Care Home: 30 Broad Lane

What the care home does well Everyone knows how to help people and know how they will let them know what they want. This is because each person has written paperwork, which tells staff and others all about the person. The home make sure that people can do as much for themselves, as they can, as safely as possible. The home make sure that family and friends are kept up-to-date with what is going on in peoples` lives so that people can keep in contact and involved with people who are important to them. People are helped in the way that they prefer and choose, as far as possible. The home makes sure that people are kept as healthy as possible by writing down what help they need everyday and by helping them to go to special people such as doctors, if they need to. What has improved since the last inspection? The staff who work in the home make sure that they work with people as the paperwork says they must, so that people always know how they are going to be helped, especially when they need help to behave properly. The home helps people to do more things so that they do not get bored. The home makes sure that it writes down if people complain about anything and what they are going to do about it. The home makes sure that everyone knows who to talk to if they are worried that someone may not be being treated well. Staff are given better training so that they know how to look after people in the best way possible. The manager makes sure that he sees all the things, necessary to make sure that staff who come to work in the home are safe to work with the people who live there. The manager has applied to be registered with the Commission. What the care home could do better: There were no recommendations or requirements made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: 30 Broad Lane Upper Bucklebury Nr. Reading Berkshire RG7 6QJ     The quality rating for this care home is:   three star excellent 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: Kerry Kingston     Date: 2 1 0 7 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 28 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 28 Information about the care home Name of care home: Address: 30 Broad Lane Upper Bucklebury Nr. Reading Berkshire RG7 6QJ 01635871191 01635871191 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.milburycare.com Milbury Care Services Ltd The registered provider is responsible for running the service care home 6 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category of service only: Care home providing personal care - (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) Physical Disability (PD) Date of last inspection Brief description of the care home This service provides care and accommodation to five residents, of both genders aged between 18 and 65 with learning and some physical and behavioural disabilities. Voyage operates the home. The service aims to enable service users to live a fulfilled life underpinned by The Five Accomplishments of Ordinary Living (John OBriens). The home is a two storey detached house in situated in Upper Bucklebury. The house is Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 6 6 1 9 0 8 2 0 0 8 Brief description of the care home located on a main road but is set back from this; it is close to local amenities. The home has a good-sized rear garden and ample parking to the front of the property. The fees are from £1,050 to £1,048.65 per week. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent 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 is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 10.00 and and 4.00 pm on the the 21st July 2009. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the service manager. Surveys returned to us by other professionals and staff. Discussions with the manager,and one staff member took place. People who use the service have difficulty communicating with people who do not know them so observation of people and their interactions with staff took place during the visit to the home and during an activity at a local leisure centre. Reviewing records of the people who use the service and other records and procedures was also used to collect information on the day of the visit. All information received by the Commission since the last inspection, about this service Care Homes for Adults (18-65 years) Page 6 of 28 was also taken into account when producing this inspection report. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions policies and procedures would ensure that people know that the home is able to meet needs and how it will do so. Everyone who lives in the home knows how much they pay to live there and what they get for their money. Evidence: Five people live in the home and most have been resident since 2002, there have been no new admissions since the last inspection. The admissions procedure remains the same as it was last year, and would be an effective document to follow if someone wanted to come and live in the home. The procedure can be adapted to ensure that it suits the needs of individuals. The statement of purpose and service user guide have been developed and now use change picture bank (uses pictures and symbols to illustarte a simple written text)so people have the best opportunity to understand the content. Peoples statements of terms and conditions are also produced in change picture bank formats and include the amount charged and what they get for their money. Care Homes for Adults (18-65 years) Page 10 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has excellent plans of care that ensure staff are able to meet the diverse needs of individuals in all aspects of their lives. Risk assessments allow people to be as independent as is possible, as safely as possible. Evidence: Three plans of care were looked at in detail. They were very detailed and comprehensive, completed according to the newly developed care planning system. The plan of care consists of numerous elements such as about me documentation, this includes allergies, how I communicate if I am feeling unwell , my feelings and how I express them, relationships/friendships and how to maintain/develop them, retirement/future plans and cultural and spiritual expression. There is then a specific health action plan that covers all aspects of peoples health such as medication, food, toothbrushing, eyesight and professional support networks including psychiatrists, care managers, G.P and anyone else who is involved with the individuals care. All plans of care include short and long term goals for each element of the plan. Care Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: plans are reviewed a minimum of six monthly but more often if necessary, one persons plans of care