Care Home: 30 Keepers Crescent

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What the care home does well People have good care plans that tell staff the support they need.People are supported to go out when they want to and do the things they enjoy doing.People go on holiday.People are helped to keep in touch with their family and friends. This helps them to keep relationships which are important to them.Each person has their own bedroom which is decorated how they want it to be.The staff have training so they know how to look after people and to keep them safe. What has improved since the last inspection? The home wrote to us before we went and told us all the things which have happened to keep on making things better for the people who live at the home.Staff have more information on how to give medicines. This helps to make sure people have all the medicines they need. What the care home could do better: The home is doing many things well.The home knows it needs to have a manager. A manager from another home is helping until this happens. Key inspection report Care homes for adults (18-65 years) Name: Address: 30 Keepers Crescent Off Redhill Way Donnington Telford Shropshire TF2 9NZ 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: Rosalind Dennis Date: 0 3 0 6 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 33 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 33 Information about the care home Name of care home: Address: 30 Keepers Crescent Off Redhill Way Donnington Telford Shropshire TF2 9NZ 01952201715 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Daniel.Frater@dimensions-uk.org www.dimensions-uk.org Dimensions (UK) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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 (LD) 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home 4 people live at the home. It is not far from Donnington which is near Telford. There are buses which stop near the home. People are supported by staff to go out in the homes own car. This means people can get around easily and visit different places. The home is suitable for people who use wheelchairs. Care Homes for Adults (18-65 years) Page 5 of 33 Everyone has a bedroom of their own. People can bring in their own things. There is a lounge, large kitchen and a place to eat. There is a large garden. The home has a book called Service User Guide which tells people about the home and how much it costs to live there. Care Homes for Adults (18-65 years) Page 6 of 33 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 Care Homes for Adults (18-65 years) Page 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home We went to 30 Keepers Crescent on 3rd June 2009 and stayed there for six hours. The home did not know we were coming. We were made to feel very welcome. We spent time watching how staff support people. We spoke to some staff who work at the home. We looked at two care plans to make sure staff know how to support people in the way they want. Care Homes for Adults (18-65 years) Page 8 of 33 We looked around the home to see it is a nice place to live. We looked at things we have been told about the home since we last visited in 2007. What the care home does well People have good care plans that tell staff the support they need. Care Homes for Adults (18-65 years) Page 9 of 33 People are supported to go out when they want to and do the things they enjoy doing. People go on holiday. People are helped to keep in touch with their family and friends. This helps them to keep relationships which are important to them. Care Homes for Adults (18-65 years) Page 10 of 33 Each person has their own bedroom which is decorated how they want it to be. The staff have training so they know how to look after people and to keep them safe. What has got better from the last inspection The home wrote to us before we went and told us all the things which have happened to keep on making things better for the people who live at the home. Care Homes for Adults (18-65 years) Page 11 of 33 Staff have more information on how to give medicines. This helps to make sure people have all the medicines they need. What the care home could do better The home is doing many things well. The home knows it needs to have a manager. A manager from another home is helping until this happens. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 12 of 33 If you want to speak to the inspector please contact Rosalind Dennis 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT 01216005300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 13 of 33 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 14 of 33 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 can be confident that when they move into the home they will have all the information they need about the home and that their needs will be met. Evidence: The four people who currently live at Keepers Crescent have lived there for sometime and we observed staff supporting these people well. We looked at the processes the home would use in the event of a new person being admitted, which shows that people would have their needs fully assessed and would be supported to spend time at the home before they were admitted, so that they have opportunity to meet staff and the other people who live at the home. The senior staff member currently overseeing management arrangements explained that careful consideration would be given to make sure that anyone admitted would be able to fit in with the people already living at Keepers Crescent. Copies of the homes statement of purpose and service user guide are available in the entrance to the home, and a copy of the guide is also kept in each persons support plan. We looked at the service user guide, which contains a good level of clear information about the service and is written in an easy read format, including photos and pictures to Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: assist people with their understanding of what the service provides. Included within the guide is information on the fees charged, so that people know who is responsible for payment of fees. Care Homes for Adults (18-65 years) Page 16 of 33 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 living at 30 Keepers Crescent are involved in decisions about their lives, and are supported by staff to take risks within a risk-assessed framework. Evidence: We looked at two peoples support plans which were very detailed in explaining how people want their needs to be met. The plans contain detailed instructions of the actions staff need to take to support the persons in order to