Care Home: 50a Avis Road

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What the care home does well The relaxed, homely and welcoming atmosphere has evolved over many years and reflects the consistency and dedication of the experienced manager and the effort and commitment of the staff team, who have clearly developed close professional relationships with the residents. Staff are evidently valued and supported by the manager and he is clearly held in high regard not only by members of staff but residents and their relatives as well. Effective systems are in place for the admission and ongoing care of residents. The manager and staff remain clearly committed to developing the service and are constantly looking to improve outcomes for residents. High quality, person centred, support plans, developed from comprehensive pre admission assessments, promote continuity of care and ensure that the complex support needs of residents are met in a structured and consistent manner. Communication and consultation with residents` family members is effective with relatives having the opportunity to partake in individual assessment, care planning and reviewing processes. What has improved since the last inspection? Stability has returned and morale has evidently improved within the staff team, following a relatively unsettled period. Following the departure of the previous incumbent, a new deputy manager has recently been appointed. There were no requirements or recommendations made as a result of the previous inspection. What the care home could do better: It is hoped that the progressive and high quality service provision can be maintained. There were no requirements made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: 50a Avis Road 50a Avis Road Newhaven East Sussex BN9 0PN     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: Nigel Thompson     Date: 2 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 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: 50a Avis Road 50a Avis Road Newhaven East Sussex BN9 0PN 01273612171 01273612171 avisroad@southdownhousing.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southdown Housing Association Ltd 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 to be accommodated is 5. 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 50a Avis Road is a care home, which provides personal care and accommodation for up to five residents with complex learning and physical disabilities. The home is owned and run by Southdown Housing Association who are a large voluntary organisation that have been providing services to people with learning disabilities across East Sussex for over 16 years. The home is a spacious purpose built bungalow on the outskirts of Newhaven, close to a large supermarket, garden centre, restaurant, local pub, train station and bus stop. The town centre is within walking distance. Each service user has their own bedroom, Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home which is personalised with their own possessions, photographs and pictures. Communal areas include a large kitchen/dining area, lounge and a garden. There are two bathrooms, which have adapted equipment to meet the needs of the service users. The service users undertake a range of activities in the home and in the community. There are two vehicles, both of which are wheelchair accessible. The home is well decorated and maintained throughout and has a friendly and homely atmosphere. The home provides personal care and support to residents who are funded by Social Services. The homes fees as of 29th January 2010 are £1650 - £1670 per person per week. This includes, chiropody, all in house activities, outings (excluding entrance fees), transport, the cost of occasional meals out and the staffing and cost of meals for an annual holiday. Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. A copy of the homes most recent inspection report is available on request from the home. 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: 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: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. This unannounced inspection took place over four and a half hours, between 10.00 and 14.30, in January 2010. It found that all of the key National Minimum Standards that were assessed had been met and the overall quality of care provided was very good. On the day of the inspection there were five residents living at the home. The inspection process involved observation of working practices, examination of the homes records and discussion with two residents relatives, two members of staff and the Registered Manager. Communal areas throughout the home were seen and all residents bedrooms were viewed. Care Homes for Adults (18-65 years) Page 6 of 29 The focus of the inspection was on the quality of life for people who live at the home. 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 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 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 9 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 thorough admission policy and procedures ensure that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents are provided with sufficient relevant information to know that the home is able to meet their individual care and support needs. Evidence: Information is available to prospective and existing residents in various formats. The Statement of Purpose and Service User Guide have been thoughtfully and imaginatively produced to a high standard and are both comprehensive and informative. The Statement of Purpose provides an introduction to Southdown Housing Association, details of the Registered Manager and the number, relevant qualifications and experience of staff working in the care home. It also contains details of the overall service provision including: the accommodation, arrangements for residents to engage in social and leisure activities together with any Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: therapeutic techniques, arrangements for dealing with concerns or complaints and the systems for ensuring that residents needs are identified, met