Care Home: 3a Lansdowne Road

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What the care home does well 3a Lansdowne Road is an established, well managed and well maintained service that continues to provide good quality care and accommodation for people with learning disabilities. The comfortable, relaxed and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team and the open and inclusive management style. Thorough policies and procedures are in place for the admission and ongoing care and support of service users. Effective communication and consultation systems enable service users to be directly involved in developing and reviewing their individual care plans as well as many decision making processes within the home. What has improved since the last inspection? There was one requirement made following the previous inspection, regarding the number of staff undertaking NVQ training. This has evidently been addressed. What the care home could do better: It is important that service users` care plans contain specific guidelines to ensure staff meet their identified support needs in a structured and consistent manner. Care plans should also be regulalry reviewed to reflect the individual`s changing needs. It is recommended that a pictorial menu be developed and displayed and that, as appropriate, service users and staff sit down together for the evening meal. It is essential that poilicies and procedures relating to safeguarding vulnerable adults be regularly reviewed. The complaints preocedure should be reviewed and amended to include timescales and updated contact details for the CQC. Key inspection report Care homes for adults (18-65 years) Name: Address: 3a Lansdowne Road 3a Lansdowne Road Hove East Sussex BN3 1DN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 0 7 0 4 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: 3a Lansdowne Road 3a Lansdowne Road Hove East Sussex BN3 1DN 01273731380 01273731380 sandradaviesftf@tiscali.co.uk www.ftf.org.uk Frances Taylor Foundation Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Davies Type of registration: Number of places registered: care home 9 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 9. 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 3a Lansdowne Rd is registered to provide accommodation and personal care to nine adults with learning disabilities. The home is located in Hove with good access to local transport and amenities. It is a two-storey building that offers a range of communal space and nine single bedrooms. Service users access a range of day, leisure and vocational activities. Further information about the home, including the current range of fees can be found Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Brief description of the care home in the homes Statement of Purpose and Service User Guide, copies of which can be obtained directly from the Provider. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This unannounced inspection took place over five hours in April 2010. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were nine service users living at the home. Care Homes for Adults (18-65 years) Page 6 of 29 The inspection involved a tour of the premises, observation of working practices, examination of the homes records and discussion with two service users, two relatives, three members of staff and the registered manager. Responses from a CQC service users survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. 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. 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. The thorough admission policy and procedures ensure that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users are provided with sufficient relevant information to know that the home is able to meet their individual care and support needs. Evidence: Information is available to prospective and existing service users in various formats. The Statement of Purpose and Service users Guide have been thoughtfully and imaginatively produced to a high standard and are both comprehensive and informative. The Statement of Purpose provides details of the Registered Manager and the number, relevant qualifications and experience of staff working in the home. It also contains details of the overall service provision including: the accommodation, arrangements for service users to engage in social and leisure activities together with any therapeutic techniques, arrangements for dealing with concerns or complaints and Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: the systems for ensuring that service users needs are identified, met and reviewed, in accordance with person centred planning. The Service users Guide is presented in an easy to read format, which incorporates the use of colour pictures and symbols including a photograph of the home. It gives an overview of the philosophy of care, purpose of the service, accommodation and outlines what support and care individuals can expect from the home including support and communication, personal space, individual planning, holidays, day service provision and terms of occupancy. It was noted that both documents are currently being reviewed and updated so as to accurately reflect the current situation within the home. The manager confirmed that since the previous inspection there has only been one person admitted to the home. Any new prospective service user is assessed by the home manager who also emphasised the importance of compatibility with existing service users. She cconfirmed that as part of the admission process, prospective service users and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and service users. New service users evidently undergo a flexible trial period at the home, during which time their suitability and compatibility are assessed and it is established whether their identified care and support needs are able to be met. A full review is held at the end of this period, involving the service user, their relative or representative, their Care Manager and the Home Manager. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive, person centred support plans must be reviewed and amended to ensure that staff meet the assessed and changing care and support needs of service users in a structured and consistent manner. Systems for consultation and participation are effective and service users are treated with respect and encouraged and enabled, as far as practicable, to make decisions about their day to day living. Evidence: Since the last inspection,person centred care plans have been developed for each service user, clearly linked to the individuals assessed needs. The plan, including a separate document Me and my life, is formulated by the manager and evidently with the direct involvement of the service user or family member, as appropriate. At the front of each plan is a personal profile incorporating general background information and detailing the individuals needs and preferences, likes and dislikes and identified personal goals. It is evidently intended that this plan is service user driven. