Care Home: 44 Manorford Avenue

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What the care home does well The service is run by a competent and experienced manager and good systems are in place to ensure people are supported by trained and competent staff. It continues to review its systems to ensure the needs of people who wish to live in the home are fully assessed. Detailed care plans are produced in formats that people can understand and regularly reviewed to ensure their needs and personal preferences are met. People are supported to make their own decisions and to take controlled risks. Risk assessment procedures followed by the service promote and support people to independent lifestyles. The service encourages and supports people to express their views. Thire well being and safety is protected by the service`s policies, procedures and practice. What has improved since the last inspection? The service has addressed all the requirements from the last inspection. This includes the fitting of a new kitchen, replacing the front porch and arranging for the electrical wiring in the home to be safety checked. Care plans and information provided to people living in the home are regularly reviewed and updated. Picture formats are being replaced with photographs of people carrying out tasks and participating in activities. This makes the information more meaningful to people who use this service. What the care home could do better: During this visit we discussed some environmental issues that should be addressed to ensure all facilities meet people`s needs and preferences. People living in the home told us they would like the bathroom refurbished to make it a more pleasant environment for them to relax when bathing. Fencing that provides more security and privacy should be erected at the rear of the grounds. A written procedure for the management of controlled medication should be produced, understood by staff and kept available for reference when required. Regular reviews are carried out and plans implemented, where identified, to improve the service being provided. An annual development plan should be made available to people who live in the home, their relatives and other interested parties. This will ensure they can be fully confident their views are listened to and acted upon. Key inspection report Care homes for adults (18-65 years) Name: Address: 44 Manorford Avenue 44 Manorford Avenue West Bromwich West Midlands B71 3QH     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: Linda Elsaleh     Date: 1 5 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 28 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 28 Information about the care home Name of care home: Address: 44 Manorford Avenue 44 Manorford Avenue West Bromwich West Midlands B71 3QH 01215322749 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: manorfordaveocs@aol.com Optimum Care Services care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 3 Date of last inspection Brief description of the care home 44 Manorford Avenue is a small residential home, registered to care for three people with a learning disability between the age of 18 and 65. The detached four-bedroom property is situated at the end of a crescent within a residential area close to bus routes into West Bromwich town centre. At the front of the home there is a small garden and parking space, to the side and rear are extensive gardens. The ground floor consists of front porch, hallway, lounge, dining room, kitchen, laundry and shower room. Upstairs are the four bedrooms (including staffroom), toilet and bathroom. Care is provided on the basis that it is the home of the people who are receiving a Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 3 Brief description of the care home service and they are involved in all decisions that are made. The size of the home enables staff to provide a high level of support and interaction with each person to promote independence. Frequent use is made of outside agencies including day centres and advocacy services. The manager should be contacted for update fees charged for this service. Care Homes for Adults (18-65 years) Page 5 of 28 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: We looked at the information that we had received about the service since the last inspection. The manager was asked to complete an annual quality assurance assessment (AQAA) about the service and to provide us with dated relevant facts and figures. This was returned us when we asked for it. This unannounced inspection was carried out by one inspector on 15th September 2009. We spoke to the staff and the people who live in the home. A random selection of records kept by the service was seen and we looked at the files for people living in the home and staff employed to provide them with support. This was done as part to help us to assess the outcomes for people receiving a service. The atmosphere in the home was relaxed and friendly. People appeared healthy and well looked after and told us they liked living here and staff were very good. The ppremises were clean, tidy and suitably furnished. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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. People are provided with the information they need to make an informed choice about where to live. Good systems are in place to assess peoples needs and aspirations and includes opportunities to visit and test drive the service. Evidence: A Statement of Purpose and Service User Guide is available in the home. This is regularly reviewed to ensure people are provided with up to date information about the service. Both documents are produced using text, pictures and photographs. The people living at the home told us they like the way the information is presented because it is easy for them to understand. There have been no recent admissions to the home. However, the service has continued to review its assessment and admission procedures to ensure all members of the staff are provided with up to date guidance. These were last reviewed in November 2008. The process for assessing needs and arrangements for introducing people to the home Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: was explained to us by the manager. She stated a copy of assessments and care plans carried out and produced under care management arrangements are sought from relevant agencies as well the service carrying out its own needs assessment. The manager told us prior to a place being agreed careful consideration is given to matching the persons needs with the people already living in the home. An individual planned introduction to the home is also produced for visits and overnight stays. This is so the individual, people already living at the home and the staff can get to know each other. Written confirmation that the service is able to meet the persons needs is