Care Home: 40 Fir Tree Road

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What the care home does well Prospective residents are provided with information that will enable them to make a choice about living at the home. The needs of prospective residents would be assessed before they are offered a placement at the home. Residents can make decisions with the support of staff. The staff on duty during the site visit were interacting appropriately with the residents they appeared to be friendly and supported the residents as and when required. One member of staff stated that the majority of the staff group have worked at the home for a long time and are able to know, through signs and body language what the residents want or when they are not feeling well. There is good documentary evidence that the residents are supported to choose their bedroom furnishings and the decor for their bedrooms. The people who live at the service are encouraged by staff to participate in a range of wide range of appropriate activities. Staff promote contact with family, friends and the local community. A balanced diet is provided to residents. There is a complaints system that enables residents and their families to raise concerns. What has improved since the last inspection? The organisation has appointed a new manager to undertake the day-to-day running of the home and a new ethos has been introduced to 40 Fir Tree Road. After a series of safeguarding event involving staff and residents an increased awareness has been adopted by the home in order to offer a new awareness of safeguarding and whistle blowing within 40 Fir Tree Road. The people who live in the home are now supported with their personal care needs in a way which promotes their dignity or wellbeing. The home has increased and reviewed the levels of supervision offered to the residents. Risks management processes have been identified to ensure that potential risks to protect people from harm are reviewed. As a result of the two resident vacancies there sufficient numbers of staff on duty to ensure there is time to engage in social interaction with people and promote choice of activity for people who live in the home . There is in addition now sufficient staff available to supervise people adequately and meet their social and emotional needs. The Organisation has introduced measures to ensure that the manager receives adequate support and resources to manage the home effectively. What the care home could do better: The responsible individual should endeavour to undertake regular environmental risk assessment to ensure the continual safety of the residents and staff. All staff files should be audited to ensure that an gap in the person employment histories are identified and documented appropriately. The responsible individual must ensure that prior to the residential vacancies being filled, a full staff review must be undertaken to ensure that there will be sufficient and effective staff on duty at all time to meet the needs of all residents. Key inspection report Care homes for adults (18-65 years) Name: Address: 40 Fir Tree Road Banstead Surrey SM7 1NG     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: Kenneth Dunn     Date: 1 6 0 9 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: 40 Fir Tree Road Banstead Surrey SM7 1NG 01737379242 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): firtreeroad@c-i-c.co.uk www.c-i-c.co.uk Community Integrated Care The registered provider is responsible for running the service care home 8 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. 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 40 Fir Tree Road is a care home providing personal care and support for eight adults with learning disabilities of mixed gender. Some of the people using services may be over 65 years of age and/or may have physical disabilities as secondary conditions. The building is a large, detached, two - storey house situated in a residential area, on a busy main road. A parade of local shops is within walking distance of the home. All community amenities are within close proximity in Banstead village and in nearby towns. All bedrooms are single occupancy and arranged on the ground and first floor, accessible by passenger lift. One bedroom has an en suite Care Homes for Adults (18-65 years) Page 4 of 29 2 6 0 8 2 0 0 8 8 Over 65 0 Brief description of the care home bathroom. Bathrooms and toilets are located on both floors and have suitable adaptations and aids to meet the specialist needs of the people accommodated. Communal areas are on the ground floor. These include a large combined lounge/dining room, a separate small lounge, a spacious fitted kitchen, separate utility room and an office. Car parking facilities are at the front of the home and to the rear is an attractive, enclosed garden. The building is wheelchair accessible and service provision includes a wheelchair accessible vehicle. Fee charges range from 1192.91 to 1365.60 pounds sterling per week. 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: This unannounced site visit was part of a key inspection. The last key inspection was carried out 26th August 2008. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment ( AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA ,which gave us all the information we asked for. Reference is made to this assessment throughout this report. We received six feedback from representatives of the people that live in the service, members of staff and three from external health and social care professionals. During this visit we met with four people who live in the service . We met with Care Homes for Adults (18-65 years) Page 6 of 29 members of staff. During this visit we observed the lunch time meal preparation,activities, looked at staff recruitment, and training records, care plans, risk assessments, menus, quality assurance systems, medication administration policies, health and safety records and policies and procedures were sampled. We also reviewed other information that we have received since our previous inspection including notifications. 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: The responsible individual should endeavour to undertake regular environmental risk assessment to ensure the continual safety of the residents and staff. All staff files should be audited to ensure that an gap in the person employment Care Homes for Adults (18-65 years) Page 8 of 29 histories are identified and documented appropriately. The responsible individual must ensure that prior to the residential vacancies being filled, a full staff review must be undertaken to ensure that there will be sufficient and effective staff on duty at all time to meet the needs of all residents. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering the service as a place to stay are provided with information that they would require to know to ensure that their needs would be met. A full assessment of the individuals needs will be undertaken prior to admission. Evidence: The service has a, statement of purpose and service user guide both documents provide detailed information about the service and what it is able to offer. The manager stated that this information is discussed with prospective residents and their families or Representatives to ensure that there is a understanding of the home and the service it provides. This document has been incorporated with pictures to make it accessible for people. The home has a comprehensive pre admission and assessment process. After receiving initial enquiries, information is gained from the person, their representative, previous placement, care manager and any relevant health care professionals. People seeking to ,move into the home are invited to visit the home to meet the other residents and staff in the hope to introduce the home in an appropriate manor. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Information supplied in the AQAA states that the service has undertaken a detailed review of their referral and assessment procedure, introducing a more thorough risk assessment. A file sampled for a person living in the home confirmed that risk assessments had been completed prior to admission ensuring peoples welfare and safety. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has developed a plan of care that the resident has been involved in developing. Residents needs and goals are met and they are able make decisions about their life. Residents are able to take risks as part of an independent lifestyle. Evidence: Three care plans were viewed as part of the case tracking process. Care plans included information in regard to the physical, personal, health care needs, social behaviour, religious, communication and activities. Clear instructions are recorded in regard to attending to the personal care needs of residents. Care plans had been signed by staff to indicate that they have read and understood their role in respect to the care offered to the individual concerned. The manager stated that the residents were not able to sign that they have participated in the process. During discussions with staff it was evident that they had read the care plans and were attending to the needs as recorded. The manager and staff told us Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: that care plans will be reviewed every six months or more regularly if there are any changes to the needs of the resident. There was documented evidence on file that annual reviews with residents care managers have been arranged or undertaken. Daily notes are maintained for each resident they contained relevant information to provided a clear picture of the individual. Staff continue to offer choices to residents, and use various methods to communicate with them, which includes using key words and pictures and makaton signing. These enable some residents to convey their choices to staff. One member of staff stated that she has worked at the home for many years and know the residents well. Staff told us that they can tell by residents body language and facial expressions if they are not happy with a particular choice. Risk assessments had been produced for all residents living at the home, including highlighted risk associated with the building work being carried out by the home. This was in compliance with a requirement made in the inspection report of the 26th 08 2008 The Annual Quality Assurance Assessment (AQAA) informs that residents are encouraged to make choices. Up to date care plans and risk assessments are in place. The AQAA also informs, under plans for improvement in the next twelve months, that more risk assessments would be produced. Evidence found during the site visit supported the information provided in the AQAA. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged by staff to participate in a range of activities. Staff promote contact with family, friends and the local community. A balanced diet is provided to residents. Evidence: At the time of this site visit no resident was undertaking paid employment. Residents continue to attend day centres where they take part in a variety of activities appropreate to their indavidual needs and asperations. On the day of the site visit a reflexologist was present at the home. The reflexologist attend the home every week and provide relaxation theraphy to the residents. Staff were observed to be friendly and interacted well with the residents who were at home on the day of the site visit. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: During discussions staff told us that there are no restrictions on visitors to the home. On the day of the site visit the only visitor was the reflexologist, however a review of the visitors book evidenced that the home recives many visitors. Feedback from family member stated that there were no restrictions to visiting times, and that staff support residents to maintain contact with their families. This was confirmed during discussions with the manager and staff during this site visit. Residents have the opportunity to meet other people at the day centres and when going out into the community. Due to their complex levels of understanding and communication difficulties it was not possible to have discussions with the residents that were at home at the time of the site visit. Residents were being supported as and when required by staff who are able to understand the complex needs of individual residents living at the home. The menu was viewed during the site visit. Meals prepared include meat, fish, pasta, fresh and frozen vegetables. A bowl of fruit was available for all residents in the communal room. The training matrix provided by the manager evidenced that all staff had received training in regard to food hygiene and handling. The AQAA informs that weekly activities take place and they ensure that they maintain good family links with all relatives. Evidence found during the site visit supported the information provided in the AQAA. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care of people using the service is based on their individual needs. Accurate health care records are maintained and up to date. The principles of respect, dignity and privacy are put into practice. Evidence: During discussions with the manager and staff we were told that residents require support with their personal care. This was recorded in the care plans sampled, included the type of support required, and what the resident could for themselves. Personal care is attended to in the privacy of bedrooms and the bathroom. A member of staff stated that there is always a female member of staff on duty to attend to the personal care needs of the female residents. Staff continue to knock on bedroom doors and call residents by their preferred names. Residents were observed to have access to all communal parts of the home. All residents now have Health Action Plans in place, they included information in regard to appointments with the General Practioner (GP), dentist, optician, psychologist and chiropodist. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: The home follows the organisations Medication Policy and Procedure. The manager told us that no current resident is taking a controlled drug or is self medicating. The home continues to obtain medication in the original packaging form the local pharmacist, and the Medication Administration Record sheets (MARs) for the recording of medication. Medication is appropriately stored in a lockable medication cabinet. Medication held balanced with the medication records. The home maintains a record of medication received and returned to the pharmacy. Two members of staff sign the MAR sheets to minimise the risk of errors. During discussions the manager and staff told us that only staff who have received the appropriate training administer medication. Information received by the commission from two health care professionals inform that staff at the home always seek advice and act upon it to manage and improve individuals health care needs. The AQAA informs that residents are supported with their personal care and this care is carried out in private with dignity and respect. Residents have Health Care Action plans and the medication is audited on a weekly basis. Evidence found during the site visit supported the information provided in the AQAA. 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. People who use the service have access to a satisfactory complaints system that enables residents and their families to raise concerns. Residents should be protected from abuse through the homes provision of staff training and policies and procedures in regard to Safeguarding Adults. Evidence: The Care Quality Commission has been notified of four safeguarding adult referrals and the resulting investigations undertaken be Surrey County Councils safeguarding team. As a result of the referrals and the conclusions of the safeguarding meetings the home has had a staff review and staff members have been disciplined and dismissed. A greater awareness of safeguarding and whistle blowing was demonstrated by the staff on duty during the site visit and individual discussion held with the staff during the day. One member of staff stated that as a direct consequence of the safeguarding event over the last 12 months the staff team are very aware of there roles and responsibilities in protecting the residents. The training matrix provided by the manager evidenced that staff, including the manager, had attending training in regard to Safeguarding Adults. The staff on duty during the site visit were knowledgeable about abuse and have developed a good understanding of the procedures to be followed, one stated that this was a direct result of being a witness and being involved in the recent safeguarding meetings. The home continues to follow the organisations Policy and Procedure in regard to Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: complaints, which was last reviewed in July 2008. This document included the timescales for responding to complainants and the contact details from the Commission For Social Care Inspection. The manager told us that they have not received a complaint since the last inspection. This was confirmed by viewing the complaints book. During discussions staff told us that they can tell by the body language, moods and behaviour if residents are unhappy. The home follows the organisations Safeguarding Policy and Procedure that was last reviewed in May 2008. A copy of the Surrey Safeguarding Procedures are kept at the home for staff to read. The AQAA informs that there is a A clear complaints procedure is displayed in the home and a flow chart, to ensure stages and time scales are followed. Service users have a pictorial copy on their file that has been discussed with them and there is access to an audio version. The organisation has a Whistle blowing policy which is discussed periodically at team meetings and staff supervision. in addition they have a Safe Guarding of Vulnerable Adults procedure in place and all staff receive training in this. All staff have attended sova training and are aware of what action to take in the event of suspected abuse. Evidence found during the site visit supported the information provided in the AQAA. 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. People who use the service live in a safe, well maintained and comfortable environment. Evidence: A part tour of the premises was undertaken as part of this site visit, all communal areas and two vacant bedrooms were viewed and after gaining the permission from one resident an occupied bedroom was also seen. The home is a large detached house that has been extended to provide accommodation to eight residents who have a both learning and physical disability, and is wheelchair accessible. The accommodation includes eight single bedrooms. The manager stated that the residents are supported to choose their bedroom furnishings and the decor for their bedrooms. The one occupied bedroom seen was appropriately furnished and contained the residents personal belongings that included family photographs, television. It was however noted that the wall mounted television was very close to the curtains in the occupied bedroom and it was agreed that an environment risk assessment would be completed to ensure that this bedroom was safe. