Care Home: 36A Birling Avenue

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What the care home does well The support staff on duty managed very well with our unannounced visit, despite the registered manager`s absence and a planned external activities trip for service users. Support staff spoke enthusiastically about their roles and values and enjoy working at the home. Service users like living at the home and feel happy and safe. The provider continues to commit to having a well trained workforce, resulting in all support workers being trained to NVQ level 2 care or equivalent. Support workers are also encouraged and financially supported by the provider to continue with their further education. This better equips support workers to undertake their roles. Survey respondents` comments about the service included "The service enables my relatives to get out and about a lot more and interact with others in the community. I`m very happy with the service. My relatives cannot wait to go back, they absolutely love it". "I`m happy with the service and when I had an issue the service put matters right. There is always somebody my relative can talk to if they are unhappy about anything. Staff seem to want to keep the clients occupied and stimulated. My relative never returns home bored. I know I can go away and feel happy and confident my relative is in good hands. All the staff are always very obliging and helpful". "The manager and staff are very open. It`s very good and far friendly now. My relative loves it. My relative is always welcomed. The home provides a variety of activities and clients are always going somewhere". What has improved since the last inspection? Service users` bedrooms have been refurbished with new furniture and bedding. One of the bathrooms has been refurbished. The rear garden has been re done and provides vegetable plots at the bottom. The pond has been improved and repaired and provides a pleasing central feature. All the televisions have been replaced with flat screen ones. The new televisions allow service users to access far more channels for entertainment purposes. Support workers have received training from a registered nurse so that they can safely administer insulin. What the care home could do better: Improve the hand washing arrangements for support workers undertaking laundry duties, so as to minimise potential cross infection risks for everybody staying and working at the home. Clinical waste should be stored so as not to impact on service users` facilities. Make sure that care plans and risk assessments are kept up to date to reflect individual service users` current needs and condition. There are plans to improve the home inside and outside so it is more comfortably and homely. No requirements have been made but a number of good practice recommendations have been made throughout the body of this report. Key inspection report Care homes for adults (18-65 years) Name: Address: 36A Birling Avenue 36A Birling Avenue Rainham Gillingham Kent ME8 7EY     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: Elizabeth Baker     Date: 1 4 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 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: 36A Birling Avenue 36A Birling Avenue Rainham Gillingham Kent ME8 7EY 01634234423 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: paula.robbins@medway.gov.uk Medway Council care home 7 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 7 The registered person may provide the following category of service only: Care Home only (PC) to service users of the following gender: Either;Whose primary need on admission to the home are within the following category : Learning Disability (LD) Date of last inspection Brief description of the care home 36a Birling Avenue is a care home providing short stay respite care and accommodation for up to seven people with a learning disability. The home is owned and managed by Medway Council. The home is currently used by just over 80 people annually. The home is situated in a residential area of Rainham, within walking distance of shops and local amenities. Public transport is nearby. Parking outside the home is allowed. Bedroom accommodation comprises one double and five single rooms. There is no lift access to the two bedrooms situated on the first floor. Fees currently range from £6.54 to £21.00 per night, depending on individual assessed need and financial situation. Additional charges are payable for trips and outings, entrance fees and refreshments and meals purchased at outside venues. Support is provided to Care Homes for Adults (18-65 years) Page 4 of 29 7 Over 65 0 Brief description of the care home assist people in attending religious or cultural services in the community. Activities include horse riding, gym, swimming, bowling, cinema, baking and cooking, retail shopping and pub lunches. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: On the 14 July 2009 we the Commission carried out a key unannounced visit to the service. The visit lasted about six hours. We walked around the home and talked with all the six service users and three support workers. Four of the service users were interviewed in private. At the time of compiling the report, in support of the visit, we received surveys forms about the service from one service user and four support workers. Telephone interviews with three carers were subsequently undertaken on the 16 July 2009. As required by regulation, the service returned the annual quality assurance assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The assessment gave us most of the information we asked for. Care Homes for Adults (18-65 years) Page 6 of 29 We have incorporated some of the information gathered from the above sources into this report. The registered manager was not available at this visit. A support worker assisted in this inspection. Verbal feedback was provided to the support worker during and at the end of the visit. The last site visit to the service took place on 17 July 2006. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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. Care Homes for Adults (18-65 years) Page 8 of 29 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users using the respite service can be sure they will have an assessment of their needs and will be offered a place only if their needs can be met by the service. Evidence: The home has produced an information pack which includes its statement of purpose, service user guide, written agreement, staff organisation chart, quality assurance and complaints procedure. The complaints procedure is available in widget format if required. This is good practice. However the statement of purpose is not completely up to date. For example where it refers to the homes accommodation it does not specifically give precise details. Instead it refers the reader to the national minimum standards. Not all members of the public are aware of the national minimum standards. The service user guide makes reference to a pre inspection questionnaire being issued by us. We no longer issue these documents. And our contact details for obtaining inspection report are stated as the National Care Standards Commission. This body ceased to be in March 2004. All prospective service users are initially referred by care management. The Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: prospective service users and their carers are then invited to visit the home. This is followed by a tea visit and a subsequent night stay visit. This enables the home to determine whether the prospective service user is suitable for the level of respite support and care provided, as well as an opportunity to meet other service users and support workers. If it is established the home can properly support the needs of the prospective service user and their carers with a respite package then an agreement is made between the prospective service user and the home. This sets out the rules and responsibilities for staying at Birling Way. Records inspected contained signed copies. Information gathered at these visits, together with the information supplied by care management and other professional bodies, is then used to generate a plan of care. Care Homes for Adults (18-65 years) Page 12 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. Service users are enabled and live an independent life as far as is possible. Evidence: Service users staying at the service looked happy and relaxed. Support workers spoke to them to in a respectful manner and supported them in making choices. During the visit, it was clear that support workers have a good understanding of service users individual needs. Each person has an individual care record that outlines their assessed needs. The three care records inspected contained a care plan composed at the home as well as care plans from their funding authority. In addition care records contained a pen picture, admission pack, contact sheets and medication administration record charts. The records covered areas such as medical condition, medications, eyesight, hearing, mobility, sleep, diet, physical care, personal care, mental health, communication and social skills, occupation, education and leisure and day time activities. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Generic risk assessments are completed for daily activities including going out, using the homes equipment, excursions, transport and fire. However the inspection of one of the care records identified the service user is at risk because of a medical condition. Indeed their carer has provided the home with updated information on this because the condition has deteriorated. However this information did not trigger a specific risk assessment or a care plan component, despite the home already having taken appropriate action to monitor the condition. Nor did the care file contain a continence assessment, although the service users condition sometimes results in them now being incontinent. The care records also identified some service users would require assistance in the event of a fire. The files did not contain individual risk assessments for this either. Although service users only stay for short respite periods, the home participates in service users care reviews, where this is practicably possible. If support workers are unable to attend, a form is completed and sent to the service users care manager so the homes input is included. This is good practice. The homes current model of care plans does not entirely promote the person centred care approach. However the home is working on a new model which will require more input from the service users. The new document is in an easier to understand format, and includes pictures. Care Homes for Adults (18-65 years) Page 14 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. With assistance and encouragement from support workers, service users are enabled to expand their social and occupational links and experiences during their respite stays at the home. Evidence: On our arrival preparations were in hand for all the service users to go to Gravesend for a bowling trip. Service users were busy getting ready, laughing and talking to each other and to support workers. One service user took us around the home and introduced us to other service users. Another service user showed us the gardens. All service users spoken with said they like staying at the home and feel happy and safe. Although the home has a weekly programme of activities, service users also discuss what they want to do during a Sunday morning meeting. This is to try and make sure all individual preferences are identified and met where this is possible. Indeed Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: swimming and banger racing has been introduced because of individual service users preferences. Service users said they go shopping, go to pubs, go to the cinema and go bowling and have rides out in the mini bus. A service user said she is able to carry on going to her day centre when staying at the home. Since the last visit televisions have been replaced. All bedrooms have been provided with a flat screen TV. And a wide flat screen TV is in the lounge. The new televisions have increased the choice of programmes service users may wish to watch. Service users are able to bring small items with them into the home, such as CD players. And one service user said how much she likes listening to this in her room. Service users said they can get up and go to bed when they want, have a bath when they want and choose what to wear. Indeed service users were seen appropriately dressed for the time of day and with attention to detail where this is important to them. Because the service is for short respite stays only, religious services are not held at the home. However where attending services is important to service users, they are supported in attending services in the community. For privacy purposes, all bedrooms are lockable. All bedrooms have a lockable facility in which they can securely keep small items of importance or their medications if they self administer. The homes menu is devised with input from service users and is normally changed twice a year. In addition to the weekly menu, a special themed menu is available on Saturday nights. Menus include choices. Residents said they like their food, helping in the kitchen and laying tables. 