meet their individual needs in relation to all aspects of their daily lives including their personal care, communication, health care and social needs. Support plans include short and long-term goals and focus on the persons strengths, abilities, likes and dislikes. One persons support plan looked at their emotional needs and contained clear guidance on a specific behaviour of concern, instructing staff to re-direct them from that behaviour. We saw that staff followed this plan when the behaviour occurred. The person was aware of their support plan and how staff would support them during this behaviour of concern. We saw that the service looks at ways to support peoples religious, spiritual and cultural needs. Twenty-four hour support plans are in place, which describe the persons needs and preferred routines over a twenty-four hour period so that new or agency staff can establish quickly how a person Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: wants and should have their needs met. The people living in this home have their own methods of communication, some of which involve elements of formal systems and some of which have been developed by staff to support the person with communication. One person shared with us their photographic communication book, which has photographs of the person and staff using particular signs and their meaning, to support them with their communication for example, their preferred television programmes, going to the pub and identifying staff who work at the home. We saw that staff are very good at knowing how each person makes their wishes and choices known and include the people who live at the home in all aspects of life. We saw risk assessments informing staff how to support the person to take risks whilst ensuring that they could be as independent and as safe as possible. Risk assessments are reviewed and updated when the persons needs change. Care Homes for Adults (18-65 years) Page 18 of 33 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 supported to make choices about their lifestyles, develop their life skills and maintain contact with families and friends. People are provided with balanced meals in accordance with their personal preferences. Evidence: People living at the home are supported to take part in their preferred activities. One person has a keen interest in gardening and a section of the garden has been developed into a vegetable plot and staff described how they support the individual with this activity. The person was clearly happy with their achievement in growing many vegetables, which are then used in meal preparation. Another section of the garden is used for storage of items for recycling, a person who is normally involved in this activity chose not to take part and staff supported another person to take items to the local recycling centre during the inspection. One person went out to an art and craft class and is also supported to attend college. We saw records which demonstrate that people are supported to take part in a variety of Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: activities, inside and outside of the home including bowling, going to the cinema, shopping, going to the pub, watching DVDs and listening to music. The home has its own transport which staff are able to drive so that people are able to go out. Staff described how people are supported to use public transport and to go walking in the community, depending on their abilities. People go on holidays and day trips supported by staff. The Annual Quality Assurance Assessment (AQAA) and staff described the success of day trips where family members and people from other services also participated. Records show that people are enabled to keep in touch with their family and friends so they can maintain relationships with people who are important to them. The service also looks to finding creative ways to help people maintain meaningful contact, for example when people are less able to visit. We observed during the day that people are supported with basic housekeeping tasks as much as possible to develop and maintain their independence, for example one person who spilt a drink was encouraged to clean up the spillage. People are supported to take an active role in food shopping. People were given a choice of what they wanted to eat and drink throughout the day and staff described how menus are flexible depending on what people want to eat. Staff sat to eat with people whilst they ate and drank, so making it a social occasion and supported people who needed more assistance. Care Homes for Adults (18-65 years) Page 20 of 33 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. People receive support and care in the way they prefer and need. Their health needs are met and they are protected by the homes policies and practices regarding medication. Evidence: Care plans detail the guidance and support needed to meet individual personal and health care needs. Care plans state what the person is able to do themselves which encourages them to be as independent as possible. On the day of inspection we observed people whose appearance reflected what was written in their care plan of how they prefer to look and dress. The health needs of each person are recorded in their health action plan, which is a plan of what a person needs to stay healthy and the healthcare services they need to access. The plans have been enhanced since the last key inspection, are in an Easy Read format, and include pictures so making it easier to understand. We saw that health care professionals are involved in the care of people who live at Keepers Crescent. On each persons file we saw a document which they would take with them if they were admitted to hospital, which is very good practice as it shows how they would want to be cared for and supported by the hospital staff. Information was readily available to inform staff how to support a persons specific health condition and the interventions needed in an emergency so that the person is kept safe. Observation of records show that people are Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: provided with holistic therapy in the form of massage and staff described the beneficial effects this has had with different individuals. Medication for people is pre-packed by the pharmacist in individual doses for each person, which makes it easier for staff to know what medication each person has and at what time. We looked at the medication records for the two people we case tracked and saw that these records were up-to-date and properly completed. Medication is stored in a