the Annual Quality Assurance Assessment (AQAA), and we saw that there are good processes and procedures in place to help people decide if the home is suitable for them. Admissions would consist of carrying out assessments and adopting a phased approach to moving in according to individual needs. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that the home will be responsive to their changing needs and respect their choices. Evidence: Previous inspections have found that the home do well in understanding peoples needs and planning for their care. This helps to make sure that people receive the care that they need, in ways that they prefer, and from staff who are consistent in their approach. We saw that each person had a file in place containing profiles, support plans, risk assessments, ongoing care information, and other documentation. Support plans identified short and long term goals. They were clear, easy to understand and covered all aspects of peoples complex care needs. The files provide staff with good information to enable them to care for people in a way that meets their individual needs and preferences. New support plan formats are being developed that reflect the need to try and involve residents more in their individual plans, and make support plans relevant to them. We saw an example of one being worked on with one resident. It contained photographs and reflected their personal views and needs. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Limitations placed on residents in order to support their needs were clearly identified and explained. It was clear that staff try to be sensitive in this. For example one person needs close monitoring due to the potential for seizures and falls. Their risk assessment said X enjoys having free access within the environment of the home, however staff to discreetly observe X at all times and be aware of their whereabouts. People living at 295 Long Lane mostly have no verbal communication. However during the day we saw and heard that staff supported people to try and make choices. Pictures are available for use, and as seen from peoples care plans and other documentation, staff are aware of the ways in which residents communicate using body language and facial expression. Peoples right to make choices is recognised and encouraged. Examples were given during the day of how staff try to engage residents to make choices. A visiting professional said, They give choices to service users as much as they possibly can. Although residents are not able to fully understand or express their views regular residents meetings are held. Again staff are working on ways to assist residents in expressing their views using tools such as happy/sad faces. Care files contained clear risk assessments relevant to individual needs. Actions and processes for managing these risks was in place. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a lifestyle that suits their needs and preferences. Evidence: People are encouraged to take part in a variety of different activities and recreation both in and outside the home. No one living at 295 Long Lane attends any formal day care placements. The manager said that they are always exploring different educational and other opportunities that may be of interest to people. Personal files, weekly opportunities timetables, talking to staff and other information showed that people enjoy going for walks, swimming, trampolining, shopping, eating out, seeing shows and other activities according to their personal preferences. An aromatherapist visits the home on a weekly basis to provide a relaxing massage. There was evidence around the home, such as photographs of activities undertaken and enjoyed by people. Residents have the opportunity to enjoy a regular holiday. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: People are supported in using, and being part of the local community. For example doing the shopping and using local hairdressers/barbers. The home has their own minibus available to facilitate local community access, and trips further afield. Peoples rooms reflect their own interests, and all have the opportunity for listening to music or other activities as wished in their rooms. People living at the home also have opportunities to socialise with other people through social events and parties involving people from other homes run by the provider. Most people living at 295 Long Lane have families who support them and advocate on their behalf. People can welcome their friends or family at any time and their involvement is encouraged. Staff interacted well with residents during the day. Staff are aware of when people might want time alone and people were facilitated in having time in their own rooms at different times in the day. The home uses a six weekly rotating menu, which staff said was devised in discussion with and through knowing peoples individual likes and dislikes. The menu plan is changed as necessary to accommodate the needs of the day and residents choices. Menus viewed and records of what people had eaten showed that a range of different foods are offered. People are encouraged to make individual choices through the use of pictures. Information was available so that staff were aware of peoples individual likes and dislikes. The lunchtime meal looked plentiful and was enjoyed by people. Lunch was a relaxed occasion. Where people needed assistance or supervision with eating this was done in a sensitive manner. We did notice that everyone wore aprons that were folded onto the table so that they also acted as place mats. This did not seem very dignified. We discussed this practice with the manager, who said that residents did this as they liked to stay clean. However we saw staff flip the aprons up into this position before putting the plates onto them. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good personal and health care support to meet their individual needs. Evidence: People living at 295 Long Lane benefit from being looked after by a core team of staff who have mostly worked at the home for some time. Staff know the residents very well and support them in maintaining their preferred routines and style. This is supported by a good key worker system and good care planning. Most people living at the home were not able to express their views about the care they receive, but all looked relaxed and comfortable. A visiting professional said, I think that the service provides a high standard of care to the residents that live at 295 Long Lane. Staff felt that the standard of care was high and made comments such as, As a team we all work for one goal, to make sure that all support is given and that the quality we deliver is of the highest standard for the people we support, and, Everyone at the home is working hard to maintain the high standard. Records viewed showed that people access good