had been reviewed every three months because of some behavioural issues and anothers had been reviewed more frequently because of some health issues. Full multi-disciplinary reviews are held annually, usually at the same time as the care management review. An individual support plan notes peoples preferred daily routine, this includes preferences and how I express them, detailed communication methods, help needed with finances and personal care. The personal care element for the plan of care details how people are given and make choices about their daily routines and includes guidance about their known preferences likes and dislikes. Decision making also forms a separate part of the plan of care and gives excellent detail of how people make choices. Reference is made to the Mental Capacity Act and also notes if thought needs to be given to whether there is any deprivation of liberties issues. The manager advised that he had recently received training in this area of work. Guidance is also noted about contacting the individuals network of professionals, that is, using a multi disciplinary approach, as appropriate. There is a risk assessment to accompany all elements of the plan of care such as showering, daily chores, helping in the kitchen, mobility and behaviour. Risk assessments are detailed working documents giving people as much indpendence as possible and specifically related to one area in plans of care such as domestic skills. All risk assessments seen were up-to-date and had been reviewed in June 2009. Care Homes for Adults (18-65 years) Page 12 of 28 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 are given opportunities to take part in interesting and rewarding activities, that they choose and are appropriate to their needs. They are supported to be part of the village and wider local community. People are offered balanced and nutritional meals that they are as involved in choosing and preparing, as is possible. Evidence: People have individual activity plans for the week, for external activities. Internal activities and those provided by care staff are flexible, according to peoples wishes and choices, on the day. Activities are age appropriate and designed to meet peoples very individual needs such as people in their sixties and less physically able do not participate in some of the activities such as trampolining. There are a range of activities offered such as trampolining,cycling ,aromatherapy,swimming and outreach. The instruction to staff is that each person is to be offered at least one activity, Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: outside of the home, per day. The home keep an activities log, which notes activities participated in. Although this is not always kept up to date, daily notes include detail about what people have been doing and if they enjoyed it. Notes described people going out to the pub , going shopping, having lunch out, visiting nearby towns, walking to the village shop to make purchases, attending social clubs and attending a local church group. There was evidence of good relationships with neighbours such as people being invited to visit and the local pub being welcoming to the people who use the service. Plans of care include cultural and spiritual needs (including religious festivals and special dates),retirement goals and holidays and activities needs. This year two people have enjoyed a three night trip to Blackpool, two others have booked a holiday to Butlins and one person has chosen to participate in day trips rather than staying away from home. People are supported to keep in contact with families and friends, as noted on the plans of care. The manager said that some families have increased their contact and visit the home more frequently. The home has several letters from the families of the people who live in the service, thanking them for keeping them in touch and for the good and improving care they are offering to their family member. One person has contact with an advocate. Plans of care include detail of how to ensure people are given choices and how to respect peoples privacy and dignity. Care staff were observed, briefly, during the morning of the visit treating people with great respect and communicating positively with them. They were further observed supporting people with an external activity and displayed the same respect and sensitivity to the needs of the people they were working with. Menus seen included balanced and nutritious plain food, which is preferred by the people who live in the service. The weekly menu is displayed in the kitchen on a large notice board with photographs of meals and parts of meals, that show what is on the menu. People who use the service, also use the photographs to choose meals that they would like to have. The photographs are also helpful to staff to see how the meal should be presented if they are not sure. The kitchen is being refurbished and decorated, it has a new large cooker and all new units and worktops, work will be completed imminently. The large kitchen incorporates three different dining areas that are set up to best meet the needs of individuals and the group. Plans of care include how to encourage individuals to help in the kitchen, as is appropriate to their ability level and behaviour and a risk assessment is developed to Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: support this work. Care Homes for Adults (18-65 years) Page 15 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meet the personal care and health needs of the People who live there very well. Peoples emotional well being is improved by the use of detailed and effective behavioural guidelines that all staff follow. Medication is administered as safely as is possible. Evidence: An individual support plan within the plan of care notes peoples preferred daily routine, this includes preferences and how I express them and detailed communication methods. The personal care element of the plan of care details how people are given and make choices about their daily routines and includes guidance about their known preferences likes and dislikes. Anyone with behaviours that can cause them or others difficulties have specific behavioural guidelines, these are detailed and focus on methods of recognising when people are not happy and encouraging positive behaviour. One persons behaviour has improved 80 (manager estimation) since the new guidelines have been put in place. Staff are more confident to follow the guidelines, which are discussed in staff meetings Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: and individual supervision sessions, guidelines being adhered to has had a very positive effect on people. A survey received from a psychology professional who works with