provided prior to a placement being agreed. The manager told us the up dated assessment and admission procedures remain untested as there have no new admissions to the service. The service has one vacant place and has received a recent expression of interest. Care Homes for Adults (18-65 years) Page 11 of 28 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. Peoples needs and personal goals are reflected in their care plans. They are encouraged to participate in decisions about their lives, supported to take risks as part of an independent lifestyle and consulted on about all aspects of life within the home. Evidence: The two people living at the home have done so for a number of years. Care plans are developed with the individual. The persons care plan we looked at in detail shows a holistic approach is taken to planning the individuals care. It identifies their strengths, personal preferences, individual goals and the support to be provided. An explanation of the meaning of particular words used by the individual is included in relevant sections of the care plan. This ensures there is effective communication between the person and staff team, reducing the risk of misunderstandings. A full review of the care plan took place with the individual, their relative/representative and significant health and social care professionals in March 2009. Since our last visit the service has continued to improve how care plans are presented. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: For example, standard pictures have been replaced with photographs of the person doing tasks independently and, where required, being supported by staff. One person showed us some of the photographs in their plan and said they like these and thought they were better than pictures. This demonstrates that care plans continue to be working tools used by the individual and the staff team and that a very positive approach to person-centred planning is implemented by the service. People are supported to know their rights and make their own decisions to enable them to lead purposeful and fulfilling lives as independently as possible. The staff team provide individuals with information to enable them to make informed choices and decisions. One person has recently decided they no longer wished to attend a local day centre. The records show her decision is being respected by staff. The manager told us the day centre have stated they will ensure a place is available for her should she wish to return. Both people also receive support from an independent advocate who visits them on a regular basis. We looked at the minutes of house meetings held with the people living in the home. These show people are continually consulted on the day-to-day running of the home and how their views have been acted on. An example of this is the comments made by people living in the home have been instrumental in producing the new communications board on display in the kitchen and how it is used. Peoples files show individual risk assessments are carried out to ensure risks are managed to ensure individuals are fully supported to lead the life they wish and encouraged to maintain their independence as far as possible. During this visit we saw people being supported in different ways by staff in accordance with their care plan and risk assessments. The manager discussed recent concerns raised about one persons health. The service has been pro-active in its consultation with relevant health care professionals and produced monitoring systems and interim risk assessments for the persons well-being and safety whilst these concerns are being investigated. Any limitations on freedom, choice or facilities are agreed with the individual, reflect the persons best interests and detailed in the assessments seen. Care Homes for Adults (18-65 years) Page 13 of 28 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. People who use this service are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet the individuals expectations. Meals are provided to meet their dietary needs and personal preferences. A pleasant environment is provided for people to enjoy mealtimes. Evidence: Information seen during this visit show the service is pro-active in seeking suitable education and vocational services within the local community that may interest people living in the home. As previously stated, one person has recently chosen not to attend their local day centre. We were informed the service has a good relationship with the centre and the persons place will be available should she change her mind. Certificates of achievement are on display in one persons bedroom. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: People choose the tasks and activities they wish to participate in on a daily basis. Photographs and pictures relating to the task or activity are displayed by them on the communication board next to the tasks to be undertaken by staff. No times, with the exception of planned appointments, are displayed so people are able to decide when they wish to do these. Where required, support is provided by staff. This flexible approach to meeting peoples needs and respecting their choices demonstrates the service is person-centred. The records show tasks and activities are closely monitored and reviewed to ensure peoples needs and wishes continue to be met appropriately. The service supports people to maintain contact with relatives and friends. A record of contact such as telephone calls and visits are kept on the individuals file. Visitors are requested to sign the visitors book which is kept in the hall. One person showed us photographs of her family taken during one of their visits to the home. An information pack about the service is provided to visitors and includes a copy of its most recent inspection report, complaints procedure and comment cards. The people living in the home made us very welcome offering us drinks throughout our visit and spoke freely about what they like to do and the support they receive from staff. Mealtimes are viewed as social occasions and usually taken in the dining room. The choices of meals are decided by people on a daily basis. These are displayed on the communications board and people have access to the board should they wish to change their mind. People are provided with advice about health eating options and a wide selection of meals are available to meet their dietary and cultural needs. People are supported to prepare their own meals. One person made us a cup of tea and staff provided the help they required in accordance with her risk assessment. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and require to meet their physical and emotional health needs. Medication is handled on behalf of individuals by staff trained to do so. The practice in the home ensures that people receive their medication as prescribed. However, a procedure needs to be produced for handling controlled medication to ensure these are available to staff when needed and fully protect peoples well being. Evidence: People receive support with their personal and health care needs from a motivated and trained staff team. Recent training has included first aid and caring for people with dementia. The care plans we looked at show people are independent in meeting their own personal care needs and only require prompting from staff. The staff group is all female thereby reflecting the gender of the people who live here. Practice observed during this visit demonstrated the staff team respect peoples right to privacy. People are able to choose their own local GP. Health care plans are detailed and action Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: is identified in conjunction with health action plans completed by the persons GP. They are supported with accessing community-based health care facilities, such as dentist and opticians. Arrangements are made for health care professionals to visit people at home if and when necessary. The service is pro-active in raising any health concerns with the relevant health care professionals. One persons records shows a health assessment is currently being carried out. Whist this is being undertaken the service has arranged for a safety gate to be installed and used during night time hours to reduce the risk of this person falling down the stairs. Medication for both people is managed on their behalf by the service and their consent to this is available on their case files. People told us they are happy this arrangement. All members of the staff team are trained in the safe handling and administration of medication. We looked at the medication administration record (MAR) sheets and found these are well completed and no issues where raised. The current medication cabinet does not meet the storage needs of the service and the manager told us she was expecting this to be replaced shortly. No controlled medication is being held on the premises. However, we were informed that suitable arrangements can be made at short notice to accommodate this. The medication policy, procedures and practice guidance has been revised since our last visit and is accessible to staff at all times. However, this does not include a procedure for managing controlled medication. The manager was informed a written procedure should be made available to and understood by staff to ensure peoples well being is fully protected. Care Homes for Adults (18-65 years) Page 17 of 28 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 are regularly consulted about their care, the day-to-day running of the home and feel their views are listened to and acted upon. Suitable procedures are in place to promote peoples well being and they are protected from abuse by a trained staff team. Evidence: People are encouraged to express their views and concerns in a safe and caring environment. They told us they are happy with the service provided and feel safe and well supported. The complaints procedure is available in text and pictorial formats making it easy for people living at the home to understand. A verbal explanation using the pictorial format is given to ensure people understand its contents. Both people told us staff listen to them and will address any issues they are unhappy about. Information provided to us by the service states no concerns or complaints have been raised with them. None have been received by us, the Care Quality Commission (CQC). As previously stated, visitors to the home are provided with a copy of the services complaint procedure and comment cards in their information packs. Adult protection policies and procedures are available in the home. No safeguarding concerns have been reported to us and none were raised during this visit. The records Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: show staff have received training in adult protection and the Mental Capacity Act, Deprivation of Liberties Safeguards. The manager told us regular discussions take place with staff to ensure they are confident in reporting any issues of concern. Care plans provide staff with information about how to respond to changes in a persons mood that may lead to potentially challenging behaviour. The service has a no restraint policy. The majority of the time there is one member of staff on duty and they are aware of the importance of sharing information with the manager and colleagues to ensure people are provided with support that is consistent, safe and continues to meet their needs. Suitable arrangements are also made to support people to manage their personal allowance. Records are kept of all transactions made on a persons behalf and these are regularly audited to ensure procedures are being appropriately followed. Care Homes for Adults (18-65 years) Page 19 of 28 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 live in a homely, comfortable and safe environment and some recommendations have been made for improving the premises. Good procedures are in place to ensure the home is clean and hygienic. Evidence: The home is situated in a residential estate. The premises include a lounge, dining room, kitchen and shower room on the ground floor. People have unrestricted access to these rooms and to their bedrooms and bathroom located on the first floor. Supervision, where appropriate, is provided in high-risk areas such as the kitchen. People are encouraged to participate in light household duties and are supported by staff to keep their own rooms clean and tidy. Bedrooms are decorated and furnished to meet the individuals taste. Since our last visit the service has carried out some refurbishment and re-decoration. The people living in the home and staff told us they were all involved in plans for replacing the front porch and choice of kitchen. Everyone said they were very pleased with the work. Discussion with the manager showed the home has very limited storage facilities. Unwanted items are being stored in the unused garage. It is advisable for these items to be disposed of and consideration given to providing storage facilities in the garage especially for rarely used items, such as seasonal Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: decorations, seen in the staff bedroom. There is a large rear garden with trees, bushes and patio and lawn areas. This is tended by a gardener employed by the company. It is advisable for suitable fencing to be erected at the rear of the grounds to provide better privacy and security. People live in an environment that meets their specific needs. The service continues to monitor peoples mobility and risk assessments are undertaken where any concerns are raised. For example, grab rails are fitted in the bathroom and shower room so people can maintain their independence when bathing. People we spoke with told us