health care support to meet their varied needs. A range of different professionals are involved in individual residents ongoing care including doctors, chiropodist, optician, dentist, pharmacist and Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: occupational therapists. Records showed that peoples health is monitored. A number of residents have epilepsy and good records are maintained relating to this. Peoples health care needs are reflected in care planning, with individual health care records and monitoring sheets being maintained. We saw that when someone visited a health care professional that this was well documented with outcomes and any actions needed clearly identified. The home are currently working on developing individual and detailed health actions plans. Because the home is small and the residents known well by staff, any concerns or changes are quickly picked up and appropriate actions taken. Training records showed us that staff undertake relevant training to support peoples health care needs such as epilepsy. Peoples weight is also monitored so any changes can be noted and actions taken as necessary. No one living at 295 Long Lane is able to manage their own medication. We looked at systems in place to ensure that this aspect of their care is managed safely. We saw that each resident has their own section in the medication folder that included a photograph medication administration records and other information. Protocols for the administration of medicines that are required on an occasional basis were in place. The AQAA told us that peoples medicines are reviewed regularly to ensure that they are still meeting their needs. We saw evidence of this on peoples individual files. No errors or shortfalls were noted in the system. A member of staff advised, and records viewed showed, that the system was audited once a week to check for any errors. Training records showed us that staff have received training in the administration of medicines and that policies were available to guide their practice. Staff records showed us that their practice is periodically monitored to make sure that good standards are being maintained. Although good policies were available to staff it was advised that a copy of the Royal Pharmaceutical Guidelines on administering medicines in a social care setting be obtained as this would provide useful additional guidance and support for staff. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for safely through practice in the home. Evidence: The provider has a clear complaints process in place. This is available in an easy read format to assist peoples understanding. Each resident now also has a folder in their room containing information in accessible and pictorial formats. This includes the homes complaints process. We saw that at each residents meeting staff seek to ensure that everyone is happy, and that people have no concerns. On surveys, that staff had helped the residents to complete, people said that they were aware of how to make a complaint or raise concerns. When we looked at the homes complaints records we saw that one complaint had been logged since the previous inspection. This related to an issue with a neighbour. Records showed that the complaint was well recorded and had been managed effectively to everyones satisfaction. No concerns or complaints have been raised with us, (CQC.) No safeguarding concerns have been raised about 295 Long Lane. Training records showed that staff have received training in safeguarding vulnerable adults. Staff spoken with confirmed this and understood about safeguarding. Staff files showed that they had all recently been issued with a handbook about safeguarding that was issued by the Local Authority. We saw that the homes own policy relating to safeguarding was up to date. The Local Authority guidelines relating to safeguarding were readily available for staff to refer to. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Support plans showed us that peoples behavioural needs are understood and managed in a consistent manner. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a pleasant home. Evidence: 295 Long Lane is a bungalow that provides a homely and pleasant place for people to live. Everyone has their own room that is decorated and personalised to their individual taste. One resident told us that they liked their room and spending time in there. They said that their bed was comfortable. A member of staff said It is very homely and meets all service users needs. The premises appeared well decorated and maintained. Staff said that the system in place for managing ongoing repairs worked reasonably well. Since the previous inspection a new kitchen has been fitted. Some assistive technologies such as epilepsy mats have been installed to assist in supporting peoples individual needs. The home has a pleasant garden for people to enjoy. At the site visit the home was clean and there were no offensive odours. A suitable laundry area was available. The AQAA indicated and training records confirmed that only the manager and one other member of staff have received training in infection control. The manager is aware that this needs to be addressed. We did however see that there was an infection control folder in place that provided staff with useful information. During the day we saw that staff used personal protective equipment Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: such as gloves appropriately. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 a caring and established staff team. Evidence: During the day we saw that staff had a very good understanding of peoples needs, and worked with them in a kind, caring and friendly manner. One resident said that they liked the staff. All residents were relaxed with staff and clearly had a good rapport with them. A visiting professional said, I believe the service and the staff within the service work hard and use all the skills and experiences to make the service as high quality as they can. Staff at the home have mostly worked for the organisation for a number of years, and at 295 Long Lane for at least a year and often much longer. Staff therefore know the residents very well. Only one member of staff has left during the last year so staffing is stable. Where shifts need covering this is done by the homes own staff or regular bank staff. This helps to provide people with consistent support from people that they know. In discussion and on surveys staff felt that teamwork and support at the home were good. So that people receive support from a skilled workforce it is recommended that at least 50 of a homes staff achieve a National Vocational Qualification (NVQ) in care at level two or above. This has nearly been achieved at 295 Long Lane. Out of eight permanent support staff three have achieved an NVQ at level three and a further Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: two staff are completing this qualification. The home are therefore on target to meet the recommended standard. Staffing levels at 295 Long Lane are maintained at two staff during the day and one awake staff at night. As well as supporting residents staff carry out catering, cleaning and laundry tasks. Staff spoken with felt that staffing was usually sufficient and could be flexible to a degree depending on plans and activities. The manager has one supernumerary day each week to complete paperwork and other tasks. To see that people are protected by the home having robust recruitment procedures in place we looked at a number of staff files. The previous inspection identified issues relating to recruitment procedures and availability of staff records. Since that time the organisation has put processes in place so that staff records can be fully accessed for the purposes of inspection. It was difficult to fully assess the quality and effectiveness of the homes recruitment procedures. From information given the most recent staff to start work at the home have been there for over a year. Although they are new to the home they have worked for the organisation for a number of years, since 2004 and 2005. We had ready access to staff records and viewed a number of files. Records viewed were not consistently well maintained. For example it was not always possible to establish peoples start dates or see their employment history within the organisation. No files contained statements of peoples physical and mental fitness to undertake the role, although one file did have a uncompleted form in place relating to this aspect. Some files had no recent photograph. We saw that a good and recorded interview process had taken place. All files had evidence that appropriate checks such as references, identification and Criminal Records Bureau (CRB) checks had been undertaken. It was positive to note that CRB checks were being repeated at three yearly intervals to make sure that staff remained safe to work with vulnerable adults. Only one of four files viewed showed any evidence of staff induction and there was a completed Skills for Care programme in place. Again this may reflect the length of time that most staff at the home have worked for the organisation. There should however have been evidence of at least a basic induction into the home for newer staff who have transferred from elsewhere in the organisation. This would to identify that things such as fire procedures and issues individual to the home and residents had been explained. One member of staff said We are always finding new ways of supporting the people we support by going on training with new updates. Each member of staff had a training and development file in place. Again these were not well maintained and had a range of different paperwork in place displaying varying levels of completion. For example one file had two personal development records in place. One was blank and one had a last entry of 13/04/06. Another had a quarterly review of objectives which Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: was blank. Discussion with staff, training files and a training matrix showed that staff undertake a range of basic training covering things such as moving and handling, first aid, food hygiene epilepsy and so on. There was no evidence that staff undertake additional training to increase their knowledge and skills in areas relating to learning disability or old age. The manager said that they are hoping to achieve this soon through the Local Authority. On surveys staff said that they were supported and met regularly with their manager. The home is small and the manager mostly works as part of a shift so that they can observe staff practice first hand. The AQAA said Staff have regular supervision at which time their key worker tasks are discussed together with their role within the home. It is at this time that they are given the opportunity to voice any issues of concern that they have about the service provision. We saw some supervision records, but again recording seemed patchy. This may be because many records are now kept electronically. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well managed home. Evidence: The manager at 295 Long Lane is registered with us and is experienced and competent. They are currently undertaking appropriate training courses to fully qualify them for the role. The manager was not present for most of this site visit. The person in charge of the shift was knowledgeable, experienced and competent in running the home in the managers absence. Staff felt that the home ran well. One said. Everything is well managed and works well. Service users are happy as are their relatives. We saw that the organisation has processes in place to monitor the quality of the service. We saw a report from a 2008/9 satisfaction survey. Although there was 100 satisfaction with the service, the response rate was very low. A recommendation was that the home do more work in seeking the views of families and other people involved with the service. The manager said that more surveys are just about to go out. Also in place was a operational plan for 2009/10 outlining objectives for the home. This shows that the service is continually seeking to develop and improve. As is required by Regulation, a monthly visit is carried out to the home by a Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: senior person in the organisation. This is to ensure that the home is complying with standards. Records also showed us that a number of audits such as medication, residents and home monies, and health and safety are undertaken on a regular basis to ensure that standards are being maintained. The AQAA was completed by the manager. All sections were completed, however some sections could have given us more detail. For example at the last inspection requirements were made in relation to staffing records and recruitment. The AQAA did not reflect how this had been addressed or what improvements had been made. Other parts of the AQAA were not fully completed. For example no dates were given for the last review of policies and procedures, and mostly no dates were given to indicate when systems and services in the home had last been serviced. We had to check this information at the site visit. This however showed us that systems and services are checked and maintained on a regular basis. No health and safety issues were highlighted during the site visit. Fire records viewed were well maintained and a fire risk assessment was in place. Although documentation could not be found the manager said that a recent fire service visit had found no concerns. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 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. 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