Care Home: 50 Fordbridge Road

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What the care home does well The residents are well supported to maintain their independent life skills, to develop new skills and to be actively involved in the running of the home. During the site visit members of staff and residents were observed to have a relaxed, friendly relationship and there is warm, homely atmosphere in the home. The individual care and health action plans for residents are well written and demonstrated regular reviews. The plans were extremely detailed and provided staff with clear information and guidance on how residents needs can be effectively met. Residents are supported by the staff group to develop power point presentations to enable them to participate in their annual reviews to demonstrate items and events that are significant to them and areas that could be developed further. The residents are very well supported by the staff to participate in their local community. In addition the residents are encouraged to engage in a excellent range of activities that have been designed specifically to met their needs. The home has its own vehicle to enable residents to get to their activities. The residents are supported and encourages by staff to keep in contact with their family and friends. The service is developing new methods to allow the residents to expand there network of friends in the community to ensure that they have as fulfilling a life as possible. The residents are supported by a small but effective team of staff and it is clear that staff are dedicated to the needs of residents. The home has a very stable staff team and staff spoken to during the site visit stated that they are happy working at the home and some had worked there for a number of years. The home is effectively managed in an open way and it is clear that all aspects of the home are led by the wishes and needs of those living there. What has improved since the last inspection? The home has developed a system of for resident care review that now includes a power point presentation. The presentation is designed by the individual residents to highlight their own achievements and areas of improvement in the previous 12 months. The residents circle of friendship is being expanded to allow them to make new friends in a larger setting. The medication storage system has been reviewed and will now offer a greater level of Independence to the residents. What the care home could do better: The organisation must ensure that all staff records are returned and stored appropriately in the service in line with Standard 34 Schedule 4 .6 of the National Minimum Standards. Key inspection report Care homes for adults (18-65 years) Name: Address: 50 Fordbridge Road Ashford Middlesex TW15 2SP     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: Kenneth Dunn     Date: 1 9 0 1 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: 50 Fordbridge Road Ashford Middlesex TW15 2SP 01784421223 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: fordbridge.rd@owl-housing.org Owl Housing Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 50 Fordbridge is a large detached house which can accommodate up to eight adults who have a learning disability. It is situated in an established residential area of Ashford with shops, leisure facilities and public transport available nearby. The registered provider for the service is Owl Housing and the premises are managed and maintained by Airways. The property is a two storey building and a lift enables service users to access all areas. There is a large garden with patio which can be accessed from the dining area or the lounge. Ramps and handrails are provided to support service users mobility. Car parking is avialable to the front of the property. The fees at this service range from £994.01 per week to£1077.94 per week. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 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 site visit was part of a key inspection process, it was unannounced. We arrived at 9.30 am and left at 13.30 pm Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which provided us with all the information we asked for. Reference is made to this assessment throughout this report. Other methods used to inform our judgements made in this report include discussions with members of staff and community health based professionals. We looked at training records, care plans, risk assessments, menus, quality assurance systems, medication administration policies, health and safety records and policies and Care Homes for Adults (18-65 years) Page 5 of 30 procedures were sampled. We also reviewed other information that we have received since our previous including notifications that the service is required to inform us about. Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The organisation must ensure that all staff records are returned and stored Care Homes for Adults (18-65 years) Page 7 of 30 appropriately in the service in line with Standard 34 Schedule 4 .6 of the National Minimum Standards. 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 30 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 30 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. The needs of potential resident will been fully assessed before their admission to the home. Prospective residents are provided with substantial information about the home in to enable them to make the decision about the appropriateness of the home in meeting their needs. Evidence: The home has not admitted any new residents since the previous site visit by the Commission 10/01/2007. The manager provide detailed information about the assessment process in the completed AQAA. During the site visit the manager explained that the assessment process is designed to ensure that the home could meet the needs of any future prospective resident. The manager stated that the assessment process requires all prospective residents to visit the home on a number of occasions, usually of increasing length, they would be invited to stay for a meal and possibly overnight, if it appeared that the home was suitable. The manager stated that it is essential that the assessment highlights the Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: compatibility of the prospective resident in relation to the existing residents and to minimise any effects a new member of the household may have on them. The manager has developed a statement of purpose and a service users guide that contains considerable information about the home, the services it provides and the staff. A review of these documents demonstrated that they would aid and assist potential residents in making their choice about moving into the home. During the site visit it was discussed that with the manager that there is a need to review all contact details of external agencies involved in the care of the residents to ensure they are current. The manager stated that a audit of the documents would be undertaken and additional information would be added to expand the contact details to allow residents and their families or representatives to have ease of access if they require. Care Homes for Adults (18-65 years) Page 11 of 30 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. Care