Care Home: 50 Cherry Orchard

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What the care home does well People living at home appeared happy and very at ease in the home. There is a friendly and warm atmosphere, which has a positive effect on the people living there. People appeared relaxed and confident within the home and when interacting with staff. Peoples health needs are monitored and met by having access to a range of healthcare professionals, thus providing an excellent level of support and development opportunities for residents with complex needs. Residents live in a well-run home and they are very well supported with their needs being met by caring and creative staff. The home is managed by an experienced and qualified manager, whose aim is to create a homely environment where people are treated with dignity and respect. The home reviews the quality of service it provides and people are encouraged to share their views and ideas. What has improved since the last inspection? The recommendation from the last inspection has been met. What the care home could do better: No requirements or recommendations have been made to the home from this inspection. However residents would benefit from the company updating its policies and procedures to include current best practice guidelines that inform staff`s provision of care. Key inspection report Care homes for adults (18-65 years) Name: Address: 50 Cherry Orchard 50 Cherry Orchard Highworth Swindon Wiltshire SN6 7AU     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: Patricia Hellier     Date: 1 9 1 0 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: 50 Cherry Orchard 50 Cherry Orchard Highworth Swindon Wiltshire SN6 7AU 01793765090 01793765090 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: White Horse Care Trust care home 5 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 5. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home 50 Cherry Orchard is a home in Highworth offering accommodation and care to five adults with a learning disability. The home is one of a number of homes managed by the White Horse Care Trust. The home is located in Highworth and is situated close to local shops and community amenities. All residents have the benefit of single bedrooms. There is a large enclosed garden to the rear of the property with a seating and recreational area. The home is normally staffed with a minimum of two staff on duty throughout the waking day with additional staff at peak times. There is no waking night staff. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: This inspection took place over one day, was unannounced and the registered manager was present for part of it. As part of this key inspection the manager sent us an Annual Quality Assurance Assessment (AQAA), which was well completed. The AQAA contains general information about the home, and of the people living and working there. Is also told us about the improvements made since the last inspection and what the service is hoping to improve in the future. As a way of judging the quality of the service overall during our visit, we (the Commission) spent time speaking with the staff and manager and observing residents interactions with staff, through spoken, behavioural and non-verbal communication. We also looked at the care and accommodation offered to people living at the home Care Homes for Adults (18-65 years) Page 5 of 28 and observed care provision and support provided for them. Practices were observed and documents relating to care, recruitment and health and safety were reviewed. Care Homes for Adults (18-65 years) Page 6 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 7 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 8 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. Residents assessed needs are well met. Residents and their representatives have the information they need to make an informed choice about the home. Evidence: The home has a clear and concise Statement of Purpose and Service User Guide both of which are written in an easy read, pictorial, format to enable prospective residents to understand what they can expect of the home. There is also an audiocassette version of the Statement of Purpose available, and the home is looking to make a video introduction to the home for prospective residents. This is excellent practice and is to be commended. There have been no new admissions to the home since the last key inspection. Many of the people living here have done so for a number of years. Previous inspection reports show that the home has good processes in place when considering an admission to the home. The Service User Guide, a copy of the contract of residency and a pictorial complaints Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: procedure are all included in each individuals care file. We looked at two care files, which showed that information is gathered from various professionals, relatives and prospective residents themselves before admissions take place. We read a very informative assessment which included information about the persons physical, mental health and social care needs. In the assessment was information about their likes and dislikes and their preferred choice of social and therapeutic activities. We saw good written evidence that assessment records are regularly evaluated and updated. This helps to demonstrate residents needs are monitored and reviewed regularly to ensure their care needs are met appropriately. Assessment processes ensure that the home is able to meet the individuals needs. We also saw written evidence that residents are involved in the assessment and care planning process in an appropriate manner to their ability. This demonstrates how residents are being supported to make their own decisions about the type of care they need, and their lifestyles. The staff talked about ensuring that the stability of the house is maintained by considering the needs of the people currently living at the home when assessing the suitability of future residents. This is important with only five people living at the home and demonstrates a person centred approach to care management. Care Homes for Adults (18-65 years) Page 10 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. Residents are provided with assistance and support that is tailored to their needs and aspirations, enabling them to make decisions, choices and take risks in their daily lives. Residents needs are well met through good practices that are supported by detailed care plan documentation. Evidence: We observed the staff on duty talking to the residents in a sensitive and calm manner, communicating through listening and awareness of non-verbal cues that contributed to the conversation. We also observed staff and other residents communicating using Makaton sign language. The staff and residents told us they had enjoyed learning this to facilitate greater communication with another of the residents living in the home. Residents in this home have complex needs which are well managed by a stable and sensitive staff team. People living at the home appeared happy and content, and interactions observed with staff showed a good rapport and also between the residents themselves. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Each person living at home has a well-developed care plan. We looked at two plans of care to help us judge how care is planned and delivered. We saw care plans written with the involvement of the resident, and their relatives where appropriate. This gave us good information about their personal history, their physical and mental history, and also their family and friends. An informative care plan had been prepared which clearly stated how the persons physical, mental, social and emotional needs were to be met. It clearly set out the individuals wishes and preferences and how to support them, while promoting independence as much as possible. Regular reviews of peoples support needs are held and people are involved in these reviews. Family members and care managers are also invited to attend where appropriate. The home has a key worker system, which means that staff are allocated specific responsibilities for individual people, thus enabling them to build a meaningful relationship, and to ensure the home provides a quality of life for that individual. In the care plan we saw detailed information about potential risks the person may face, and any risks from particular activities they take part in. The care plan showed careful risk assessment of the activity and the preferred approach staff should take, which was helpful and informative. During the course of the inspection we saw residents go out with staff for various social and therapeutic activities, as well as medical appointments. This demonstrated how residents are well supported to take risks in their daily lives, and are able to undertake enjoyable activities of daily living. Information contained in the residents daily records show that staff aim to support them to maintain their independence in daily living. Interactions and care provision observed supported this information, and demonstrated staff understanding of the individuals needs and care provision. Staff told us they were always given up-to-date information about the support needs of the people living at the home. We were told there is good communication in the home with one member of staff telling us any changes are discussed with all of us. Discussion with the staff and manager during our visit showed that they had a good understanding of the communication needs of the people in their care and their commitment to developing further communication skills for the benefit of individual residents. During the inspection we saw evidence to show good liaison with other professionals and agencies to ensure the residents needs, and their choices are met. Care plans showed good interactions with other healthcare professionals and we observed good Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: interactions between them and the home staff during the inspection. Residents spoken with indicated they enjoyed living at home and had a happy life, with all their needs being met. 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. People living at the home are treated as individuals and staff respect their rights. They have the opportunity to enjoy regular events and activities within the local and wider community to enhance their quality of life. Residents benefit from balanced and varied meals that support their likes and dislikes. Evidence: We were told about the various activities enjoyed by the residents both inside the home and in the wider community. Some people attend weekly clubs for people with a learning disability e.g. One Step Ahead. On the day of the inspection we observed two residents being taken to medical appointments and two other residents were taken shopping. The home offers a wide variety of choices regarding leisure and social activities. Preferences and needs are detailed in individual care plans and these are incorporated Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: into the weekly and monthly activity planning. The home accesses local facilities including shops, pubs, cafes, library, and the cinema. They also plan an annual holiday for residents who would like one. During the inspection we were told of the recent holiday for two residents in the Hampshire area. One resident demonstrated they had obviously enjoyed it immensely. Daily life at the home is agreed with the individuals and planned in response to their choice. However flexibility to the timetable is maintained to ensure well-being. The home also provides in-house activities which include evening activities for the residents and a monthly craft session. We were told by staff, and information in care plans supported this, the home encourages contact with family and friends as often as residents wish. Staff were knowledgeable about each of the residents care needs, preferences and behaviours. Staff were observed using their skills to manage behaviours that can be challenging, and to facilitate a calm community environment. Residents and staff are involved in housekeeping tasks and we observed one resident assist in the preparation of lunch. Menus inspected showed they are provided in pictorial form and contain a list of ideas that individuals can choose from. This means that meals are prepared to meet individual tastes and choices. A balanced and varied diet is offered. The kitchen is small and domestic in scale and provides an important area for daily living tasks and activities. The home has not had a recent visit from the Environmental Health Officer (Food), however the kitchen looked clean and tidy and all appropriate records were maintained to ensure the safety of food provision, and best practice management for the health and well-being of residents. 