locked cupboard so that people are not at risk of taking medication they are not prescribed. The homes medication policy was available for staff to read as well as leaflets in different formats on individual medication which were seen in peoples care files. There were also guidelines as to how the person takes their medicine so that staff know how to support them. The home is looking to put in secure storage in bedrooms so that a more personal approach to medication administration can be used. Training records show that staff involved in the administration of medicines have received training in safe administration. Care Homes for Adults (18-65 years) Page 22 of 33 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 complaints procedure, which provides people with information so they know how to complain and ensures concerns and complaints are listened to and acted upon. Staff are provided with training to equip them with the skills to safeguard adults from harm. Evidence: The home has a complaints procedure that is included in the service user guide and is given to each person and their relatives. The procedure is in an easy read format to make it easier for people to understand, although it is likely because of peoples needs they may need additional support to raise any concerns. The AQAA informed us of the steps it is taking in conjunction with the local authority to improve the frequency and availability of advocates to ensure the voices of the people we support are heard and we saw notices which gave the details of advocacy services. The AQAA stated that no complaints have been made to the home in the last 12 months. We looked at where the home records complaints and saw the last complaint was in 2006. We have not received any concerns or complaints directly about the service. The training records we looked at and the staff we spoke with confirmed all staff working at the home receive training on safeguarding vulnerable adults from the risk of abuse. Staff knew where the homes policies on the protection of vulnerable adults are kept, which provides staff with written guidance on the procedure to follow if a concern or allegation occurs. The AQAA notes that three referrals and two investigations have been held under safeguarding adult procedures in the past 12 months, and we have been Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: informed the necessary action has been taken and the investigations concluded. The people we case tracked need support to manage their money and we looked at their individual finance books which demonstrates that their money is looked after appropriately and is safe. Detailed information is included within support plans to explain peoples abilities and capabilities with finances, so staff know the support needed. Some people who live at 30 Keepers Crescent may demonstrate behaviour that determines staff must work with them in a particular way to help keep them safe and well. We saw guidelines on peoples care plans which explain how the staff should support people with these needs. Training records show that staff have received training in the management of actual physical aggression and the service also ensures that agency staff also receive this training, prior to working shifts at the home which is very positive as it means all staff are consistent in their approaches to behaviours of concern. The staff team have attended awareness training in the Mental Capacity Act (2005). The Act governs decision making on behalf of adults, and applies when people lose mental capacity at some point in their lives or where the incapacitating condition has been present since birth and it is important that staff know how to put the Act into every day practice. Staff have yet to attend training on Deprivation of Liberty Safeguards, which forms part of the Act, but information has been obtained about how this legislation may affect people who live at 30 Keepers Crescent. We saw that a recent staff meeting included a discussion on this. Care Homes for Adults (18-65 years) Page 24 of 33 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 provides accommodation, which fully meets the needs and abilities of the people who live there and provides people with the opportunity to maximise their independence wherever possible. Evidence: The AQAA describes how the home is in good condition and meets the needs of the four people who live there and our inspection findings support these comments. We looked at the bedrooms for the people we case tracked which shows people are supported to personalise their rooms with pictures, photographs and music centres. Staff confirmed people are involved in choosing how the home and their bedrooms are decorated. There is a large communal lounge, which includes a dining area and a smaller lounge used for activities or when people prefer a quieter environment. Good quality furniture was seen in the rooms we looked at. The kitchen is spacious with lots of storage and worktop space for preparing meals. There is a separate laundry room which was clean and we saw that substances such as cleaning products that could cause harm to people had been locked safely away. People have wash hand basins in their rooms, toilets are located near bedrooms and people are provided with commodes depending on their needs. The home has a bath which is equipped to assist people so they can access this safely and there is a shower room on the ground floor which means people are provided with a choice of facilities. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: There is a ramp at the front and rear of the building, which enables people who may have mobility difficulties with accessing the home and rear garden. There is a choice of stairs or a lift to provide access between the ground and first floor. The garden is fully enclosed and well-maintained and one person has taken a particular interest in developing one section of the garden to grow vegetables. Most staff have received training on the prevention of infection and management of infection control and we saw staff putting into practice skills to minimise risks of crossinfection when an incident arose during the inspection. Care Homes for Adults (18-65 years) Page 26 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who have the skills and knowledge to meet their needs and who are suitable to work with vulnerable adults. Evidence: When we arrived at the home, staff were welcoming and informed people of our role so they knew the reason for us visiting. We werent able to communicate with all the people who live at the home so we watched the way