Care Home: 492 Maidstone Road

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What the care home does well The atmosphere in the home is warm and friendly and the staff group manage the challenging behaviour well and within recognised guidelines. Staff follow practises that promote the involvement of the people in the home in directing and actively participating in matters that affect their daily lives within the home. During the inspection good evidence was seen that the people in the home were given positive choices in a manner they could understand and cope with. The recent improvements in the kitchen have enhanced daily life. Choices are currently being offered over the colours to used when decorating the walls. The organisation has a robust training programme in place and gives a high priority to induction training. All staff are supervised monthly and have a number of work based assessments e.g. medication, shift planning and health and safety. This helps them feel involved in the running of the home and promotes a positive ethos. The organisation has good quality assurance systems in place and senior manager carry out regular audits to ensure the home continues to meet its planned level of care and standards. What has improved since the last inspection? The kitchen has been refurbished to a high standard and is now waiting to be decorated. A new sink has been fitted to the laundry room. The new manager is now full time and is currently registering with the Commission. What the care home could do better: Recent staff shortages, including the post of Deputy Manager, have meant that some of the activities planned for the people in the home have had to be cancelled. The Commission is aware that the home is trying to appoint appropriate people, but this needs to be urgently addressed for the benefit of the people in the home. The hallway and lounge flooring need to be replaced. The window latch in the bathroom needs to be replaced. It is recommended that the home obtains a copy of the Royal Pharmaceutical Society of Great Britain guidelines for the Safe Handling of Medicines in Care Homes. It is also recommended that the organisation reviews the medication training it delivers to staff. Key inspection report Care homes for adults (18-65 years) Name: Address: 492 Maidstone Road 492 Maidstone Road Blue Bell Hill Chatham Kent ME5 9QN     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: Sue McGrath     Date: 0 7 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 492 Maidstone Road 492 Maidstone Road Blue Bell Hill Chatham Kent ME5 9QN 01634869716 01634869716 Maidstone.road@theavenuestrust.co.uk glebe.house@theavenuestrust.co.uk Avenues Support Services care home 4 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): 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 4. 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 492 Maidstone Road is a residential home providing care and support up to four people with profound learning disabilities. The home is in Bluebell Hill Village, a residential area situated between the towns of Maidstone and Chatham. The centres of both towns are approximately five miles away. The home is within a few minutes reach of the M2 and M20 road links and is close to a bus route. The nearest shops, GP surgery and other local amenities are located at Walderslade village. This is approximately one mile away. The home is one of a group of community homes owned by the local Primary Care Trust (PCT). It is managed and run by the Avenues Trust. Services provided include personal support and in house and community based leisure Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home activities. Health services are arranged and accessed through local health care teams. The accommodation is provided in a bungalow. There are four single bedrooms, a lounge, kitchen/diner, bathroom, shower room and utility area. Outside there is a safe and enclosed rear garden. There is room to park up to five cars to the front of the premises. The weekly fees for this home are £1,852 per service user. 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 was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and regulations and that the outcomes are promoting the best interests of the people living in the home. The actual site visit was carried out by 1 inspector over the course of 1 day. We (the Commission) spent time touring the building and talking to all the people living in the home. We also spoke to the manager and staff and reviewed a selection of assessments, care plans, medication records, menus, staff files and other relevant documents. The manager was present throughout the inspection. Prior to our visit an Annual Quality Assurance Assessment (AQAA) had been sent to us within the required time limit. The AQAA is a self assessment that is required by law. This assessment focuses on how the service considers they are meeting the outcomes Care Homes for Adults (18-65 years) Page 6 of 29 of the people using the service and where it feels it can make improvements. It also provides statistical information about the service. Information from the AQAA has been used in this report where appropriate. Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Care Quality Commission (CQC) to be able to make an informed decision about each outcome area. Overall this was a positive inspection with generally good outcomes for the people who live there. The inspector on leaving the home was satisfied that people were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 29 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. The home provides the people who live there, and their supporters, with the information they need in a way they can understand. Appropriate assessments are made. This ensures that any changing needs of the people who use the service are identified and met. Evidence: We looked at the information provided to people who use the service to find out whether it was detailed and answered all their questions, and to find out how the service passed on the information. The home has a Statement of Purpose and a Service User Guide that are written in Plain English. These documents provide good information for the supporters of the people who live in the home. These documents are unsuitable for the service users and other ways are found to ensure that they can understand their rights whilst living in the home. The manager is in the process of updating these documents to include pictorial information. Direct and indirect observation confirmed that they are very Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: much at home and can make their wishes clearly known by non-verbal communication. There had been no new admissions to the home for a long time, but the manager was familiar with Avenues admission policy, which was robust and would ensure any prospective person would be admitted in a safe and professional manner. Examples were seen of the paperwork that would be used. 