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: There is a communal lounge dining room that is suitably furnished to meet the needs of the residents. It was again noted that there was quantity of electrical cables stretched across the pelmet of the curtains in the sitting room. This was discussed with the manager who agreed to conduct a risk assessment regarding the safety of the wiring. The rest of the accommodation included a conservatory, laundry room, kitchen, communal toilets, bathrooms and shower room. Communal areas had liquid soap and paper towels. Staff were observed to be wearing protective clothing when attending to personal care needs. There is a fully accessible garden with patio that residents can use when they want to. The garden was appropriately maintained to provide a relaxing area for the residents to enjoy. On the day of the site visit the home was clean, tidy and free from offensive odours. The AQAA informs that the environment is clean, safe and well maintained. 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. The arrangements for staffing at the time of the site visit are satisfactory, ensuring staff have the qualities and training to meet the needs of the reduced resident numbers. People who use the service should be protected by the organisations recruitment policy and procedures. Evidence: The duty rota was viewed during the site visit, this provided evidence that there are sufficient members of staff on duty to meet the needs of the residents. A requirement was made in the previous inspection report requiring the home to ensure that sufficient staff are on duty at all times to offer appropriate care to the residents. The manager stated that there has not been a staffing review as the service had two resident vacancies, which results in the the existing staff figures effectively meeting the needs of the remaining individuals living in the home. It was discussed with the manager that the staffing figures should be reviewed prior to the vacancies being filled to ensure that all the residents needs will be effectively met. The home follows the Organisation recruitment policy and procedure. Four recruitment files were sampled during the site visit, including one from a member of staff recently employed to work at the home. Each file included an application form, two references, proof of identification, health screening and records of notes taken during the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: interview. Records of Criminal Record Bureau check reference numbers were maintained for all staff. Two files however had gaps in the staffs previous employment histories. This was discussed with the manager who stated that an audit of all staff files would be undertaken to ensure that there are no further gaps and where they are found they would be discussed with the member of staff and documented on their file. The manager told us that new staff attend induction training that is in line with the Skills For Care Council Induction standards, and the Learning Disability Qualification (LDQ). This was evidenced during the site visit and confirmed during discussion with the new member of staff concerned. Staff have individual training and development files where training certificates are maintained. During discussions staff members stated that they receive good training at the home, and their training records are updated to make sure they are up to date in regard to attending to the assessed needs of the residents. At the time of the site visit the six of the full time staff team of ten had obtained an NVQ level 2 in care. The manager has commenced providing formal one to one recorded supervision for each member of staff. Records of these were evidenced during the site visit. During discussions staff told us that they receive regular supervision sessions. The AQAA informs that all staff receive regular support session which monitor the effectiveness of training raise or identify any training or performance needs. Evidence found during the site visit supported the information provided in the AQAA. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation has appointed an experienced and qualified person to conduct the day-to-day management of the home. The home is now run in a way that ensure the home is run in the best interests of the people who use the service. Evidence: The organisation who owns and operates 40 Fir Tree Road has appointed a new person to manage the day-to-day running of the home this person has been in post since the 5th of December 2008. The manager stated that she has applied to the commission to become the registered manager and is awaiting a date for the process of registration to continue. The AQAA states that The home manager has 22 years experience in the field of supporting people with learning disabilities. She has 16 years experience managing services for people with learning disabilities. She has Registered General Nurse (RGN) and Registered Mental Health Nurse (RMHN). qualification and is planning to commence NVQ in Leadership and management very soon. The manager has complied with the requirements made at the last key inspection, however, she must now sustain this and ensure that good practise is embedded into the ethos of the care home. The manager told us that she has monthly meetings with residents, staff Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and Representatives of the residents. Monthly Regulation 26 visits are being undertaken at the home, and copies of these reports were available at the home. The manager stated that CIC has a comprehensive quality monitoring tools in place to enable her to review the service being provided at the home. The training matrix provided evidence that mandatory training had been undertaken by staff that included fire, manual handling and food hygiene and handling. The training matrix also evidence that First Aid training had been provided to care staff and Infection Control. The manager stated that the home has an up to date risk assessments in regard to the Control Of Substances Hazardous to Health (COSHH). The following health and safety records were sampled during the site visit of September 2008. Fire risk assessments, servicing of the fire extinguishers. The gas safety certificate, and the Environmental Health Officer. The AQAA informs that the home adheres to the corporate policies and procedures regarding health and safety the homes local policies are reviewed regularly and all staff are aware of their content. 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 1 34 19 A full and detailed history of all staff must be recorded in all confidential staff files. To ensure that the residents are safeguarded from harm or abuse. 23/10/2009 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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