people who live in the home commented that the manager thinks creatively about how to improve peoples quality of life, responds quickly to requests for intervention. The home could consider more creative ways to meet sensory needs, staff would benefit from more training around communication and intensive interaction. I think the manager has contributed to improving this service significantly. People were observed to be calm and very comfortable in staff presence,staff reacted quickly to people expressing their needs , such as someone wanting to use the toilet and choosing a particular staff member to support them with this activity. Plans of how to protect privacy and dignity such as, same gender support when possible and leave on the toilet for 5 to 10 minutes alone (wait outside the door and check everything is alright verbally). Everyone who lives in the home, has a health action plan that forms part of their plan of care, it includes all the information needed to ensure health care needs are met. Health records detail when people visit various health professionals such as the chiropodist/podiatrist,dentist,optician, GP and any specialists such as the psychiatrists. The home also have psychology support from the in-house behavioural specialist. There have been two recent hospital admissions, which were well handled, the home has special laminated sheets of paper that can be taken in an emergency and include vital information about the individual. Weight charts are kept, everyone is weighed monthly or more often, as necessary.People are unable to communicate clearly if they are feeling unwell and the home recognise that weight gain or loss, along with unusual behaviours (for that individual) can often be the first sign of an underlying health problem. Health action plans include how people communicate pain and/or may be feeling unwell. Four residents have had their annual health check in the surgery, the fifth receives a health check at home, as they are more comfortable in their own environment. The GP returned the survey to us answering all the questions positively, these included, peoples social and health care needs are always properly monitored and met by the care service. The manager said that the homes relationship with the G.P surgery has improved, they are very supportive and helpful. The home has a robust medication policy and procedure. All staff are trained in medication awareness but not all staff administer medication, those who do are trained and assessed as competent to administer by a senior staff member. There have been two medication errors since the last inspection, the staff member concerned was re-trained and re-assessed , medication errors are a disciplinary issue. The home now use the local G.P surgery to dispense their medication, staff have been trained to use the new system. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: The Primary Care Trust looked at all aspects of the homes medication administration system on the 28th April 2009 and they received a Good (standards met) rating, there were no actions or requirements. One person receives medication, as required to help with their behaviour, there are detailed protocols and guidelines for their use, as there are for the use of as required pain relief , such as paracetamol,for each individual. Care Homes for Adults (18-65 years) Page 18 of 28 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. The home has a comprehensive complaints procedure and listens to people if they have complaints or concerns. The home protects people from all forms of abuse. Evidence: The complaints procedure is presented in the change picture bank format, this is a pictorial and symbol system that gives people who may not be able to read very well an opportunity to understand the procedure. There has been one complaint since the last inspection, this was dealt with appropriately and very effectively. People who live in home would probably be unable to complain without help, the home therefore ensure that families and advocates have an up-to-date copy of the procedure,the home received a letter from a family member which included thanks for the copy of the new complaints procedure. The home have received no complaints about the care they give, two letters of thanks, from families were seen. These detailed the good care the home offered, how happy and well looked after their family member was and also noted how well the home kept them informed and involved. The Commission has received no information with regard to complaints about the home. There have been no safeguarding referrals since the last inspection, all staff have been trained in safeguarding (Protection of Vulnerable Adults) as noted on training records for the staff team. The Inter agency safeguarding policy and procedures is displayed prominently, in the staff office. The manager has a good knowledge of safeguarding Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: policy and procedures. Staff are trained in non violent crisis intervention but have not used any physical restraint since the last inspection. Only one person has guidelines that say physical intervention may be used but this has not been necessary as they have responded to behavioural guidelines that focus on early interventions. Behavioural guidelines are excellent, detailed and good working tools to ensure the safety of people who use the service, ensure their liberty is restricted as little as possible and the safety of staff. The manager has recently trained in the Mental Capacity Act including the deprivation of liberties and is intending to adjust some plans of care and procedures in line with this. Other staff are to be trained in these areas. The provider company, act as appointees for the people who live in the home. All have their benefits specified, how much they pay and who pays and how they are to be helped to deal with their finances, detailed in their plan of care. The manager is aware of everybodys benefits, their contributions to the transport and their personal allowances, these are all detailed in the individuals statement of terms and conditions. The home has access to bank accounts for personal monies, there are two signatories for withdrawals. Records were seen for two people, receipts are kept and records seen were accurate. People are helped to spend their money on appropriate items such as social activities, clothing and personal care items. Care Homes for Adults (18-65 years) Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home maintains a good standard of comfort and hygiene. It is able to offer a pleasant environment that meets the diverse needs of individuals and the needs of the group, as a whole. Evidence: Some areas of the home have been redecorated and those that have not are on the improvement plan to be completed by the end of this year. The kitchen has been completely refurbished with a large cooker and all new units and work tops. There is a new light fitting on the landing to ensure better lighting in a dark area of the home. The home has the necessary adaptations and any equipment needed to meet the needs of people with sensory or physical issues. The conservatory has been altered so that one person can sit in the heat of the sun for as long as possible, this has helped them to reduce some behaviours that others find difficult to cope with. Bedrooms seen, are well kept and personalised, reflecting peoples choices and needs. There is good quality, robust garden furniture which is enjoyed by people who like to spend alot of time outside in good weather. The home was clean and hygienic, carpets in the sitting room and conservatory are stained but these are due to be replaced imminently. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a stable staff team, who are gaining qualifications and are trained to meet the needs of the people who live there. The home has a robust recruitment process to ensure that staff that are appointed are safe to work with the people who use the service. Evidence: The home operates with a minimum of three staff per shift, but more generally with four staff in the morning (when all residents are up) and three staff in the afternoons/ early evenings. There is one waking night staff and one person sleeping in. The home has a total of sixteen staff, one staff member has left since the last inspection and there is one support worker and one senior staff vacancy, The majority of staff have been in post since the last inspection and the home has been able to reduce their use of agency resulting in no agency being used since March 2009. This has a positive impact on people who use the service who respond better to people they know and have worked with over time. The recruitment records of the two newest staff were seen, the organisation keep the detailed records in head office but the home keep pro - formas, which the manager signs to say that he has seen all the necessary information, these were completed fully and up-to-date. The manager confirmed that he has seen all the necessary Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: records to ensure the safety of the people who are appointed to work in the home. Staff files also included a completed induction checklist and a record of supervision/appraisal sessions. The manager and deputy interview all staff,one resident sits in on the interviews, on occasion, otherwise staff observe peoples interaction with the people who use the service. The home has a training summary so that they are able to see when people need to up-date mandatory training courses, such as health and safety. They also have an individual training record, records showed that mandatory/core training was up-todate. A large percentage of training is completed, on-line. Six of the 16 staff have an NVQ 2 or above qualification, another person is registered and other staff are working through the LDQ (learning disability qualification.) Surveys from four of five staff were returned to us. They were all positive and comments included, the home works well with individuals whilst still living in a group environment, I have seen 100 improvement over the last year. , we give people choices in every way we can. We communicate well. I did not speak, at length, to staff during the inspection visit as they were working directly with the people who use the service to offer them activities and opportunities to go out. Brief observations showed that they were treating people with respect and sensitivity and communicating positively with them.` Care Homes for Adults (18-65 years) Page 23 of 28 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 does not yet have a registered manager but is well managed in the best interests of the people who live there. The home has improved the quality of life for the people who live there, since the last inspection. The home adheres to Health and Safety policy and procedure so that people are kept as safe as possible. Evidence: The manager has been in post since April 2008,he has now been confirmed in post and has applied to the Commission, for registration. He has completed an internal manager development programme and is completing his Registered Managers Award, currently. Surveys from four staff noted that management was supportive and there is good team work. A fellow professional, a staff member and family members have all noted and commented upon the improvement in various aspects of the service over the past year. The manager advised that the home came second in a national competition organised by the provider to find the most improved of the services they run.The home won £500 to spend and they are planning to move the office upstairs to Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the sleeping in room to leave a room downstairs that people who live there can use to increase their access to activities, such as some sensory equipment. The AQAA and the manager confirmed that all policies and procedures were reviewed in 2008. The home has a robust Quality Assurance procedure, the organisation has a Quality assurance manager who audits all their services, on occasion. The service manager completes monthly regulation 26 visits and writes a report. The home send annual quality questionnaires to all interested parties and asks them to answer the questions and give their scores, as if they were the individual receiving the service. For instance a care manager would be asked to score the questions for each of her clients and a family member would be asked to give scores only for their relative. An action plan is developed as a result of the questionnaire responses, this is reviewed monthly with the service manager and annually prior to the next set of questionnaires being sent out. Improvements in the home to the environment, staffing and record keeping demonstrate that action plans are used as a working tool. The manager explained that they are trying to work imaginatively with the people who use the service to see if they can find a way of more directly involving them in expressing their opinions. Health and safety checks are up-to-date as noted on the AQAA and confirmed by the manager. A small sample of Health and Safety maintenance records were seen and were fully completed, at the appropriate times. Accident and incident forms are kept and actions are taken to minimise the risk of recurrence, as necessary. The home has very good quality individual and generic risk assessments. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!