Care Home: 33 Blanford Road

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What the care home does well The home provides service users with an environment in which they can feel safe, well supported and where they are valued as individuals. Independence is encouraged and each person has the support they need in order to develop and maintain skills. Needs are fully assessed before new service users are admitted and transitions to the service are carefully planned. Staff are well trained and supported and familiar with the needs of each person. Care plans are well presented and of good quality they reflect current needs,preferences and goals. Risks are assessed and needs are reviewed internally each month. The environment is that of a family home and service users have comfortable personalised bedrooms.Ongoing refurbishment of the building takes place to keep it fresh looking. The management approach is inclusive and it seeks the views of service users and includes them in making decisions about the home. What has improved since the last inspection? The home has appointed a well qualified deputy manager to support the registered manager. The range of activities on offer to service users has been increased and five service users have been so far been supported to obtain passports.This is being extended to the remaining service user. Furnishings in the lounge/dining room have been replaced and there is a new Parker bath. Fire safety assessments and procedures have been reviewed. What the care home could do better: The home should progress work on person centred planning as is intended so that care plans are made more accessible for service users. Suitable specialist training should be provided for the activities coordinator so they have equal access to training specific to their role. Paper hand towels and hand washing materials must be refilled and replaced when they run out in toilets and bathroom areas. The carpeting in two bedrooms where there are odours must be replaced as was stated is the plan. Key inspection report Care homes for adults (18-65 years) Name: Address: 33 Blanford Road 33 Blanford Road Reigate Surrey RH2 7DP     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: Deborah Sullivan     Date: 1 2 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: 33 Blanford Road 33 Blanford Road Reigate Surrey RH2 7DP 01737243818 01737243818 blanford@prospectha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Prospect Housing and Support Services care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 33 Blanford Road is a large, detached bungalow located in Reigate. The home is registered for up to six adults who may have learning or physical disabilities. The home is owned and managed by Prospect Housing and Support Services. Service users have individual bedrooms and share bathroom, toilet and shower facilities. There is a combined lounge and dining room which has views over a large enclosed garden. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: 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 key inspection of 33 Blanford Road took place over five hours,during the visit time was spent with the registered manager,deputy manager,care staff,the activities coordinator and the acting director of the organisation who was present for a short while. Short notice of the visit was given to make sure that the house was accessible in the snowy weather and that service users would be present. A range of records and documents were examined including care plans,medication records,staff supervision and training information and some policies and procedures. A tour of the home took place and some bedrooms were viewed.Information in the Annual Quality Assurance Assessment(AQAA) that we received prior to the inspection has also been used to inform the inspection. We received four surveys from service users who had been supported to complete them by staff. Five staff sent in surveys and we received four sent out to relatives,advocates and carers and two from health and social care professionals, some of the comments and responses on the surveys Care Homes for Adults (18-65 years) Page 5 of 29 have been included in this report. Care Homes for Adults (18-65 years) Page 6 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 7 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 8 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 9 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. Comprehensive assessments of need take place before a place at the home is offered and service users can visit and spend time there before deciding to move in. Evidence: Information about the home is available for prospective service and their representatives that is kept up to date. The home was full at the time if the visit, the most recent admission had been nearly two years previously. Care plans contain pre admission assessment information and needs are fully assessed before a place at the home is offered.Relatives and professionals are involved in the assessment process and the AQAA tells us that personal transition plans are devised . Surveys that had been completed by four service users with assistance from staff told us that they had been asked if they wanted to move to the home,during the visit one person said they had stayed for two weekends before making their decision,they said they were very settled at the home. Transition to the home takes as long as the service user needs and the manager gave two examples of where it had taken a number of months. The needs of service users are regularly reassessed internally and reviews involving Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: care managers are held at least annually,from the available evidence the home was continuing to meet the needs of the people living there. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each service user has a care plan that is personalised,up to date and reflects their assessed needs,preferences and goals. Risk are assessed and regularly reviewed. Service users are supported to make decisions and to be involved in the day to day running of the home. Evidence: Each service user has an individual care plan that is kept up to date and gives comprehensive information about their assessed needs. Three care plans were sampled,all were clearly presented,they included pen pictures,personal details and background information on the service user. The information also includes clear guidelines for staff to follow on care and support needs,records of internal reviews and reviews attended by relatives and care managers,risk assessments that were up to date and signed,collated daily diary notes,health information including records of any Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: appointments and relevant information on finances. A record is kept up of the monthly internal reviews by keyworkers,these include goals and progress made towards reaching them. Where possible service users are encouraged to be involving developing their care plan,one read contained a large number of documents that a service user had signed. Work is planned to continue on making the plans more person centred and accessible such as with the use of more pictorial content and the manager said this is a goal for coming months. Risk assessments are personalised and examples of risks assessed are those for swimming sessions and the personal management of finances. Two surveys returned to us by representatives for service users stated person centred planningand person centred approachin the section asking them what the home did well, one person added Residents are treated as individuals. A relative wrote that The service assesses my (relatives) condition and needs and meets them to the best of their ability Decision making is supported and promoted,this was in evidence on care plans.Service users need varying levels of support to make choices and decisions.Daily diary notes include examples of choices made, for example about activities and meals and during the visit these and other choices were offered. The majority of service users have limited or no verbal communication,staff showed awareness of the responses of service users via their mood,gestures non verbal communication or body language. One person manages their own finances with support. Staff spoken with during the visit clearly knew service users well and were used to their methods of communication. There are opportunities for service users to participate in the daily running of the home,they can choose to attend staff meetings,help with shopping,contribute to menu planning and choose furnishings and colour schemes for their bedrooms. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a wide range of social,leisure and educational activities both at home and in the community. Service users are given the support they need to keep in contact with relatives. Meals are healthy and nutritious and service users are involved in menu planning. Evidence: The home offers a wide range of activities for service users,each person has their own activity plan and a full time experienced activities coordinator is employed.Social,leisure and development needs are recorded on care plans and activities of the day are recorded in daily diary sheets. The weather was very cold and snowy and some roads not gritted at the time of the visit so it was unsafe for the Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: usual community activities to take place and for the minibus to be taken out.One service user has their own motability car. Most of the service users were involved in activities at home with the activities coordinator and staff, such as painting,making collages and watching TV or listening to music. Some people were able to engage for longer periods than others with tasks and although the weather had necessitated long periods at home, no one appeared to be bored or agitated due to the change of routine due the efforts of staff to occupy them. A survey from a service user told us that they thought the home did well at providing trips out and activities. The range of activities in the community is diverse,age appropriate and geared to each persons needs,abilities and interests.Activities include,swimming,bowling,visits to the cinema and theatre,hydro sessions,trips to places of interest and the coast,shopping and having coffee and meals out.One person especially enjoys going to a monthly hairdressers appointment and the eldest service user attends Age Concern and another session in the community for older people on a regular basis. Examples of activities that take place at home are arts and craft,music sessions and cookery. The majority of service users have a passport and application is underway for one who doe not have one yet.Annual holidays are provided and there have been trips in this country and to Spain and Euro Disney,holidays are being planned for this year. The home promotes and supports contact with friends,relatives and advocates,they are welcome to visit and keep in touch via telephone or correspondence.Bedrooms seen contained family photos. One person regularly visits a relative and others keep in touch.One relative wrote in a survey that Staff are friendly and welcoming to relatives and another They make me welcome and often give lifts when I visit. Routines are flexible and promote choice such as when to get up,choice of activity and choice of bath or shower. The menu is healthy and varied and the home has sought the opinion of a dietitian who found it satisfactory.There is a good balance of meat, fish and fruit and vegetables.The menu can be flexible and there is choice available. Dietary preferences are recorded,one person has a pureed diet and staff are aware of a food they cannot eat due to their faith.The main meal is taken in the evening,a hot light lunch was freshly prepared during the visit which service users enjoyed. The manager said that people choose when they have breakfast and it can depend on when they get up. Drinks were available throughout the day. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Care Homes for Adults (18-65 years) Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal support preferences of service users are recorded and respected,personal care is delivered discreetly and respectfully. The procedures in place for medication are robust and protect service users. Evidence: Health and personal care needs and preferences are thoroughly recorded in care and health plans, where needed there are related risk assessments. Records are kept of medical appointments and outcomes.From reading the plans and discussion with staff and the manager it was clear that any health concerns or changes are quickly looked into and referred to health professionals.The manager promotes good relationships with other agencies. Service users are supported to access health professionals such as chiropodists,occupational therapists,continence advisors and district nurses.One person had recently been referred for assesment by a behavioural specialist due to concerns about their behaviour.Another service users mobility had reduced during the past year,they had been supported to access equipment to help them maintain as much mobility and independence as possible. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: A district nurse called to do a blood test during the visit,the service user chose not to have the procedure done and the nurse was return another day.The home demonstrates awareness of the Mental Capacity Act and had referred a person for an assessment from an Independent Mental Capacity Advocate(IMCA) in respect of some dental treatment due. Preferences for the delivery of personal care are respected and recorded in detail.One persons care plan said they liked having bubble baths but did not like any products on their hair.There is a keyworker system,keyworkers are responsible for coordinating appointments and keeping written information about health up to date. Staff are knowledgeable about individual needs and personal care is delivered in a manner that respects privacy and dignity and provided by staff of the same sex as service users. Medication is suitably stored and medication recording sheets sampled were correctly completed.A photo of each service user is kept with the sheets along with personal details,details of any allergies and guidelines for as required medications. Medication is only administered by staff who have attended medication training and are assessed as competent. A pharmacy inspection by the pharmacy the home uses had taken place last year,no medication concerns were raised and no actions identified. Care Homes for Adults (18-65 years) Page 18 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. Complaints are taken seriously and addressed according to the homes procedures. Safeguarding procedures are in place and staff are provided with awareness on how to protect service users from abuse and report any concerns. Evidence: The homes complaints procedure is on display,it is available pictorially. One complaint had been made since the last inspection that the home had responded to fully in accordance with its procedure.The manager provided evidence on the service users care plan as to how additional monitoring of some specific needs had been put into place as a result . Most of the service users would require support in order to complain due to their personal communication needs,the home involves independent advocates if necessary two of whom returned surveys to us with positive comments about the service. Staff spoken with and observed showed that they knew how people demonstrated they were uncomfortable or unhappy. Staff receive safeguarding training which is updated and there is a safeguarding procedure.Awareness of safeguarding is included in staff induction. Five staff members returned surveys, they all told us that they know what to do if someone has concerns Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: about the home and their recruitment included all the necessary checks.Recruitment is managed by head office in liaison with the manager and the procedures in place safeguard service users. There has been one safeguarding alert in relation to the service since the last key inspection,the organisation investigated it comprehensively and provided us and the Local Authority with their findings,a number of robust actions were put into place as a result. Service users personal spending money is kept securely and records kept of purchases made such as on trips out or for personal items are through. The manager audits the records weekly,the organisation audits monthly and an external audit takes place annually. Care Homes for Adults (18-65 years) Page 20 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. Service users benefit from living in a homely,well presented and well maintained atmosphere. Bedrooms are personalised and shared areas have the feeling of a family home. Evidence: The building is a bungalow that has a friendly and homely feeling,it is well decorated,furnished and maintained.New lounge furniture and curtains have been purchased and the large lounge/dining room is light and airy. No domestic staff are employed so care staff do all the cooking,cleaning and laundry. The home was clean and hygienic,the kitchen and laundry well equipped. Service users were mainly spending time with staff in the lounge and dining area and there was plenty of room.There are pictures on the walls and in corridors and touches that make the home feel like a family environment such as framed collages on the wall made by a service user who used to live there. Comments on two surveys from representatives of service users say building service has a homely atmosphere. Some bedrooms were visited,all were very nicely furnished and decorated, they are personalised with items such as sound systems,TVs,photos of outings and relatives,pictures and soft toys.One person has a large flat screen TV as they like to Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: watch films in their room. Two bedrooms had slight odours,new carpets for both were on order. Aids and adaptations are provided and fitted for specific use or to generally benefit those who may need support to maintain mobility or independence such as hand rails,a raised toilet seat and a ceiling track hoist in a bedroom and bathroom. There are two bathrooms and a shower room,one bathroom has a new Parker bath.The shower room/toilet had run out of hand soap,hand sanitiser and paper towels,the manager said this would be addressed. Even under a fair amount of snow it was evident the garden is attractive,well maintained and accessible.There is a patio area with patio furniture.One person was discussing their wish to take up gardening again following a period in which their mobility had reduced with the acting director who was present for a while,ways in which to facilitate this were being considered. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a staff team who are well trained and supported and knowledgeable about their needs. The service has a through recruitment procedure that protects service users. Evidence: The home was fully staffed,some recruitment had taken place over the past year and new care staff and the deputy manager had joined the service.The recruitment process was discussed with the manager. No agency staff are used, if there are gaps in the rota the organisation has bank staff available although as there was a full staff compliment the manager said they had not been used for a while. Recruitment records are held at the organisations head office,the manager confirmed that he was very involved in the process and saw references and CRB (Criminal Records Bureau) disclosures before staff were appointed. The AQAA tells us that one service user has been involved in the staff recruitment process. There were enough staff on duty to meet the needs of the service users,the staff group is diverse and there were male and female staff on duty.One person has one to one staffing for twelve hours a day funded by their local authority as they have Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: complex needs. Internal induction takes place and new staff receive core training that is updated at necessary intervals,there is also equality and diversity training.Courses specific to the needs of people living at the home are also given such as on person centred planning,epilepsy and the Mental Capacity Act.Some specific training needs to be sourced and provided for the activities coordinator to help them develop in their role and add to their expertise. The training schedule had been updated and some updates due were recorded and being arranged.Some team building training has taken place during the past two years to strengthen and develop the staff team as a whole. The majority of care staff have gained an NVQ (National Vocational Qualification) in care at level two or above,one staff member spoken with had just enrolled on level three. Monthly supervision meetings are held,currently the manager supervises all staff but there are plans for the deputy manager and other senior staff to undertake some supervision. Supervision records were sampled,personal development is discussed as part of the process and there are annual appraisals.Team meetings are held that service users can attend. Staff who sent in surveys told us they felt well supported ,one wrote that there was,Always someone to speak to if you need support or are unsure about anything.One staff member put on their survey that there could be better communication between staff members. Surveys from relatives included a number of complimentary comments about staff, one relative said, The people at Blanford Road seem to genuinely care about the residents,they work hard,doing a difficult job and another that the service did well at Patient support to my(relative) on a daily basis. Staff spoken with individually,working with service users and observed had good relationships with service users and a good rapport whilst giving them support and direction in a professional manner. 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 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 a friendly atmosphere and promotes the health and safety of service users and staff. Systems are in place to make sure that the quality of the service is internally assessed. Evidence: The registered manager is experienced,well qualified for the role and has worked at the home for eight years.The manager undertakes regular training,and keeps up to date with new developments and changes in legislation. A deputy manager was appointed in mid 2009.The manager and deputy manager temporarily transferred to another of the organisations services from July to November 2009 to undertake a specific piece of work there,a manager was then put in place temporarily for Blanford Road.The organisation kept us informed of the changes. Since returning the manager and deputy have continued to work on the development of the service and are catching up on some work such as planning training and progressing the further Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: development of person centred plans. The home has a friendly and inclusive atmosphere it is well run and organised. One service user saidThe manager is marvellous,he helps us a lot. Internal quality assurance takes place,a representative of the organisation visits and complies a report monthly as is required,external and internal audits are completed and the views of service users and stakeholders are sought. Policies and procedures are available for staff to access at any time,new staff are required to sign that they have read them and staff are made aware of when they are reviewed.A sample of the policies and procedures was read,they were clear for staff to follow.All confidential information and recording is securely stored and the office is very well ordered,equipped and information easy to locate.All the records seen during the visit were well maintained,completed in enough detail and up to date. Staff were observed to be using safe working practises and the safety of service users and staff is promoted.The building is well maintained and the manager had compiled a new fire safety folder last year that included environmental and individual risk assessments for service users in the event of a fire. The information in AQAA completed by the registered manager is of good quality and helped to inform the inspection. 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. 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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