they seldom use the bathroom but would do so if it was more pleasantly decorated. We looked at the bathroom. The fittings are dated and the decor did not provide a warm and relaxing environment in which to bathe. Therefore, the service should consult with people and make plans for the bathroom to be refurbished. This must include a non-slip floor covering to reduce the risk of slips occurring. Toilets for the use of people using the service are appropriately located within the home, are easily accessible and in sufficient numbers. The home is generally clean and tidy, and there have been no outbreaks of infection. There is good access to information about the control of substances hazardous to health and to protective clothing needed for carrying out specific tasks. The service was last visited by the Environmental Health Agency in January 2009. The manager provided evidence to show issues raised in agencys report have already been addressed. The manager is making good progress in introducing systems and providing photographic information to meet the Essential Steps to Safer, Clean Care. Arrangements have been made for staff to attend refresher training in the prevention and control of infection. Care Homes for Adults (18-65 years) Page 21 of 28 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. People are supported by trained staff that know them well and understand their needs. They are protected by the services recruitment and selection policy, procedures and practice. Evidence: People are provided with care and support from a staff team they are familiar with and who are familiar with their needs and individual preferences. There have been no changes within the staff team since before our last visit. The staff team support each other and share their skills and knowledge. The roles and responsibilities of staff are clearly defined and understood by them. The service has a robust recruitment procedure that has the needs of people who use the service at its core. The interview records for the last person employed shows people living at the home are included in this process. There is a copy of the interviewees responses to the questions asked them by a person living in the home. This staff members file shows the service has followed good recruitment practices such obtaining written references and carrying out relevant safety checks. There is an induction pack for newly appointed staff and workbook that meets the Skills for Care specifications. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Records are kept of all training undertaken by staff which includes the National Vocational Qualification (NVQ) Level 2, additional client-centred training and relevant health and safety courses. Certificates of training completed by staff are kept available on the premises. The manager continues to be pro-active in respect of identifying and monitoring the training needs of staff and a plan for future training is produced. One member of staff is currently undertaking NVQ Level 3. Care Homes for Adults (18-65 years) Page 23 of 28 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. People living in the home benefit from a service that is run by an experienced and competent manager. Good opportunities are provided for people to express their views. There are minor improvements required to the services quality assurance system so people living in the home, their relatives and other interested parties can be fully confident their views underpin the services self-monitoring, review and plans to development. Policies and procedures are in place to promote and protect the health and safety of all people in the home. Evidence: The service is run by an experienced and competent manager. She has had to reregister with an accredited training organisation to obtain a recognised management qualification due to her course being cancelled by the previous training organisation. She meets regularly with a representative of the company to discuss issues and the monthly reports produced by the company representative during his unannounced Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: visits to the service. The manager told us the work she has been undertaking to reproduce information in formats suitable for people living in the home has highlighted that she, and the service, would benefit from her being provided with the opportunity to further develop her computer skills. There are various checklists in place to show different aspects of the service are being monitored. These include issues such as environmental standards and the reporting of accidents for which action plans are produced. The manager is advised that a section for her comments would assist her when assessing the services overall performance. An annual development plan should be produced based on the services own evaluation, the views of people living at the home and other interested parties. This would further demonstrate the service is run in the best interests of the people who live here and their views are listened to and acted upon. The home has a comprehensive range of policies and procedures to promote and protect the health and safety of all people in the home. These are updated on a regular basis in consultation with staff and people living in the home. There are clearly written recording of all safety checks carried out and since our last visit and the electrical wiring in the home has had a five year safety check. Health and safety systems are regularly reviewed and updated. The manager ensures all members of the staff team are trained in health and safety matters. Periodic refresher training is also arranged to ensure staff are aware of any new regulations and good practice guidance. People we spoke to were positive about how the home is run and told us the manager is always available to discuss issues and open to exploring new ideas for the service. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 1 20 A written procedure for the management of controlled medication should be produced, made available to and understood by staff to ensure peoples well being is fully protected. The service should ensure suitable fencing is erected at the rear of the grounds to ensure people are provided with better security and privacy. Consideration should be given to providing suitable storage facilities for occasionally used items such as in the garage which is not currently being used. The service should make plans to refurbish and re-decorate the bathroom to ensure this facility meets the needs and preferences of people living in the home. The service should produce an annual development plan based on its own findings and the views of others. This will ensure people can be fully confident their views are listened to and acted upon. 2 24 3 24 4 27 5 39 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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