Care Home: 46 Derby Road

What the care home does well The home is able to provide a clean homely and friendly environment for people to live in. People using the service are able to personalise the home and take part in ordinary domestic activities. Plans of care include assessments of risk for activities in the home and the community. Staff promote individuals right to take responsible risks on a daily basis. Individuals if able to, access work and leisure pursuits of their choosing, and are able to develop relationships with other people from the local community. The manager and staff hold strong values around the support and care needs within the home to provide a good quality service. The staff have open and positive relationships with people who use the service. The development of good relationships and the knowledge of individuals needs, has enabled the staff team to work closely with the people who use the service, The home has a staff group that is balanced and diverse to enable individuals a choice of male or female staff, and the staff team are of varying ages. What has improved since the last inspection? The choice of social opportunities have become wider range and include, train rides, boating trips with support, accessing more football matches. All people using the service choose their own individual holidays. Staff training has improved and more outside training is being accessed. Decoration has taken place in various areas of the house, dining room, office. New washing machines and dryers have been purchased. A new central heating system has been installed. What the care home could do better: Paperwork needs to be updated to include the Care Quality Commission. Key inspection report Care homes for adults (18-65 years) Name: Address: 46 Derby Road 46 Derby Road, Burton On Trent Staffordshire DE14 1RP     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: Kathryn Marks     Date: 1 8 0 5 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: 46 Derby Road 46 Derby Road, Burton On Trent Staffordshire DE14 1RP 01283536290 01283516341 46derbyroad@robinia.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Robinia Care Homes (2) Limited 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 46 Derby Road is a large period semi-detached property situated in a residential part of Burton on Trent and does not present as a care setting. The home is within easy walking distances of local amenities and with good links to public transport. The house is set back from the main road and has parking spaces at the rear, which is accessed by drive to the side of the house. The building is on two floors and comprises; three bedrooms (1 en-suite shower), an office, sleeping in room, lounge, dining/activity room, kitchen, one bathroom with shower, and one separate toilet, laundry room and storage. The home is not suitable for any person with a severe physical disability. There is a garden at the front and rear, and a useful patio area at the rear. The home is registered to provide accommodation for three individuals with a learning disability. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 3 Brief description of the care home The home promotes independence and the development of social skills and individuals are able to take an active role in the daily management of the home. The home provides a minimum of two staff on duty at all times to meet the complex needs of individuals resident in the home. Peoples contracts are negociated individually and vary according to need. Readers of this report may wish to contact the service for up to date information regarding fees. 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: 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 inspection was carried out on Monday 18th May 2009 by one inspector who used the National Minimum Standards for care Homes for Younger Adults, aged 18 to 65 as the basis for the inspection. The last Key Inspection on this service was completed on 17/05/2007 On arrival for this inspection there were three staff on duty and three people using the service. The care Manager provided written information regarding staffing, staff training, menu and dietary provision, that was observed to be in place at the home. On arrival at 46 Derby Road, one person had gone to college, and the other two people were deciding what they were going to do. Care Homes for Adults (18-65 years) Page 6 of 28 Arrangements for the day were discussed with us, and to avoid disruption to people using the service, the Care Manager came on duty to enable people to continue with their plans. We spoke to the three people using the service, and with their permission looked at and discussed their care plans. We discussed food with the people living here, all had their own favourite foods. One person told us he was cooking tea today with staff. We also looked at the Annual Quality Assurance Assessment (AQAA) this is a self assessment tool, and had been very well completed with a lot of detail, and sent to us prior to the key Inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to move into the home receive the information they require and they are assessed so that they can be assured the home can meet their needs. Evidence: The AQAA we received prior to the inspection told us that The service would carry out an assessment with the person and current placement staff, and the persons families and outside agencies, this assessment would be carried out with respect and dignity. The peoples families and outside agencies, would be shown the services statement of purpose which is in a person centred and service user friendly format, which contains photos of the people who live in the home, the home and staffing. It would be arranged for all people to meet and view the home, this would be done with sensitivity to each individuals needs. A service user guide is provided that is written using symbols and or format suitable for each individual. Before admission the AQAA told us the service assess whether the needs of the person can be met and a contract in a format to suit the individual is given to them. We saw that the service users guide provided clear accessible information for people Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: in a pictorial format. People we talked to were able to understand the pictures and discuss them with staff. The service carries out detailed assessments prior to admission, with people making a number of visits to the service prior to moving into the home. All people involved in the care of the person are involved in the assessment. We saw assessments on peoples care records, reviews of assessments are documented. Care plans were compiled and agreed with the person using the service following assessment, and a key worker allocated. This means people could be assured that the service and staff could meet their needs. We talked to people using the service who told us they were happy, and liked living at Derby Road. We observed that people had very positive relationships with the staff on duty, and that the staff, treated people with respect and consideration. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are involved in decisions about their lives, and play an active role where able to do so in planning the care and support they need. Evidence: The AQAA we received prior to the inspection told us that The service are promoting independence, offering support as much as is needed to lead a fullfilling lifestyle. The people using the service have the right to make a decision about their life and what they want to achieve. The service have support plans which are developed with the person and these outline personal information, religion, likes and dislikes and are person centred. Support plans are developed in a format which is understood by the person using the service. The plan includes photos of the persons choice and is developed to each individual. Photos include evidence of activities undertaken. All plans are reviewed regularly, key workers review and work one to one support system. The support plan consists of what support the person requires and how best to support. Personal information, families, outside agencies and goals for the future, risk assessments and support plans which are cross referenced with the risk Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: assessment. People have access to all information which is held about them within the home. The service works with peoples families and outside agencies to meet the needs of the person. The service holds regular meetings in which they discuss what is happening with the service, any health and safety issues and changes they would like to make within the home or the service they receive. All people have reviews that are documented. We saw that all three people have individual plans of care and various support plans that they were aware of, and gave us permission to look at. Care plans are reviewed on a regular basis and updated to meet changing needs. We were told that each person is consulted on their care plan, and is encouraged to take part in reviewing them. We saw one staff reading and discussing a support plan with the person using the service, who agreed and signed the plan. The personal care plan covers health assessments, medication, and risk assessments. The Care Plan identifies procedures for dealing with challenging behaviour, staff are trained to deal with this. We saw staff encouraging people to make decisions about daily routine, what they would like to eat, if they wanted to go out. Staff accompanied one person to go for a walk and another to go shopping. One person talked to us about their social worker and how supportive they were. Individuals are supported to take risks, we saw risk assessments in place for people using the service. The Care Manager and staff had a good awareness of Health and Safety. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are given the opportunity to enjoy fulfilling lives and relationships with others. Evidence: The AQAA we received prior to the inspection told us that People using the service are supported to live as independent a lifestyle as possible. Individuals are supported to make decisions regarding the support they wish to receive, and how with a minimal of risk, to suit each individuals lifestyle. All are supported in acheiving their goals both in house and in the community. All people have different routines to suit their needs and individuality, all have a planner which is person centred and is completed each week with staff supporting. All people are are involved in all aspects of their lives, and decisions they make or wish to make are supported. The service promote social inclusion in all aspects, people attend college and one person is in paid employment in which he received full support and he now completes independently. People help with Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: the house chores, shopping, they choose the meals they want to eat, each week people do cooking and preparation of meals. They do fresh bread, and soup with support. All meals are healthy with fresh veg and fruit which is available at all times. Basic food preparation is completed independently with a minimum of support. We saw on arrival at the home that there are three people living at Derby Road. We talked to one person who told us he had a paper round delivering a local newspaper, this is paid employment. He told us staff used to support him but that he now does this unsupported. We saw one person going out for a walk with staff, deciding where they were going to walk before leaving the home. We saw another person going shopping with staff. One person attended college and talked to us on his return, about the home and how staff helped him. We were told by people using the service about the different things they do at college and learning centres. All people using the service go to social venues on a daily basis where they have made friends with people, and were able to talk to us about this. People go to football, music concerts, and trips to London are arranged. We observed staff talking to people throughout this visit in a respectful and sensitive way. All people have keys to their bedroom doors, staff were observed waiting to be asked to enter bedrooms. We saw a menu in place that is altered if people change their minds about what they want to eat. People told us they enjoyed their food and that they had enough to eat. We were told by one person that they were cooking tea this evening with a staff member. A healthy nutritional diet is offered with people shopping locally for produce. Fresh fruit is freely available, people told us they enjoyed their food. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the health and personal care needs of the people using the service. Evidence: The AQQA we received prior to the inspection told us that The people using the service receive person centred support in all aspects of personal and healthcare. The statement of purpose and the service user guide outline, health care and personal care that the service can provide support for. Health action plan file which is in people friendly format to suit the needs of individuals, this outlines personal information about the individual and how they wish to receive support . Two people require a minimum of support when completing personal care, this is done with sensitivity, privacy and respect. All people require support with their health care needs, choices are put forward to make a decision with regards to the healthcare they wish to receive. At times where needed health professionals visit the home to support people. Staff within the house follow support plans and risk assessments and are aware of any behaviour, and health changes that may occur. Support plans are in place, health action plans, record keeping, communication, training and on how to assess and handle each situation. Medication policy in place which staff follow, and have read and understood and they have signed to say they have done so. Risk assessments are in Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: place for each individual, along with a support plan. Health action plan and medication file contains a guide line on how each individual takes their medication. Staff are medication trained and this is refreshed accordingly, only trained staff can give out medication. We saw staff supporting people in a sensitive way to meet the needs of the people using the service. We saw that peoples physical and healthcare needs are met by accessing local healthcare practices, and registering with a General Practitioner. Records tell us that there is regular monitoring of peoples health, all attend well man clinics. We saw policies and procedures in place for the administration of medication, the AQAA told us these are updated regularly. Staff were aware of policies and procedures. We saw detailed staff training matrix that identifies staff who have been trained to administer medication. There is a monitored dosage system in place at the home. Medication is stored in a locked metal cabinet and is signed for individually as it is administered. No people using the service are self medicating. 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 using the service are able to make complaints and are safeguarded by the homes procedures. Evidence: The AQAA we received prior to the inspection told us that People friendly copy of the complaints procedure is displayed in the home, stating what to do in the event of a concern, complaint and who to go to. All people have a copy of the procedure in their files. The service have had no complaints in the last twelve months. People have stated during reviews and meetings that they are happy and safe, they are happy with the support they receive and the staff who support them. All staff are aware of the complaints concerns procedure and its policy, staff offer to talk to individuals if they are upset or are having worries and do this with sensitivity and respect. All complaints are recorded and are acted upon immediately. The manager has an open door policy and both people and staff can go and talk freely should they have anything they wish to discuss. The service have a no restraint policy, all staff are aware on how to handle any given situation should one arise both in house and in the community. Individuals have risk assessments and support plans, positive behaviour guide lines, which are completed where possible with the individual so as to give support in a positive manner, incident reports are sent to local authorities where deemed necessary under safeguarding policies and procedures. All staff are booked on completed safeguarding adults course and are aware of procedures. Manager and team leaders are trained in supervisions and appraisals, and supervisions are carried out every six weeks and Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: appraisals every year. We saw that the service has in place a complaints procedure. The procedure is included in the service users guide in a pictorial format, the Care Manager told us this is explained to people using the service. We asked people using the service if they know who to talk to if they are unhappy about something, they told us they would talk to staff and gave us staff names. Complaints information needs to be updated to include the Care Quality Commission details for people using the service, the team leader told us she would arrange to do this. People are protected from abuse by systems in place at the home. We were told by the Care Manager that any allegations of abuse would be acted upon immediately. We saw staff training records that told us that staff are trained in recognising signs of abuse and the actions to take if any abuse is suspected. The staff we talked to were aware of Staffordshire Social Services Safeguarding procedures. Criminal Records Bureau and Protection of Vulnerable Adults checks are carried out prior to employment of staff. 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. The design and layout of the home enables people to live in a safe, well-maintained and comfortable environment. Evidence: The AQAA we received prior to the inspection told us that All people have their own bedrooms, one individual has an ensuite bathroom, the bedrooms were chosen by themselves and are decorated in colours of the persons choice and personalised in any way they wish. All rooms have adequate heating and fixtures. All rooms are checked for health and safety issues each Thursday with the individual, any issues that arise are sent to the maintenance team who will then come and fix the problem. There are two toilets for all to use and one bath shower room within the home. The rooms within the home are decorated to the persons choice and furniture which they have chosen.There is a laundry room and a utility room with a washing machine and a dryer.The lounge is spacious with two sofas a television and a free view box, the dining room has a six seated table and chairs, activity cupboard, payphone and fresh fruit which is available at all times. The kitchen is spacious with hob oven and all utensils and workspace, all rooms are accessible to all persons with the exception of individual bedrooms. Any changes individuals wish to make are discussed during persons meeting and are acted upon. All rooms within the home are checked every Thursday for health and safety issues. The design layout of the home is in the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: statement of purpose, and