plans are detailed and informative and provide excellent information to staff to offer appropriate support to individual residents. A series of robust risk assessment have been completed. The residents supported and en powered to make independent decisions. Evidence: The home has developed a series of comprehensive care plans for each resident. The care plans clearly highlight the support needs of the individual residents and the services and facilities essential to meet their needs. The completed AQAA states that the plans are regularly monitored, evaluated and updated with service users involvement. During the site visit the manager confirmed that the majority of the residents receive an annual multidisciplinary review, while two receive six monthly reviews as they are funded by a different council. In addition to the multidisciplinary reviews the residents participate in two monthly action planning Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: meetings where they review plans and set individual goals for the coming weeks. A random sample of two care plans was undertaken and it was evident that they were in good order, contained the required information, regularly reviewed and where appropriate resident have been encouraged to sign that they have participated in the review process. The manager stated that the residents of 50 Fordbridge Road have been encouraged and supported by staff to make power point presentations to be presented by the individual during their review to highlight events and areas where they have enjoyed taking part in or have benefited from the activity. The manager stated that the power point presentations had been very successful and provided a good alternative to method for the residents to communicate their achievements during the previous months. The home has developed a robust series of risk assessments in order to minimise potential areas of conflict or harm to the residents. The Assessment sampled, involved individuals mobility, personal care and bathing, fire, choking and vulnerability to abuse. These were very detailed and included ways to prevent risks and how to manage them to minimise the risks to residents, whilst enabling them to be independent. The residents are again encouraged to sign the assessment to signify they that they have been involved in the process and have had the assessment explained to them. The AQAA sates that staff have good knowledge and skills in supporting and enabling the service users make their choices. e.g. shopping, preparing meals, decorating their rooms, choice of personal electrical items. They manager stated that the residents take an active part in where they want to go and what they want to do and the staff group provide support in order to achieve their goals. During the visit observations of the staff interacting with the residents demonstrated that there is a clear understanding by staff of the levels of support each individual required and the support they must offer to enable the residents make independent choices. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported appropriately to take part in a range of activities and to participate in their community. Residents are encouraged and supported to plan, shop and prepare a well balanced diet. Evidence: The lifestyle expectations of the residents of 50 Fordbridge Road are excellent. The staff working in conjunction with individuals living at the home have developed a series of highly individualised activities, that are age, peer and culturally appropriate for the residents. The AQAA states Service users have individual social activities plans, which are Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: displayed in their rooms. Their social activities are reviewed as part of their key worker and action planning meetings. Activities are also discussed in their weekly tenant meetings and trips out and activities are organised during this time. The staff support the residents to take part in a variety of activities within the local community such as pottery, bowling, cinema, shopping, craft classes needlework and cooking, the Service users attend a variety of social clubs within the local community and have developed relationships with many of the people there and have invited them to parties at the home and once a month all the service users attend a local pub for a dinner evening with some of their friends from these clubs. In addition the AQAA stated that One service user has a regular job providing discos for the social club and is supported by staff to fulfil this responsibility. This was confirmed during the site visit by the manager and a review of the residents individual plans. During the site visit the residents were observed to be coming and going to their planned or spontaneous activities going to the local shopping centre, day placements and two were having at home days with staff. The manager provided details of the planned holidays the residents participated in over the last 12 months 3 residents and staff rented a cottage in Wales during July 2009 while remaining residents went to Hayling Island in September and October as their main vacation. During the site visit large photographic displays of the holidays were framed and on display around the house. A random sample of residents files provided evidence that individuals living at this service are provided with the correct levels of support to maintain contact with friends and families. The AQAA stated that The service users are encouraged to maintain contact with their families, we invite families to meetings and reviews and to any parties we have at the house. The manager stated that the residents have recently become involved in a programme designed to build friendships out with the care home and in an environment designed to support and enhance the lifestyle expectations of the residents. The residents have a very flexible system in place for meals, they are supported by staff in the kitchen and to ensure that the meals offer a healthy balance. The manager stated that there was only one resident who had any form of special dietary requirements and that they followed guideline developed for this individual by a Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Speech and Language therapist Care Homes for Adults (18-65 years) Page 16 of 30 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. The home has consistent records and robust documentation to evidence that the residents health care, wellbeing and welfare are supported. The homes medication procedures ensure the safety of the people living in the home. Evidence: The care plans and health action plans demonstrated that the personal support needs of the residents were well documented. Within the residents individual files there was consistent evidence to demonstrate that care plans and health action plans have been developed and agreed with the resident, families and relevant health care professionals. The AQAA stated that Each service user has an individual support plan which takes into account their own preferences for the way they are supported. The support they are given is reviewed with them regularly to ensure that their wishes are taken into account. The key worker will update the plans with the service user every two months or as and when necessary. The service has a shift plan which takes into account support needs during the day and is tailored around social activities and appointments. Service users have a health action plan which they complete with their key workers which lists any relevant health information and any areas of concern or things to follow up. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: A random sample of two care plans evidenced that individual residents are engaged in the planning process. The files demonstrated that where the residents can sign that they have been involved in planning and have been fully engaged in the review process for subsequent plans they have been encouraged to do so. The random review of individual care plan provide evidence that all residents are registered with a local general practitioners(GP). It was documented that the residents have access to dentists, chiropodists, opticians and psychiatrist support if required. All medication is stored in a locked in one central medications cupboard and there is documentation to indicate that the medication is reviewed and audited regularly. The manager has incited a plan to have all medication securely stored in the each residents bedrooms this process has been started with the purchase and fitting of the storage units into the bedrooms. The manager indicated that the final process to start to store medication in the bedrooms would be completed during February and March 2010. At the time of this site visit the manager stated that none of the residents are directly involved in self medication, however there was a plan to under take a series of full medication risk assessment to highlight if in future the residents could undertake self medication with staff support and assistance. During the site visit a review of the Medication Administration Records (MAR) was undertaken no gaps or errors were highlighted. It was however noted that where corrections had been made to dosages or new medications added to the MAR sheets there was no clear guidance or explanation as to why these change had been made. This was discussed with the manager who stated that a review of the MAR sheets would be undertaken and explanations and signatures would be included on the sheets in order to clarify the alterations. Care Homes for Adults (18-65 years) Page 18 of 30 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. The people who use this service benefit from a robust set of policies and procedures designed to protect and safeguard them from abuse. Evidence: The home has not received any complaints regarding the services and services they provide since 28/11/2008. A review of the complaints records maintained by the home indicated that there have been no complaints made to the manager and staff since the last inspection In the AQAA the service stated that Our concerns and complaints procedure is in pictorial form and these are displayed in the service. We also have regular tenant meetings and action planning meetings which give the service users the opportunity to raise any problems and express their views. We also make comment cards available for any visitors to the home to give them the opportunity to provide feedback and these have been well received by those who have completed them. We carry out six monthly service user quality reviews and also send out questionnaires to families to have the opportunity to raise any concerns. This was confirmed during the site visit the complaint procedure was clearly displayed it was robust and has been produced in a pictorial format to enable the residents to fully access the process. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The manager stated that the policy is reviewed on a regular bases and updated when required. It was noted during the site visit that the contact details of external agencies were not clear and could be difficult to access by the residents or their families if they wanted to take a complaint outside of the home. This was discussed with the manager who stated that a review of the contact details would be undertaken and all relevant contact details would be made available to the residents in an appropriate format. There is a clearly written safeguarding adults procedure and a copy of the local authority safeguarding adults from abuse policy was available. The AQAA provide evidence that All staff attends safeguarding adults training as part of their mandatory training and the local procedures for dealing with abuse are available in the service for them to access. The home also has an organisation policy for protecting service users from abuse. All staff in the home undergo statutory checks before commencing employment, We have organisational procedures around whistle blowing and these are available in the office and staff also read these policies as part of their induction. All new staff undergoes the LDQ qualification which has a unit on protecting service users from abuse. Evidence of staff training was available for review during the site visit. Care Homes for Adults (18-65 years) Page 20 of 30 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 layout of the home should enable the people who use the service to live in a safe environment. The home is clean and hygienic. Evidence: 50 Fordbridge Road is a large detached house it provides 8 residents bedrooms one staff sleeping room sitting room dining room 3 bath shower rooms kitchen office and garden. The home is a large detached building the rooms are spacious, bright and fully accessible to the residents and has a lift so upstairs rooms. The AQAA stated that the service is decorated to reflect the service users choice the communal areas are decorated with photos of the service users to personalise their space. Service users are supported to decorate their bedrooms according to personal taste and are encouraged to personalise the space with photos and pictures. Key workers carry out regular checks on the standard of furnishings and furniture in the service users rooms. A part tour of the building was undertaken as part of the site visit, this included all communal areas and two residents bedroom. The home is homely and very reflective of the residents and there activities. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home is relatively well decorated and maintained. The bedroom seen was very individual and fully represented the the owner of the room with a display of items chosen by him and with meaning specifically to the resident. The communal areas were designed with the needs of the residents in mind with large comfortable seats, tables and entertainment equipment. It was however noted that on the first the lighting was very poor even with the overhead lights on, in addition the there was two free standing storage units, which were unstable and could be a potential risk to the residents and required to be attached to a wall for safety. This was discussed with the manager during the site visit and it was agreed that the lighting would be reviewed and the storage units would be either attached to the walls or removed. The home has a good infection control policy. The staff group have all had regular training to ensure that any health and safety issue can be identified and successfully brought to the attention of the correct maintenance provider. During the inspection the home was clean and free from mal odours. Care Homes for Adults (18-65 years) Page 22 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff group appeared skilled and in sufficient numbers to provide 24-hour care within the home. The systems in place for recruitment and training are designed to be robust and should protect the people who use the service. Evidence: A review of staff duty rotas during the site visit indicated that appropriate staffing levels are maintained in the service at all times. The AQAA stated that We have a stable and diverse staff team which reflects the cultural background of the service users. Te manager stated that 48 of the current staff members have completed National Vocational Qualifications (level 2) or above. This was supported in the completed AQAA and a random review during the visit. The inspector was informed that each member of staff has their own training record in place and it was evident that staff have received mandatory training in safeguarding adults, fire, food handling, food hygiene manual handling, health and safety, first aid and managing medication. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The home has good recruitment policies and procedures, based on equal opportunities legislation. During the site visit staff files were not available for review. The manager stated that on request from the organisation all staff files were removed from the home to be stored in there HQ in line with the data protection act. This was discussed with the manager during the site visit that the home must keep all staff files on site and that they must include all items referred to in the National Minimum Standards. The AQAA states that all staff has had a criminal record bureau (CRB) check and Protection of Vulnerable Adult (POVA) check prior to starting work in the home. As was previously stated in this report the original records were not available to confirm this. Care Homes for Adults (18-65 years) Page 24 of 30 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 use the service benefit from a well run home. The service actively seeks feed back a have a robust quality assurance processes in place. The health, safety and welfare of residents are promoted and protected. Evidence: 50 Fordbridge Road has a very stable management structure the manager has considerable experience working and managing care home for people with learning disabilities. The AQAA states that The home is well organised and managed due to the presence of the manager and deputy and there is a hand on approach from the manager which ensures she is open and approachable to service users and staff. The was confirmed during the site visit by direct observation, discussions with staff and a random review of the homes records. The home holds regular residents and staff meetings which was confirmed by staff spoken to and from records sampled during the site visit and a weekly pictorial agenda on display in the dining room. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The manager stated in the AQAA that Service users are supported to complete a quality questionnaire and the results are auctioned within the service. They also have weekly tenant meetings where they have the opportunity to express their views and the manager or deputy regularly attends these meetings and the minutes are presented in the team meeting. Service users also have regular action planning meetings and these are also discussed in the team meeting to ensure any actions are met by the staff team. The service has regular monthly visits from the senior management team and the service users have the opportunity to take part in these visits and give their feedback on the service being provided. The service users are kept informed via the tenant meetings of events occurring in the home such as new staff, assessment of prospective service users, visits from outside agencies and events happening in the community. The home has clear well maintained records which are easily accessed by the staff team ensuring that they are kept up to date and precise. Evidence was seen during the visit that the service operates a robust quality control system and issues quality assurance (QA) questionnaires to relevant individuals and the residents are distributed. The home undertook a organisational QA during January 2009 with very positive comments and feedback from all who took part. The QA form reviewed during the site visit was very comprehensive and detailed and was possibly overly complicated for the residents to access with ease. It was discussed during the visit that the QA form should be reviewed and updated to make it more accessible to the residents with the removal of some question and to simplify the format to allow ease of access. In addition to the QA process the provider carries out a series of monthly regulation 26 monitoring visits to ensure that the service is operating at an appropriate level. As part of the inspection process the regulation 26 log and files were reviewed and found to be in good order. However as has been previously stated in this report the interests of the residents are not safeguarded by the policy introduced by the organisation to store all staff files in there HQ and not in the care home, therefore they are not available to the commission for the purpose of inspection and safeguarding. This was discussed with the manager and a review of the National Minimum Standards was undertaken to highlight that for the purpose of inspection all staff files must be retained on site. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The commission received pre- inspection information in the form of a Annual Quality Assurance Assessment AQAA, which indicates that Owl Housing provides a range of policies, and procedures to the home. The policies and procedures are regularly reviewed and updated, the manger subsequently brings the information to staff attention during staff meetings. The AQAA stated that The service has clear comprehensive risk assessments for individual service users and general risks and staff are required to read these and be familiar with them during their daily working. The staff team undertake training specific to health and safety such as moving and handling, health and safety, food hygiene and fire awareness. Substances hazardous to health (COSHH) were stored securely and appropriately. Health and safety checks are completed and recorded regularly, Gas Certificate , Electrical Certificate, Controlled Waste Contract and Insurance Certificate. The manager provided information to indicate that records and certificates and identified systems are in place for routine service and maintenance arrangements for the environment. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 The registered individual must ensure that all staff files are maintained at the service. To ensure that the information required to safeguard the residents are available at all times to ensure that they safeguarded. 23/02/2010 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 29 of 30 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. 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