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 the care and support they need in a way they prefer, and are protected through safe practices in the management of medicines and Healthcare needs. They are well supported by the inclusion of external Healthcare professionals. Evidence: Care plans detail the level of support required by people in respect of personal care and during our visit staff attended to peoples personal care needs in a sensitive way, providing care in the individuals preferred way according to their care plan. There is evidence to confirm peoples diversity is respected. One person who chooses not to leave the house has had arrangements made for the optician, dentist, community nurse and other necessary health professionals to visit the home. Evidence was seen that the home has sourced a therapeutic masseur for one resident who has profound sensory loss. Staff members confirmed they had received strict training relating to epilepsy, Downs syndrome and diabetes and that they felt confident in their knowledge and skills to care for residents with these conditions.. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The home has good details and records about how health-related needs are met and monitored. We saw that support is provided in a flexible consistent and responsive manner, as residents were asked and assisted, to choose where to sit and what to do. Clear evidence was seen in each individuals health action plan that they receive advice and treatment from a number of relevant health care professionals including GPs, nurse specialists, occupational therapists, dentists, opticians, and speech and language therapists. Health action plans were noted to be reviewed regularly and included changes and additional information to ensure full support for the individual. We looked at how the home manages medication, its administration, storage and disposal, to see if they are handled safely for the protection of the residents. We looked at medication administration records of three residents and there were no gaps in the records. We noticed records have handwritten entries supported by only one signature and not two as recommended for best practice to reduce the risk of errors. The manager admitted this was an oversight and would rectify it immediately. The home does not have a policy for the administration of homely remedies, medicines that can be bought over the counter, however we were told these products are usually prescribed by the GP. Occasionally throat lozenges are provided without prescription and thus the development of a homely remedies policy is recommended. 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. Residents are listened to, and well supported to make complaints about the service should they choose. Residents are protected from abuse through robust systems and knowledgeable staff. Evidence: The service has an open culture and staff we met conveyed a good understanding of the importance of respecting residents views if they are unhappy about any aspect of the service. Each resident is provided with a pre-addressed postcard to send to the Chief Executive if they wish to raise a concern directly with the Trust. The service has a complaints procedure that is clearly written, and produced in pictorial form to assist residents in the understanding and communication of its content. There is also a video copy of it. The staff informed us there are good communication links with families and all discussions are fully minuted. We saw the complaints logbook and noted there had been no complaints made since before the last inspection. A number of cards and letters complimenting the service were also seen. All staff have received training in the protection of vulnerable adults to ensure they have the knowledge and skills to protect residents from abuse. Staff interviewed demonstrated a good understanding of what abuse is, how to recognise it, and steps to be taken to protect the individual. They told us they had never seen signs of abuse Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: in the home. The home has clear policy guidance and procedures in place to assist staff in protecting residents from abuse. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is suitable for their needs and lifestyles. It provides a comfortable and safe environment, that is clean and hygienic. . Evidence: The home is in keeping with other houses in the area and offers access to local communities and transport including shops, bus stops, pubs, clubs, churches and the library. It is also close to the health centre and other provisions for people with learning disabilities. This means residents can be part of the community if they wish. The home provides a comfortable and safe environment for the people who live there and is light and cheerful with a high standard of furniture, fixtures and fittings. Residents have access to all areas of the home which is clean, tidy and well maintained in all areas. There is a large secure garden which has both patio and grassed areas that have been made accessible for all residents. The home has a regular gardener for the general upkeep and some residents enjoy planting out the patio pots. The garden has a summer house and swings for people to access and in good weather activities are arranged for residents enjoyment e.g. a bouncy castle for one residents birthday. The residents allowed us to see their bedrooms. They looked clean, tidy and well Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: maintained. We saw that rooms have been decorated and personalised for each individual resident. One residents bedroom indicated that the staff team had considered the diverse needs resulting in the person having wooden tactile pictures and other tactile objects to stimulate their senses. There were wooden tactile boards at the entrance to every room to help the individual identify where they were. Staff explained that they were identified by an object of reference e.g. one member of staff explained it was her watch, and this is hung on a wooden board to enable individuals to identify who is in the room or communicate with them. Bathrooms in the home are fitted with appropriate aids and adaptations to meet the complex needs of residents. The home has a well organised laundry system where all toxic materials are securely stored for the safety of individuals who live there. Gloves and aprons are supplied for staff use in line with best practice guidance for minimising the spread of infection. The home provides good handwashing facilities with antibacterial soap and paper towels provided in communal areas. This is good practice and minimises the risk of spreading infection. Staff spoken with confirmed they attended infection control training and records inspected showed regular checks are carried out to ensure best practice is maintained. we observed good handwashing practices during the inspection for the protection of residents. The home has an ongoing redecoration and maintenance programme to ensure a safe and homely environment for residents. 