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. People have clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Evidence: We viewed the service user files to determine how the home assesses people and manages their needs. Risk assessments were also viewed to see how people are enabled to participate in all aspects of life in the home. The manager has been updating individual plans, as not all staff had received training in Person Centred Active Support (PCAS). Although the plans were fairly detailed some areas could be expanded upon, for example, personal care. When cross referencing some of the stated activities, it was evident that some were not being undertaken. This will be further assessed in the activities and staffing section. Direct and indirect observation throughout the day showed that choices were offered Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: in an appropriate way. Choices were often limited due to the complex needs of the people who live there. The manager stated that too much choice could be confusing and the staff aware aware of the long established behaviours and how best to support the people. The home endeavours to promote independence where possible and plans to integrate the people into the local community by including activities and events that are available. One person was visiting a local college on the day of the inspection for a taster day with a view to completing a life skills course for writing. 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. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability and gender. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal and family relationships. Evidence: We looked how the service managed personal development and if people were given the opportunities to take part in suitable activities and social events. We also looked at how personal relationships were managed and if families were involved with the reviewing of care plans etc. To do this we spoke with staff and viewed records. Although an acceptable level of activities is planned, evidence in the daily logs showed Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: that a relatively high number of activities had been canceled since the beginning of May due to staff shortages. Numbers missed prior to May were not viewed. Twenty nine activities for that period had been cancelled due to staff shortages. Nineteen had been cancelled for other reasons. The manager was aware of the issue and was actively looking to appoint new staff but this had proved problematic. Some of the people in the home enjoyed helping with household tasks such as preparing vegetables and mopping the floor. One person was seen assisting in making tea and sandwiches. Activities outside the home include swimming, walks and some visits to local pubs, golf and the use of a jacuzzi. Due to the complex needs of the people in the home a high staffing level is required when time is spent in the community. This is usually two staff to one person. The home provides transport and staff to support the people if they wish to make visits to families. The home encourages families to remain in contact with the people in the home where possible and will actively support this. One of thee people in the home had a five day holiday at Centre Parcs earlier this year. The other two people prefer to go out for days, as this suits their individual needs. Days trips have been made to Howlets Zoo and the seaside. One person is planning to visit an ex member of staff who has moved to the coast. Instances of challenging behaviours are well documented and CQC are kept informed of any serious occurrences. Care plans clearly identify behavioural strategies to ensure these episodes are managed well by staff. Evidence was seen in the care plans that the home continues to actively seek the advice from other professionals to enable these strategies to be effective and appropriate. Evidence was seen that regular reviews were undertaken and that families were involved. Nutrition was well managed in the home with the manager holding the food budget. Choices were seen to be offered as much as possible. Evidence was also seen that advice was sought from other professionals for those with any eating disorders or problems. 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 home actively promotes the health and well being of the people in the home and respects their privacy and dignity. Evidence: We wanted to look at peoples care plans to ensure that their health, personal and social care needs were set out in a way that would enable staff to deliver good care. We looked at all three plans to evidence this. The health and personal care needs of the people in the home were mainly recorded in the care plans. Some areas of personal care needed to contain more detail as discussed with the manager. Staff on the day were seen to be polite and respectful to the people in the home and managed some challenging behaviours in a positive and professional manner. They were seen to knock on bedroom doors and to speak to the people in a calm and reassuring way. Evidence seen in the records maintained by the home confirmed that the people living there had full access to all professional medical support as required by their conditions and needs. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: The administration of medication was reviewed. The manager confirmed she had completed an ASET course in the Safe Handling of Medication and that other staff had received a one day course managed by Avenues Trust. The manager also confirmed that she regularly audits the medication and assesses the continuing competence of the staff. It is recomended that this be recorded in an appropriate format. There have been three notifications to CQC regarding errors in medication since February 2009. The organisation needs to ensure that their own medication training is suitably robust. The manager was also advised to obtain the latest copy of the Royal Pharmaceutical Society of Great Britain guidelines for the Handling of Medicines in Social Care, as this is the guidance used by CQC. None of the current people living in the home are able to self medicate and there are sound procedures in place to ensure medication is administered in accordance with good practice. 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 live in the home are protected by a robust complaints system and relatives can feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that people are protected from abuse. Evidence: We wanted to ensure that all people concerned with the home were aware of the complaints procedure and felt confident their concerns would be listened to and acted upon. We also wanted to ensure all people were protected from any form of abuse. To do this we spoke with staff and viewed records. There were robust polcies and procedures in place for the handling of complaints and concerns. The home had received two complaints this year and both had been managed in a professional manner. Records were maintained of the issues raised and the outcomes were recorded. Both issues were dealt with in an appropriate timescale. The home had also received two compliments from the same family. The AQAA stated that the complaints procedure was in written, pictorial, CD and DVD format. Any complaints received are monitored on regular company audits. The homes AQAA states a whistle blowing policy in place alongside the complaints and grievance policy. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: All staff attend Adult Protection training and are made aware of the policy as part of their induction. The homes AQAA states any issues are responded to in accordance with the Public Disclosure Act and the Department of Healths No Secrets guidance. All staff had POVA and CRB checks in place. Peoples monies were kept secure, with all transaction well recorded. Internal audits by senior managers highlight peoples monies each month. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a clean, safe and adequately maintained environment and have safe access to comfortable indoor and outdoor communal areas. Evidence: We wanted to ensure that people lived in a well maintained environment and had safe access to comfortable indoor and outdoor communal facilities. We also wanted to ensure that bedrooms were clean and comfortable and met good environmental standards. To this we looked in the majority of the rooms. The kitchen in the home had recently been refurbished to a high standard. The staff were currently in the process of assisting the people who live in the home to choose the colour for the walls, as these needed painting. The floor covering was clean but old. The bathroom and shower rooms were clean and fresh, but the broken catch on the window, that was highlighted in the last report, had still not been repaired. It was pointed out to the manager who said she would ensure it was repaired or replaced. A new wash basin had been installed in the laundry room, as highlighted in the previous report. This room is also used to store substances and equipment that may Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: be harmful to the people living in the home should they gain access to them. The AQAA stated that cleaning material are always kept in a locked cupboard. The manager confirmed the laundry room was also kept locked at all times. The home had policies and procedures in place for infection control that staff adhered to. All of the bedrooms had been personalised to the taste of the person who lived there and every effort had been made by staff to ensure they were comfortable and appropriate to their needs. The flooring in the hallway had lifted and this was a trip hazard and needs to be reaired or replaced. A requirement will be made to ensure the people who live there remain safe. A lot of the decor was fairly bland and the manager said she was hoping to change some of the colour schemes in the home. The manager stated that the home does not have any digital aerials on any of the rooms and was hoping this would be planned for in the near future. It is recommended that this is seriously considered by the management team. The carpet in the main lounge had holes in and needed replacing. The home has a large secure rear garden for the people to use if they wish with some shaded areas. A new fence has been fitted for the full length of the garden. There are some parking areas to the front of the building. 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 people who live in the home benefit from being cared for by staff who have a good understanding of their needs, though staff shortages have resulted in people not always receiving consistent care. People are protected by the systems for staff recruitment and training. Evidence: We wanted to ensure that sufficient staff were employed, who were suitably trained and had a good understanding of the needs of people with a learning disability and challenging behaviours. We wanted to ensure they had been appropriately recruited to ensure the safety of the people in the home. To do this we spoke with the manager and viewed files. The service is currently caring for three male clients and the gender, age and ethnic mix of the staff team was good. Staff files were viewed and evidenced that training is given a high priority and that regular supervision is happening. The AQAA confirmed that of the 12 care staff employed, 7 had completed an National Vocational Qualification (NVQ) level two or above and that 3 more were currently undertaking their award. The manager confirmed the induction programme met the requirements of LDQ (Learning Disability Qualification used to be known as LDAF). Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The staff all said they work well as a team but that staff shortages have affected the levels of activities undertaken by the people in the home. The home is currently a deputy manager and one full time carer short of it designated hours. The manager confirmed she used the same 4 bank staff to ensure continuity of care. The manager stated that she had recently interviewed for new staff and was hoping to appoint in the very near future. This is essential for the smooth running of this challenging service. The company had strict and robust recruitment policies and procedures in place. All staff undergo a Protection of Vulnerable Adults (POVA) first check followed by a full Criminal Records Bureau (CRB) disclosure and a minimum of two written references. The main staffing records are maintained at head office, but tracking forms are held in the home. These forms included the CRB numbers and were seen to be in order. 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 people who live in the home benefit from living in a home where the manager is competent, enthusiastic and experienced with the care of people with a learning disability and has a clear vision for the home. The home is run in the best interests of the people who live there. The health, safety and welfare of the people in the home and the staff are promoted and respected. Evidence: We wanted to look at the skills of the management team and if the service benefited from the ethos, leadership and management of the home. We also wanted to see if the home was run in the best interests of the people who lived there. We also needed to ensure their health and safety was protected and promoted. To do this we spent time talking to the manager and her staff and reviewing records. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The current manager was in the process of registering with the Commission and had several years of experience in managing services for adults with learning disabilities. She held NVQ level 2, 3 and 4in care, the Registered Managers Award (RMA) and A1/A2 for NVQ assessing. She is also currently working towards her Diploma in Management. Throughout the inspection she demonstrated a sound knowledge of the service and displayed good management skills. She was aware of the achievements of the service and the areas that needed to improve and was working towards meeting these challenges in a positive and proactive way. The organisation had robust policies and procedures in place that were regularly reviewed and updated as required. Regular visits under Regulation 26 of the Care Standards Act were undertaken and recorded. Sound auditing of Health and Safety was undertaken on a regular basis. The manager commented that she felt well supported by the overall management and organisation. 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 24 23 The premises to be used as a care home are of sound construction and kept in a good state of repair externally and internally. In that the flooring in the hallway must be repaired or replaced. 14/08/2009 2 24 23 The premises to be used as a care home are of sound construction and kept in a good state of repair externally and internally. In that the flooring in the lounge must be replaced. 30/09/2009 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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