service users guide. All people are involved in domestic duties and are supported to complete them as independently as possible. All people have risk assessments and support plans in place. All individuals have a key to their rooms to lock them if they wish to do so, this gives a level of independence and privacy, all rooms are cleaned every week and all people understand the importance of fire health and safety. We observed the home to be comfortable, safe and well maintained to a good standard. Communal areas are bright and spacious with lots of room to move around. Many homely touches enhancing the environment. We were told by people using the service they needed a new dining table and chairs, they said there are not enough chairs. There were eight of us in the dining room at one point and only five chairs. If people have visitors who they wish to stay for a meal they have to use garden chairs from the shed. Peoples bedrooms are personalised and contain photographs, pictures, football memorabilia, model cars and aircraft. We observed the home to be clean and fresh throughout. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and consistant staff team support the people using the service and keep them safe. Evidence: The AQAA we received prior to the inspection told us that The staff receive Protection Of Vulnerable Adults and Criminal Records Bureau checks, staff are chosen for the home based on qualifications, and or if they have qualities that would suit the needs of the people within the home. All staff has a six month probationary period. Staff complete an induction into the home and are asked to read policies, procedures, service users files, risk assessments, and are assigned a mentor during the first week. Each shift has a person in charge of the shift in the absence of the manager. All staff are working towards or have completed NVQ 3. Staff offer choice and one to one support in anything the person chooses to do. Staff have regular supervisions where they can discuss their progress with their supervisor. Supervision will be signed by both parties. The staff file holds personal information, qualifications, training, certificates, supervisions, annual leave and sickness records, these records are kept locked in a filing cabinet. The manager has access to these records in accordance with confidentiality and data protection. All staff have a copy of their job description and are fully aware of their roles all staff have a contract within their files and a copy for themselves. Staff are all aware of policies and procedures which are in place , the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: service ask people, families and outside agencies, staff to fill in questionnaires, which are scored and placed within the quality assurance file. The house staffing rota is organised around individuals in the home, sickness, annual leave and days off are covered adequately by staff members within the home. All staff have good communication skills and knowledge, with people and outside agencies. We hold monthly staff meetings, all meetings are documented and are filed accordingly. We saw staff training records that identified that staff receive mandatory training with regular updates. We saw training matrix that shows records where training is provided for the staff team, to ensure the staff are adequately trained to enable them to carry out their duties safely. We talked to staff who demostrated their skills and knowledge when meeting the needs of the people using the service. The service has in place recruitment policies that ensures staff who are appointed are suitable. We saw staff files that contained Criminal Records Bureau and Protection of Vulnerable Adults checks. These checks are carried out prior to employment being offered. This means that people using the service are protected by the homes recruitment policy and practice. 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 using the service are safeguarded by competent management systems. Evidence: The AQAA we received prior to the inspection told us that The manager has now completed her registered managers award. Previous to becoming the manager, she had worked within a senior role within the company for six years. The home has a development plan the aims and objectives are achievable. The home has numerous policies and procedures that management and staff are asked to read and sign. The budget of the home is well maintained and managed. The homes certificates are displayed for all persons to see. All people using the service have a contract, they have a copy of the service users guide and statement of purpose, these are completed in a format to suit each individual. The manager undergoes training relevant to her role. The Manager conducts an open door policy and ensures that staff are leading by example and are all completing training relevant to their roles. The home has a quality assurance file, within the file it outlines the aims and strategies of the home and plans for improvement. Annual questionnaires are sent to all persons within the home , families , outside agencies , staff and these are scored and we then develop a new Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: development plan for the home based on these scores. We observed the manager has National Vocational Qualification level 3, 4, and the Registered Managers Award. She has 21 years experience with the elderly and 6 years experience with Learning Disabilities. The Manager does all training that staff do, to keep up to date with current guidelines. We observed the home to be well run with people involved in decisions, about their daily routine and the running of the home. The people we talked to said they were happy living at Derby Road. We saw records on peoples files that were up to date, and told us that they had meetings with staff, to discuss their lifestyles and what they wanted to do. We were told by one person that he wanted a particular holiday, and this had been arranged. This indicated that the persons wishes had been listened to and acted upon by the management of the home. We saw safe working practices in place, records told us that appropriate checks are carried out. Health and Safety training is carried out and, there is safe storage of hazardous substances. 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 24 Consideration be given to replacing dining room table and chairs. 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. 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