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Each individual has a weekly schedule that addresses their social, cultural and emotional needs and provides opportunities to gain new skills and develop interests and friendships. This schedule is reviewed regularly and is evidently flexible to meet the individuals changing interests and preferences or as new opportunities arise. Staff spoken with during the inspection emphasised the importance of developing close working relationships with individual service users and being aware of often subtle changes in their mood or condition. Despite the limited communication of some service users, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting service users in a professional, sensitive and respectful manner. In care plans that were examined it was noted that there was little strucure or guidance regarding how staff meet an individuals assessed needs. The manager acknowledged this shortfall. She confirmed that developing the revised Person Centred Plans was still work in progress and the essential 24 hour support summarywould be a priority for all service users. Although the manager confirmed that plans are reviewed on a regular basis, there was no documentary evidence to support this. As discussed, it is important that plans are regularly reviewed and updated to ensure that the individuals changing care and support needs are identified and continue to be met in a structured and consistent manner. Service users are evidently consulted regarding many aspects of their day to day living, including menu planning and choosing both individual and collective social, recreational and leisure activities. Service users are encouraged and enabled as far as practicable to participate in all aspects of life in the home. They are supported to help with meal preparation, undertake household tasks, make their own hot and cold drinks and go shopping. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish and links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: The recreational and leisure interests of service users are identified and recorded in their individual support plan and they continue to be enabled to access activities and facilities, reflecting their individual needs, preferences and abilities. Individual support plans examined and comments from staff and service users confirmed that activities include craftwork, music sessions, bowling and attending local colleges and other day services. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Service users are evidently consulted with and supported to choose activities that they wish to participate in. This is discussed during regular service users meetings. Community participation remains a focus in the home and service users are evidently encouraged and supported to visit the cinema, swimming pool, theatre, local shops and other amenities. One service user who has recently moved into 3a Lansdowne Road is evidently blossomming in his new environment. Hes out almost every evening, doing something or other - but hes got a lot of years to make up! The manager confirmed that, where appropriate, service users continue to be supported by staff to maintain regular contact with their families and friends. However it is evident that such contact is variable and not all service users have family members. Visitors are always made to feel welcome at the home at anytime. Details of friends, relatives and people that are important to the person are clearly documented within individual support plans, Me and my life. All meals within the home are prepared by care staff and, where appropriate, service users are supported and regularly involved in meal preparation. The menus are varied and balanced, reflecting individuals identified choices and preferences. Following discussions with staff and service users, it is recommended that a pictorial menu be developed, possibly using photographs of meals. As discussed with the manager, it is also recommended, as good practice, that staff and service users sit and enjoy the evening meal together. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual support needs. service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: In accordance with their support plan, service users are enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, staff were observed interacting with service users in a professional and respectful manner. Documentary evidence, including the recently implemented individual Health Action Plans was in place to demonstrate that the health and emotional care needs of service users are continuing to be met within the home. However, as previously documented, there is currently a lack of specific guidelines for staff, to ensure that support is provided in a structured and consistent manner and in a way that the individual prefers. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: All service users are registered with local GPs and have access to other health care professionals, including psychologist, audiologist, community nurses, speech and language therapists, physiotherapists and dentists and a qualified reflexologist, as required. In care plans that were examined it was noted that service users are supported to attend all healthcare appointments as necessary and all such appointments with, or visits by, health care professionals are recorded. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The home uses a monitored dosage system (MDS) for prescribed medicines and a local pharmacist continues to carry out quarterly monitoring visit. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. Following risk assessments, it is evident that two service users currently maintain responsibilty for self administering their own medication. It was noted that, for this purpose, each service user has a lockable facility in their bedroom. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. Service users best interests are safeguarded through relevant staff training and robust policies and procedures. However such poilcies should be regularly reviewed. Evidence: A complaints procedure is in place for the benefit of service users, their relatives and other visitors to the home. It is available in written and picture format and gives clear guidance with regards to how a complaint can be made. However, as discussed with the manager, it is ecommended that the complaints procedure be reviewed and expanded to include timescales and the updated contact details for the CQC. All complaints are recorded and include actions taken and outcomes achieved. It was noted that there have been no complaints received, or Safeguarding alerts made, by the home since the previous inspection. Service users meetings are evidently held on a regular basis and provide an opportunity for any concerns to be raised, discussed and hopefully addressed before they become complaints. Members of staff and service users relatives, spoken with as part of the inspection Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: process, confirmed that they would have no hesitation in speaking to the manager, or deputy manager, or making a complaint if necessary and each person was confident that they would be listened to. The organisation has produced detailed policies and procedures relating to abuse, including a whistle blowing policy. The manager confirmed that the majoriy of staff have undertaken specific training, in accordance with the multi agency guidelines for the safeguarding of vulnerable adults. Staff who have yet to receive this training are evidently booked on a course at the end of April. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Of some concern was the fact that the poicy regarding service users rights, protection, concerns and complaints had evidently not been reviewed since June 2006. This was discussed with the manager who is to liaise with her head office to address this issue as a matter of priority. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and remains suitable for its stated purpose. Reidents benefit from spacious accommodation that is comfortable, well maintained and decorated to a satisfactory standard. Evidence: It is evident that the physical environment of the home is generally well maintained and the decor and good quality furniture and furnishings provide a comfortable, pleasant and homely environment for service users. Individuality and independence is promoted within the home, as far as is practicable. This was evident from the personalising of service users rooms, which clearly reflects individual tastes, preferences and interests. Members of staff confirmed that service users are involved in choosing their own furniture, accessories and colour scheme. Four bedrooms have an ensuite facility providing either a bath or shower. For other service users there is a communial bathroom on the same floor. Plans are evidently in place to convert the existing shower room on the first floor into a more user friendly wet room. Two lounges provide adequate space for choice of seating and either TV or listening to Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: music, in addition to service users own individual rooms. Where adaptations are required these are installed and maintaince contracts are in place to ensure equipment works correctly. To reflect the reduced mobility of certain service users, two entances now have ramps and additional hand rails have been fitted. Infection control procedures are in place and closely adhered to and levels of cleanliness and hygiene are generally high throughout. However, as discussed with the manager, it is recommended that specific infection control procedures relating to laundry be reviewed and consideration be given to providing a sluice facility, to address the changing care needs of the increasingly ageing client group. All fire doors are fireproof and have been fitted with automatic electronic closures. Fire systems within the home are evidently checked on a regular basis. A programme of routine maintenance, renewal and redecoration is in place. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is always sufficient trained and competent staff on duty to meet the assessed, and often complex care and support needs of the service users. Service users are safeguarded by satisfactory staff recruitment policies, procedures and documentation. Evidence: The stable and dedicated staff team remains clearly able to meet the assessed, individual and collective needs of service users within the home. Through discussion with members of staff and according to duty rotas viewed, it is evident that there is always sufficient staff on duty to meet service users complex care and support needs and enable them to participate in their chosen activities. All new employees are provided with a comprehensive job description and staff spoken with demonstrated a sound understanding of their individual role and responsibilities. All new staff receive comprehensive induction and foundation training, the Common Induction Standard, which is compatible with Skills for Care and is flexible and compatible with an individuals level of relevant experience. Mandatory training is ongoing and is recorded in individual staff files. This was confirmed through discussions with staff and supported by training records Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: examined: There is always so much training and refresher training available. Ive done loads since Ive been here. The organisation is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of service users. Individual staff files that were examined were found to contain all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Each staff member undertakes a full induction programme, which includes mandatory training and during this time they will work with support on their induction standards. The Frances Taylor Foundation is evidently an accreditted provider for NVQ training. Of 11 contracted staff, eight currently either have or are working towards, NVQ Level 2 or 3 or equivelant. Staff meetings are held on a regular basis and are appropriately recorded. Staff are encouraged to contribute to the open agenda. Communication within the home is effective and morale is evidently good. There is a good atmosphere here and everyone seems happy in their work. In accordance with organisational policy, formal supervision is provided for all care staff on a regular basis. Supervision contracts are agreed and signed in advance and stored securely within the office. This was evidenced by supervision records examined and through discussions with staff, spoken with during the inspection, who acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager. It was evident, from direct observation and through discussions with members of staff that the managers also operates an open door policy, with staff feeling confident and able to discuss any issues at any time. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well run. service users benefit from a competent and experienced management team and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by effective quality monitoring systems. Evidence: The registered manager is competent and expereienced, having been in her current post for 15 years. She has achieved NVQ level 4 and the Registered Managers Award (RMA) and is clearly held in high regard by many within the home. Through discussions with service users relatives and members of staff, it is evident that the manager demonstrates a clear sense of leadership and direction and the home is very well managed. She is evidently motivated, positive and approachable and continues to create an open and inclusive atmosphere within the home. Shes a very good manager and very supportive. The home operates effective quality monitoring systems, including regular satisfaction Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: questionnaires for both service users and their relatives. The health, safety and welfare of service users and staff evidently remain of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 6 15 It is required that all care plans including risk asessments be developed with the involvement of the individual resident and regularly reviewed to reflect changing needs and circumstances. There is no evidence of how often and by whom care plans including risk assessments are reviewed. It is required that service users be protected from potential abuse by appropriate staff training and relevant and up to date policies and procedures, relating to safeguarding vulnerable adults. Service users are protected by robust policies and procedures for responding to suspicion or evidence of abuse. 30/06/2010 2 23 13 31/05/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 1 6 It is recommended that all support plans contain structured guidance for staff, to ensure that an individuals assessed needs are met in a consistent manner. It is recommended that a pictorial menu be developed and, as good practice, that staff and service users sit and enjoy the evening meal together. It is recommended that the complaints procedure be reviewed and amended to include timescales and updated contact details for the CQC. It is recommended that specific infection control procedures relating to the laundry be reviewed and that consideration be given to providing a sluice facility, to address the changing care needs of the increasingly ageing client group. 2 17 3 22 4 30 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. 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