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. Residents are supported by sufficient competent, qualified and well supervised staff who undergo a robust recruitment process. Evidence: We looked at the staff duty records for the previous two weeks to check the numbers of staff on duty are sufficient to support residents. There are usually two or three staff on duty every day shift and one member of staff at night, which we understand to be adequate to meet residents needs. The staff team has the skills to communicate effectively with residents and this was evident during the inspection. The staff team are small but relatively stable, with a long-standing core of staff to provide flexible and consistent care. There has only been one newly recruited member of staff since the last inspection. Unfortunately their employment file was not available within the home for inspection, as it has not been completed by the companies Human Resources (HR) department prior to being sent to the home. We received e-mail confirmation from the companies HR department that all the required documentation to evidence safeguarding checks had been undertaken, prior to the individuals commencement of employment at the home. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: We reviewed the training records of three staff and noted they had received training in both mandatory and specialist areas in the last 12 months. This ensures staff have the relevant knowledge and skills to meet residents needs and provide positive outcomes for them. In the AQAA we are told that all staff have undertaken the National Vocational Qualification in Care awards and this was evidenced in files inspected. The new member of staff showed us the induction document they are working through, which shows a thoroughness that when completed will enable the individual to competently meet care needs of residents in the home. We were told all new staff members have a mentor and are provided with the time to get to know each resident individually and their needs fully. Staff told us they are well supported by the manager and have regular supervision, in which their practice and development needs are discussed. Records seen confirmed supervision is undertaken and recorded on a regular basis, in accordance with the recommendations. This is good practice and enhances the service provision in the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well run for their benefit and have the opportunity to share in decisions relating to the development of the home. There is an open and approachable management style that ensures the safety of people living there. Evidence: The manager is experienced, well qualified and competent to manage this service. Ms Baxter remains the registered manager however the Trust has appointed another individual to job share this post with Ms Baxter, and she is currently applying for Registration with the Commission. This demonstrates the Trusts commitment to equal opportunities and supports the equality framework within the home. Staff members spoken with told us this arrangement works well and the ethos and leadership of the service is one of inclusiveness and openness that is of benefit to the residents. People living at home appear to interact well with the manager, and staff spoke of confidence in her / their abilities and felt that she would listen to them. The manager has a positive attitude towards inspection and regulation; she is well organised, finding documents, files and records as requested. This reflects good management and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: a well-run home. The home has several ways of monitoring the quality of the service and an annual quality assurance report is compiled which reflects the views of people living at the home, and their families. A review of the recent quality audit showed us that relatives and residents felt the staff are well trained, act on concerns raised and keep people informed. They were all happy with the quality of care provided at the home. The staff survey responses showed staff feel the manager acknowledges good performance, encourages good teamwork and provides clear information and support to enable them to care for residents in the home. No isues of concern were raised through this audit. Regular meetings are held with relatives which provide them an opportunity to have their say in an informal way and any problems or feedback arising from these meetings are dealt with in the house. The policies and procedures kept in the home are company wide and we noted that a number of these have not been reviewed within the last three years, in accordance with best practice guidelines. It is recommended that all policies within the home / company are reviewed to ensure they contain up-to-date information to ensure staff provide care that meets with best practice recommendations. During the inspection we looked at the records relating to health and safety in the home. Staff receive mandatory training in these areas which promotes good health and safety practices. The manager keeps an account of what needs to be completed in respect of health and safety and regularly checks to ensure they have been completed. The fire logbook show that the fire system has been regularly maintained and tested. The health and safety representative within the home told us the Fire Risk Assessment is currently under review to ensure it complies with recent guidelines and will safeguard residents in the event of a fire. The AQAA showed maintenance and servicing of electrical systems was up-to-date. 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 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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