and reviewed, in accordance with person centred planning. The Service Users Guide is presented in an easy to read format, which incorporates the use of colour pictures and symbols including a photograph of the home. It gives an overview of the philosophy of care, purpose of the service, accommodation and outlines what support and care individuals can expect from the home including support and communication, personal space, individual planning, holidays, day service provision and terms of occupancy. No resident has been admitted to the home since 2007, however there was evidence of a clear and thorough admission policy and procedure being in place. As part of this procedure, a detailed pre admission assessment and comprehensive Health Check are undertaken and include information relating to the individuals personal, medical, social and psychological care and support needs. The manager confirmed that as part of the admission process, prospective residents and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and existing residents. New residents evidently undergo a three month trial period at the home, during which time their suitability and compatibility are assessed and it is established whether their identified care and support needs are able to be met. A full review is held at the end of this period, involving the resident, their relative or representative, the Service Manager and Area Manager. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive, person centred support plans enable staff to meet the assessed care and support needs of residents in a structured and consistent manner. Systems for consultation and participation are effective and residents are treated with respect and encouraged and enabled, as far as practicable, to make decisions about their day to day living. Evidence: High quality, person centred care plans have been developed for each resident, clearly linked to the individuals assessed needs. The plan is formulated by the key worker, manager and evidently with the direct involvement of the resident or family member, as appropriate. At the front of each plan is a personal profile incorporating general background information and detailing the individuals needs and preferences, likes and dislikes. There are also clear guidelines for staff, including bathing, food preparation, and preferred routines, to ensure that all necessary support is provided in a structured and Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: consistent manner. It was also noted that Communication guidelines have been developed in respect of residents, who each have very limited communication. The guidelines are written in the first person and ensure that staff are aware of the individuals current physical and psychological condition and of their ongoing care and support needs. Staff spoken with during the inspection emphasised the importance of developing close working relationships with individual residents and being aware of often subtle changes in their mood or condition. Despite the limited communication of the residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting residents in a professional, sensitive and respectful manner. Residents support plans are formally reviewed every six months to ensure that the individuals care and support needs continue to be met in a structured and consistent manner. However the manager confirmed that in addition to this, all residents are discussed in detail at staff meetings and any significant changes are evidently addressed immediately. In support plans that were examined, there was clear evidence of the direct involvement of the resident or a relative in the reviewing process. A residents relative spoken with confirmed her involvement in this process: Im involved in all his reviews and in fact Im going to one tomorrow. Resident are clearly consulted regarding many aspects of their day to day living, including menu planning and choosing both individual and collective social, recreational and leisure activities. Residents are encouraged and enabled as far as practicable to participate in all aspects of life in the home. They are supported to help with meal preparation, undertake household tasks, make their own hot and cold drinks and go shopping. Individuality and independence continues to be promoted within the home and residents are encouraged to take responsible risks where necessary. It was noted that detailed risk assessments and guidance are in place for many activities of daily living, based on the needs of individuals. All those viewed had recently been reviewed and updated as necessary. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: 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. Residents are enabled and supported to maintain contact with family and friends as they wish and links with the community enrich their social and educational opportunities. Residents benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: The recreational and leisure interests of residents are identified and recorded in their individual support plan and they continue to be enabled to access activities and facilities, reflecting their individual needs, preferences and abilities. In addition to daily records and plans of care, residents are supported to maintain a daily diary of the activities they have undertaken. Individual support plans examined and comments from staff and residents confirmed Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: that activities include craftwork, music sessions, attending a local college and other day services. Residents enjoy regular supported trips out and a variety of other leisure activities, including art and craft, beauty and massage sessions. The manager confirmed that each of the residents continues to enjoy regular holidays, some of which have been abroad. Community participation remains a focus in the home and residents are evidently encouraged and supported to visit the cinema, theatre, local shops and other amenities. From examination of residents daily diaries and the homes own daily records, it is evident that, where appropriate, residents continue to be supported by staff to maintain regular contact with their families and friends. Visitors are always made to feel welcome at the home at anytime. Details of friends, relatives and people that are important to the person are clearly documented within individual support plans. All meals within the home are prepared by care staff and, where appropriate, residents are supported and regularly involved in meal preparation. The menus are varied and balanced, reflecting individuals identified choices and preferences. Specialist diets are appropriately catered for, including one resident who has his meals administered through a PEG feed system. Residents are encouraged to dine together alongside staff in the kitchen/dining area, however they have the freedom to choose to eat at different times or in other parts of the house, should they prefer. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual support needs. Residents are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: In accordance with their support plan, residents are enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, staff were observed interacting with residents in a professional and respectful manner. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents are continuing to be met within the home. All residents are registered with local GPs and have access, via the Community Learning Disability Team (CLDT), to other health care professionals, including community nurses, speech and language therapists, physiotherapists and dentists, as required. It was noted, in support plans that were examined, that residents are Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: supported to attend all healthcare appointments as necessary and all such appointments with, or visits by, health care professionals are recorded. As previously documented, following consultation with residents, specific guidelines have been developed for all staff, ensuring that support is provided in a structured and consistent manner and in a way that the individual prefers. Guidelines are in place in relation to how to support residents with their health care needs, including the management of epilepsy. Such guidelines ensure that staff are aware of what a normal seizure is for the individual and how to support them personally in the event of a seizure. The home continues to operate an effective key worker system and staff were observed working closely and sensitively with residents to meet their identified personal care and support needs. A residents relative, spoken with as part of the inspection process, commented positively on the special relationship developed with the keyworker: .......is so happy and settled there. His key worker is great and has developed such a close bond with him. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The home uses a monitored dosage system (MDS) for prescribed medicines and a local pharmacist continues to carry out quarterly monitoring visit. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. Following risk assessments, it is evident that no resident self administers their own medication. 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. The open and inclusive atmosphere within the home enables residents, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. Residents best interests are safeguarded through relevant staff training and robust policies and procedures. Evidence: A detailed and up to date complaints procedure is included within the homes Statement of Purpose and Service Users Guide, for the benefit of residents, their relatives and other visitors to the home. It gives clear guidance with regards to how a complaint can be made and how the complainant can expect it to be dealt with. All complaints are recorded and include actions taken and outcomes achieved. However, it was noted that there have been no formal complaints received by the home since the last inspection. Residents meetings are evidently held on a regular basis and provide an opportunity for any concerns to be raised, discussed and hopefully addressed before they become complaints. Members of staff and residents relatives, spoken with as part of the inspection process, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: listened to. The organisation has produced detailed policies and procedures relating to abuse, including a whistle blowing policy. Staff have undertaken specific training, in accordance with the multi agency guidelines for the safeguarding of vulnerable adults. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. The manager continues to act as an appointee for four residents and all monies are stored securely. Detailed policies and procedures ensure that balances are regularly checked daily and an examination of the relevant documentation confirmed this. Computerised systems are in place to ensure that all financial transactions are carefully monitored and appropriately recorded. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and remains suitable for its stated purpose. Reidents benefit from spacious accommodation that is comfortable, well maintained and decorated to a satisfactory standard. Evidence: 50a Avis Road is a large, purpose built, five bedroom bungalow within walking distance of the town centre, supermarket and public transport. The spacious kitchen, which appears to be a focal point of the home, has a breakfast bar and a specially designed work top and sink, which can be raised or lowered for the benefit of people who use a wheelchair. There is a large communal lounge area, with a TV and video/DVD and music system. There are two fully adapted bathrooms at the home, one of which has optional piped music and a spa facility and this is referred to as the sensory bathroom. Outside, a courtyard garden is directly accessible through patio doors from the kitchen. It is evident that the physical environment of the home remains largely unchanged and the well maintained decor and good quality furniture and furnishings continue to provide a comfortable, pleasant and homely environment for residents. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: A member of staff confirmed that individuality and independence continue to be promoted within the home, as far as is practicable. This was evident from the personalising of residents rooms, which clearly reflects individual tastes, preferences and interests. Residents are also evidently involved in choosing their own furniture, accessories and decor. All necessary adaptations have bee made and specialist equipment provided, throughout the home, to meet residents assessed mobility needs, including ceiling tracking hoists, profiling beds and assisted baths. Infection control procedures are in place and closely adhered to and levels of cleanliness and hygiene remain high throughout. A programme of routine maintenance, renewal and redecoration is in place. All the doors are fireproof and have been fitted with automatic electronic closures. Fire systems within the home were checked on the morning of the inspection. 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. There is always sufficient trained and competent staff on duty to meet the assessed, and often complex care and support needs of the residents. Residents are protected by satisfactory staff recruitment policies, procedures and documentation. Evidence: The stable and dedicated staff team remains clearly able to meet the assessed, individual and collective needs of residents within the home. Through discussion with members of staff and according to duty rotas viewed, it is evident that there is always sufficient staff on duty to meet residents complex care and support needs and enable them to participate in their chosen activities. All new employees are provided with a comprehensive job description and staff spoken with demonstrated a sound understanding of their individual role and responsibilities. All new staff receive comprehensive induction and foundation training, the Common Induction Standard, which is compatible with Skills for Care and is flexible and compatible with an individuals level of relevant experience. Mandatory training is ongoing and is recorded in individual staff files. This was confirmed through discussions with staff and supported by training records Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: examined: There is always so much training and refresher training available. Ive done loads since Ive been here. The organisation is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files contain all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. The manager confirmed that residents continue to be actively involved in the recruitment and selection process and meet with all prospective members of staff. Staff meetings are held on a regular basis and are appropriately recorded. Staff are encouraged to contribute to the open agenda. Communication within the home is effective and morale is evidently good. However from dicussion with members of staff it is clear that this has not always been the case: The team works very well together now. There is a good atmosphere here and everyone seems happy in their work but it hasnt always been that way. In accordance with organisational policy, formal supervision is provided for all care staff on a regular basis. Supervision contracts are agreed and signed in advance and stored securely within the office. This was evidenced by supervision records examined and through discussions with staff, spoken with during the inspection, who acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager: I find supervision very useful, although if I want I can talk to the manager anytime I like. It was evident, from direct observation and through discussions with members of staff that the manager also operates an open door policy, with staff feeling confident and able to discuss any issues at anytime. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well run. Residents benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by effective quality monitoring systems. Evidence: The Registered Manager at 50a Avis Road has been working for Southdown Housing Association for twenty years. He holds a National Vocational Qualification (NVQ) level 4 for both the Management of Care and the Registered Mangers Award (RMA). Since the previous inspection a new Deputy Manager has been appointed. Staff supervision is shared between the two. Through discussions with residents relatives and members of staff, it is evident that the manager continues to demonstrate a clear sense of leadership and direction and the home continues to be very well managed. He is evidently motivated, positive and approachable and continues to create an open and inclusive atmosphere within the home. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Hes a rock, a brilliant manager and very supportive. The home continues to operate effective quality monitoring systems, including satisfaction questionnaires for both residents and their relatives. A residents forum, organised by Southdown Housing Association, continues to be held on a regular basis. This enables and encourages residents to share their experiences of living within individual homes and offers them the opportunity to feedback to senior management about any concerns or complaints they may have. Minutes of these meetings are recorded and then fed back to staff during team meetings. A quality assurance file in place, produced by Southdown Housing Association, contains modules based on meeting the outcomes of the National Minimum Standards (NMS) in addition to ensuring that regular health and safety checks including the maintenance of the homes vehicle are undertaken. An annual quality monitoring day provides an opportunityy for the team to get get together to discuss and audit how well the home contiues to perform and meet residents needs. Issues covered include: the staff team, housekeeping, support and mobility for residents, meeting healthcare needs, person centred planning and health and safety matters. The health, safety and welfare of residents and staff evidently remain of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents. All accidents, incidents and injuries are recorded and reported, as required. 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 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!