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. Service users are supported with their personal care needs in the manner they prefer. Evidence: Service users do not usually stay at the home for more than two weeks during any respite period, with the average stay being one week. Where medical input is required during these stays, the home endeavours to get the service users usual GP to visit. However where this is impracticable, the home has arrangements with a local GP who provides cover. If respite stays coincide with medical appointments, the home supports the service user in attending them. Emergency dental cover arrangements are also available. A service user respondent commented The service welcomes them, looks after their individual needs and staff are always very helpful. Service users choose their own clothes, when to go to bed and when to get up. Service users are independent and are encouraged to remain so. However where support is required this is provided. Makaton is used to support some residents with communication difficulties, if this is relevant to them. Medication is stored in a metal lockable cupboard. None of the service users staying at Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the home at the time of our visit, self administer their own medications. However where service users do self medicate, they are encouraged to do so during their respite stays, after a risk assessment has been completed. Support workers have received medication administration training. And since the last visit, all staff have received training on how to administer insulin via the PEN method by a community registered nurse. This was a requirement made at the last visit. Medicines are checked at each handover. Although the care records we looked at made reference to religion, it has not been the homes practice to devise end of life care plan components. Whilst recognising this is a respite stay service, it is important to obtain some information on service users cultural and spiritual wishes and preferences in the event of death and dying. This is because in the event of an unexpected death support workers would have quick access to information at a sensitive time. 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. Service users and their carers can be confident their concerns will be taken seriously. Service users are safeguarded from harm and abuse by the practices and procedures in the home. Evidence: The complaints procedure is included in the homes information pack and is available in an easy to read widget format if required. However a review of the displayed laminated complaints procedure gives the providers address as Compass House and referred to us as the Commission for Social Care Inspection. These references are both out of date. To prevent any confusion somebody may have in contacting the provider or indeed ourselves, the procedure should be updated. The home maintains a central record of complaints and compliments. The records showed the last complaint about the service was in April 2006. Service users and carers spoken with indicated they knew who to speak to if they were unhappy about something. The registered manager is available most days and service users and their carers have ready access to her. Each service user has a key worker in the home and a care manager or assistant from their funding authority they can talk to if they have any concerns. The returned AQAA did not provide any information about complaints or safeguarding referrals having been received or made during the last twelve months. However in the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: past where safeguarding issues have been raised, the service has assisted in the investigation process. Support workers spoken with said they had received safeguarding training. 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. Although the home provides service users with a comfortable, clean and safe living environment, the proposed improvements will make it even better. Evidence: The home is clean, tidy and fresh. There are five single bedrooms and one double one. Two of the bedrooms are on the first floor and are accessed by a flight of stairs. There are no en suite facilities but there is a choice of bathrooms and shower facilities. One of the bathrooms has a fixed ceiling hoist. All bedrooms are connected the call alarm system and have television points. There is a large fitted kitchen that is assessable to the service users staying there and some of them help prepare snacks and drinks. Since the last visit new bedding and bedroom furniture has been acquired for all bedrooms, one of the bathrooms has been refurbished, all televisions replaced and the gardens have been upgraded. Following a recent away day, the home has drawn up a list of further improvements for the home and is in the process of obtaining quotes for the work to be done. The programme includes replacing all the carpets, refurbishing the other bathroom, replacing windows, redecorating all the bedrooms and painting the outside of the home. Bedroom redecorations will reflect feedback received from Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: service users who have indicated they would like more colour. Residents spoken with said they like their rooms and their beds are comfortable. The home has one emergency bed and this is an adjustable type. Residents clothes and the homes laundry are washed in house. There is one washing machine and one dryer for this purpose. Disposable bags are used for washing soiled linen and staff are provided with protective clothing. However on this visit it was identified that there is no hand wash sink. This necessitates support workers accessing hand washing facilities in a nearby toilet. As this may result in door furniture being contaminated, the practice should be reassessed and appropriate action taken to minimise any potential cross infection risks associated with the situation. Although the home was odour free, there was distinct musty smell in the ground floor bathroom near to the front door. The cause of this might be the practice of storing a large in use clinical waste receptacle in the room. This situation is not conducive to a room being used by service users for therapeutic purposes. There is a large rear secluded garden with patio, BBQ and table and chairs for use in the summer. A vegetable patch has recently been introduced and a service user said they like helping in the garden. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support workers morale is high resulting in an enthusiastic workforce that works positively with service users to make their respite stays an enjoyable experience. Evidence: There are always at least two support workers on duty during the day. Nights are covered by two sleep in support workers. The registered manager works at the home Mondays to Fridays and her presence is in addition to the support workers. Catering, laundry and household duties are carried out by support workers with some help from service users. Formal administrative support is provided by a council employee and gardening is provided by a contractor. Support workers were seen carrying out their duties in an unhurried manner. However only one of the four returned survey forms from support workers indicated there are enough staff to meet the individual needs of all the people who use the service. Two respondents indicated there usually are enough staff and the other one indicated there is sometimes enough staff. Recruitment files were not available for inspection purposes because of the registered managers absence. However there have been no new appointments since before the last inspection visit in 2006. Support workers on duty provided us with evidence of Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: their training, supervision and personal development plan. Training subjects included moving and handling, medication, food hygiene, diabetes, infection control, fire, sexual awareness and sexual health, Mental Capacity Act awareness, adult protection and breakaway techniques. Despite this support workers have not been provided with training to care for service users with Autism or Aspergers syndrome. Some of the service users using this service have the condition. It is the providers responsibility to make sure support workers are trained to provide care and support to meet current and future service users needs. Support workers have not attended Deprivation of Liberty Safeguarding training, although the registered manager has. The support workers said they will be attending the training when available. This training is important as this new addition to the Mental Capacity Act law may have implications on current and future service users. To make sure long standing support workers employed at the home are checked periodically as to their appropriateness to continue to work with vulnerable people, the provider requires them to re do their Criminal Record Bureau check every three years. This is good practice. 100 of support workers are now trained to NVQ 2 or equivalent in care, including some having achieved the Learning Disability Award Framework element. This is an excellent achievement. Indeed the provider actively encourages support workers to continue with their learning. This has resulted in one support worker undertaking a social care degree foundation course and another working towards a dementia care qualification. 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. Service users benefit from a well run home. Evidence: The home manager has been the registered manager for the service for almost five years. Since the last visit she has attained the NVQ 4 Management Award. Although the registered manager was not available on the day of the inspection, support workers provided full assistance during our visit. Service users and support workers spoke openly during the visit. The registered manager promotes an open door policy and this is appreciated by service users, support workers and carers. The homes atmosphere is relaxed and informal. Indeed a survey respondent commented that the manager and staff are very open and the home is far friendly now. The home endeavours to put right any short falls which our visits identify. Indeed the two requirements made at the last visit have now been complied with. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The home listens to suggestions and comments from service users and makes changes based on them. This includes redecorating the bedrooms with more colour choices. Our inspection report is kept near to the front door, providing easy access to anybody wishing to read it. The returned AQAA records the home has up to date policies and procedures and the homes equipment is serviced and maintained as recommended by the manufacturer or other regulatory body. The service attempts to seek feedback from service users and or their carers following each stay. A new quality assurance consultation questionnaire has been developed and has recently been sent out to users of the service to obtain their views of the care, support and facilities. The providers representative visits the home regularly and provides a written record of their findings. This may include areas which need to improve. We were told that the home has policies and procedures to reflect the Deprivation of Liberty Safeguards and that there have not been any safeguarding authorisation referrals made. For service users safety, radiators are protected and hot water temperatures thermostatically controlled. The homes fire precautions are serviced and tested by external contractors, as required. However a review of the fire safety book identified that in house weekly tests are not always carried out as required. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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