they interacted with staff on duty and how staff interacted with them. Our observations and the evidence we saw demonstrates that people are supported by a skilled and committed staff team who have an excellent understanding of individual needs. Staff communicated with people verbally, using gestures and supported people as they walked around the home. Some staff have worked at the home for a number of years which provides stability to the people the service supports. We spoke with staff, observed them working and looked at staffing rotas which demonstrated that sufficient staff were on duty to meet the needs of the people currently living at the home. Staff confirmed that levels for all shifts are sufficient and an on-call arrangement means there is always someone to contact if additional support and guidance is needed. We were informed and the AQAA shows that agency staff are used to supplement the homes permanent staff. We saw that the home ensures agency staff are suitably skilled and receive an induction and training. The home confirmed when it uses Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: agency staff it ensures as far as possible that only staff who are familiar with the service work at the home. We spoke with an agency member of staff who told us about the arrangements the home put in place to ensure they are competent to work at the home. The home is currently in the process of recruiting permanent staff including a manager. The home has not appointed any new staff for sometime but we looked at the procedures the home would follow which shows that staff would go through a robust recruitment procedure before they start work which helps to ensure staff are suitable to work with vulnerable adults. Information is also sought from agency staff employers to ensure agency staff are suitable to work with vulnerable adults. When appropriate the home involve people who live at the service in the selection of new staff and we saw that one person had been paid for being involved in this process and staff spoke of the beneficial effect this had on improving the persons self-esteem at the time. The staff we spoke with confirmed they are provided with good training opportunities. Almost all the staff have attained a recognised qualification in care (National Vocation Qualification) at Level 2 and some staff have achieved Level 3, which should contribute to ensuring that the staff team have an effective knowledge of social care. This is supplemented by specific training to meet the needs of people who live at the home including training in autism awareness, hydrotherapy and administration of specific medication. We saw documentation to show meetings for staff take place on a regular basis and they are provided with an effective formal supervision process which enables them to reflect on their practice and identify training and development needs. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently without a manager, however interim management arrangements ensure the home is safe and run in the way that the people living there want. Evidence: Since the last inspection there has been a change with the management arrangements at 30 Keepers Crescent in that the service is currently without a Registered Manager. A manager from another service is providing managerial input and attended to assist with the inspection. We spoke with staff who discussed how the staff work together as a team and the lack of a manager has not impacted on the service and the people who live there. We were informed that the home is actively recruiting for a new manager- the service must ensure that a suitable and competent person is appointed to manage the service as soon as possible to meet our regulations. The regional director had completed the AQAA, which provided us with clear information and demonstrates that the service is able to recognise its strengths, weaknesses and is run in the best interests of the people who live there. The AQAA provides information on how the service promotes equality and diversity and notes how it intends to make further changes, such as staff training in equality and diversity. During the inspection staff Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: referred to a document which has been produced by the provider which looks at words and terminology considered unacceptable and alternative acceptable words which should be used by staff and we consider this to be a very positive development. We observed results of surveys collated from people who live at Dimensions services in the West Midlands and shows that most people who responded are very happy with their home and the support. An easy read action plan is drawn up from results of the surveys to inform people of the areas done well and areas needing improving. We were informed that if results identified negative feedback with one particular service than the service would be made aware of this. We saw that relatives, friends and staff are also provided with opportunity to comment on the service. A representative of the company monitors quality at regular intervals with monthly unannounced visits. We observed the reports which are produced as a result of these visits which shows the visits are comprehensive and look at a range of matters including general observations, health and safety, checks of medication and whether any complaints have been received. An action plan is then produced so staff know the action to take and when. For example one of the reports we saw identified that a certificate regarding gas safety had expired, action had been taken promptly and we saw the new certificate. Information was provided within the AQAA to confirm servicing and maintenance of equipment is undertaken and policies and procedures are reviewed. Observation of maintenance and servicing records shows an organised process to ensure the home is safe and well-maintained. The records we looked at and the AQAA demonstrates that staff have regular training in health and safety, food hygiene, first aid and moving and handling. This ensures staff are provided with the knowledge and skills to help people keep safe. The home keeps us informed of the occurrence of accidents and incidents. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 33 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 Description 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 Description 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 32 of 33 Helpline: Telephone: 03000 616161 or 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. 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