Care Home: 53 Cambridge Road

What the care home does well The home provides care and support to enable users of the service to live fulfilling and meaningful lives. Residents are given choice in their day-to-day lives with appropriate support provided by staff at the home. There is an effective care planning system in place and each resident has a key worker who assists individuals to be involved as much as possible in this process. Residents are supported to access the local community and to undertake leisure pursuits of their choice and all residents have access to day services with individual programmes of activities. The home has a dedicated and stable staff team and they receive appropriate training to enable them to provide effective support to residents. What has improved since the last inspection? Since the last inspection the following improvements have been made to the service provided for residents and these included; The homes statement of purpose and service user guide have been updated and contain good information for any potential new service users about the service provided by the home. Care plans and Risk Assessments are now reviewed each month and service users are involved in this review process. Medication procedures at the home have improved since the last inspection and the home has obtained a copy of the Royal Pharmaceutical Society guidelines and service users are receiving their medication as prescribed. There are clear records regarding service users money and these provide a clear audit trail of residents finances. The home has a programme of redecoration and refurbishment in place and a number of new items of furniture have been purchased and some areas of the home have been re-decorated. The quality assurance procedures at the home have been improved and the views of interested parties in how the home is meeting peoples needs are taken into consideration. What the care home could do better: There was one requirement and one recommendation made as a result of this visit and other areas identified that could improve the service for residents are contained in the main body of the report, observations were; There is a medication policy and procedure at the home but this is a corporate policy and is not specific to the service, this issues was discussed with the manager and he understands that he must produce an in house policy, which will provide clear information for staff on the procedures to follow for the receipt, administration and disposal of all medication at 53 Cambridge road. The homes medication cabinet was checked and this was suitable for its current purpose as currently the home does not hold any controlled drugs. However the home has purchased a suitable cabinet for the storage of controlled drugs but this has not yet been secured to the wall. Should the home have the need to keep any controlled drugs on the premises the registered person must ensure that the cabinet is secured to ensure it meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. At present Medication Administration Records (MAR) sheets do not have any information printed on them about any when required medication that has been prescribed by the GP for residents. The manager of the home has made up his own recording sheet for this medication, and records are kept of medication administered, however the manager should contact the pharmacy and ensure that all medication that has been prescribed by the GP is printed on the MAR sheet Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 53 Cambridge Road 53 Cambridge Road Portswood Southampton Hampshire SO14 6UT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mick Gough     Date: 1 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: 53 Cambridge Road 53 Cambridge Road Portswood Southampton Hampshire SO14 6UT 02380551551 Telephone number: Fax number: Email address: Provider web address: www.choicesupport.org.uk Name of registered provider(s): Type of registration: Number of places registered: Choice Support care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users ot be accommodated is 6 The registered person may provide care to service users in the following category only: (PC) t oservice users of the following gender: Either whose primary care needs on admission to the service are within the following category : Learning disability (LD) Date of last inspection Brief description of the care home 53 Cambridge Road is a large detached house, which provides care and accommodation to up to six people who have a learning disability. The home has six single bedrooms and has a large garden, which is accessible to all service users. Choice Support took over the home in 2004 and is now the registered provider. Cambridge Road is situated in Portswood, Southampton close to local amenities and has good transport links. Fees at the home depend on the type and level of support required. Items not included in the fees are: contribution to the car, which is Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home dependent on how much the person uses it, personal items such as clothes, toiletries, holidays and personal purchases. Full details of current fees are available 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report details the evaluation of the quality of the service provided at 53 Cambridge road and takes into account the accumulated evidence of the activity at the home since the last inspection, which was carried out in May 2008 The inspection took into account the homes Annual Quality Assurance Assessment (AQAA) that was forwarded to us prior to a site visit to the premises and this provided us with information about the home. Included in the inspection was an unannounced site visit to the home, which took place on the 19 May 2009 Evidence for this report was obtained from reviewing the homes completed AQAA, reading and inspecting records, touring the home and from observing the interaction between staff and users of the service. It was also possible to gain the views of the people living at the home and we had the opportunity to speak with four residents and Care Homes for Adults (18-65 years) Page 6 of 29 three members of staff. The homes manager was also available and he assisted the inspector throughout the visit. The home is registered to provide support for 6 residents who have a learning disability and at the time of the inspection the home was full. What the care home does well: What has improved since the last inspection? What they could do better: There was one requirement and one recommendation made as a result of this visit and other areas identified that could improve the service for residents are contained in the main body of the report, observations were; There is a medication policy and procedure at the home but this is a corporate policy Care Homes for Adults (18-65 years) Page 8 of 29 and is not specific to the service, this issues was discussed with the manager and he understands that he must produce an in house policy, which will provide clear information for staff on the procedures to follow for the receipt, administration and disposal of all medication at 53 Cambridge road. The homes medication cabinet was checked and this was suitable for its current purpose as currently the home does not hold any controlled drugs. However the home has purchased a suitable cabinet for the storage of controlled drugs but this has not yet been secured to the wall. Should the home have the need to keep any controlled drugs on the premises the registered person must ensure that the cabinet is secured to ensure it meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. At present Medication Administration Records (MAR) sheets do not have any information printed on them about any when required medication that has been prescribed by the GP for residents. The manager of the home has made up his own recording sheet for this medication, and records are kept of medication administered, however the manager should contact the pharmacy and ensure that all medication that has been prescribed by the GP is printed on the MAR sheet 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear Statement of purpose and service users guide which sets out clear and accessible information for service users. Prospective new users of the service aspirations and needs are assessed before they move into the home. Evidence: We looked at the homes Statement of Purpose and Service Users Guide and this was available in each service users file. It provided service users with the information they needed to enable them to make an informed decision on whether to move into the home or not. The Service User Guide gave information on the fees to be charged and also gives details of any additional services that residents need to pay for, this included a charge for the use of a vehicle that had been leased for use by service users and they are all expected to pay a charge towards petrol. The completed AQAA stated that each service user has a individual service user guide that is clearly written with the use of symbols and photographs and we were able to confirm this at the site visit. Social service assessments are undertaken as well as the homes in house assessments. No new residents have moved into the home since the last visit to the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed needs and personal goals are reflected in an individual plan of care and they are supported to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. Evidence: Care and support plans were seen for 2 residents and these were clear and easy to follow and gave clear information for staff on what support was needed and how and when this support should be given. Both care plans had clear information and were person centred. Each plan had a personal profile and this gave information on the specific needs of individuals, there was information on the activity or task to be undertaken, information on why support was needed, when and where support should be provided and also information on how the service user liked the support to be given. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: There were plans in place for household tasks, personal care, health, communication, accessing the community and religous observation and faith. The plans were very comprehensive and put the service user at the centre of the care and were produced in a format that people could understand. Some plans had picture symbols and also had information on how the service user communicated. Service users spoken with were fully aware that they had a plan of care and told us that they were involved in its compilation and told us they sat down with their key worker to review the plans regularly. Plans seen had details of daily routines around the home, personal hygiene, socialisation, behaviour, care at night, as well as likes and dislikes. All residents have a key worker and they review care plans every 6 weeks with residents, the reviews include information on any issues outstanding from the last meeting, information on what has been achieved, what has been learnt and how things could be improved. The reviews also gave the resident the opportunity to set goals to be achieved for the next 6 weeks. Any changes are discussed at monthly team meetings and implemented as required. Staff are made aware of any changes through regular meetings, staff handover when shifts change and also via the communication book in use at the home. Daily recording takes place and there is clear documentation to evidence care delivery. Residents are supported to make decisions about their day to day lives and staff were observed interacting with residents and taking their views into account, there was evidence in care plans of residents preferences and there was information in care notes which showed that they had been offered choices and also detailed the choices made. The home holds monthly residents meetings and there were also 6 weekly reviews with their key worker. One service user has an advocate who visits regularly and the other service users have access to an advocacy service should the need arise. Resident told us that they were able to make their own decisions and that staff respected this. Both resident who were case tracked had risk assessments in place and these gave details of the assumed risk, why taking the risk was important to the person, information to ascertain if there have been any issues in the past and there were stratergies in place to manage the risk. Risk assessments were reviewed monthly and service users were involved in the reviews and signed the risk assessments together with a member of staff. Care Homes for Adults (18-65 years) Page 13 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 encouraged and supported to be part of the local community and to be involved in appropriate activities. Residents benefit from support to maintain social contacts and daily routines at the home respect their rights and responsibilities. Meals at the home are flexible and residents benefit from a healthy diet. Evidence: Two service user have part time jobs for 2 hours per week for which they are paid, three service users attend a local college and undertake, computing and cookery courses. Three service users attend an arts and crafts group, one service user attends a self advocacy group and the home supports all service users to be as active and independant as possible. All of the residents have their own individual programme of activities and these include day services and local groups for people who have a learning disability. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Residents who we spoke to were very happy with their daily activities and told us that staff support them to go out into the community, they told us that they like to go out to the local shops and visit thier local area. The home has supported one service user to go out independently, this started with trips to the local shops and staff would initially shadow the resident until they built up their confidence. As a result of this support the resident now goes out independantly and we were told by the service user that they loved the independence. The home is currently supporting another service user to go out on their own but this is currently in the very early stages. The home supports residents to go on holiday and one resident was keen to tell us of the forthcoming holiday to Butlins, we were told told that they are going with another service user and will be supported by the key worker. The home has a visiting policy and there were no restrictions. 2 service users have a lot of friends in the local area and they regularly receive visitors. 2 other service users have regular visits from family and one service user goes home to see their sister on a regular basis. The home provides support for residents to send greetings cards to relatives at appropriate times. Residents are encouraged and supported to maintain family links and staff told us they would respect residents wishes on who they did or did not wish to see. Staff were observed interacting with residents and their preferred form of address was used. The residents who were at home on the day of the visit told us that they were very happy at the home. One resident had no verbal communication but made it clear that they were happy and it was clear that residents and staff get on well together. Routines in the home respected residents rights to be involved as much or as little as they want, residents are expected to help to clean their own rooms and have a rota for doing their own laundry. Staff provide verbal encouragement and practical support as required. Mail is given to them unopened and staff support them with their mail. Menus at the home are made up each week after a menu planning meeting with staff support. This meeting helps to ensure that the likes and dislikes of residents are taken into account as is their nutritional needs. Copies of the weekly menu are kept and a record of food eaten by each resident is also kept. Residents are offered a choice of cereals and toast at breakfast, the lunchtime meal is usually a snack type meal and this is normally a packed lunch, for those residents who are out at college or day service and those who are at home prepare a snack or sandwich with staff support. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The main meal is usually in the evening and residents take it in turns to assist staff in the preparation of the meal as much as their abilities will allow. The menu is flexible and allows for change at short notice. Staff carry out shopping weekly and residents go with staff to buy food shopping for the home. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in the way they prefer and their physical, emotional and health needs are met. The home has corporate policies and procedures with regard to medication but this does not provide clear information for staff on the procedures to follow for the receipt, administration and disposal of all medication at 53 Cambridge road. Evidence: Personal support is given flexibly and resident plans give clear information to staff on how they would like their personal support to be given. Care plans had good information and those residents that are able to attend to their own personal care needs, only require verbal prompts, however staff will give extra support if needed. Those residents that require a higher level of support have good information in their care plans about what support is required and how this should be given. There is a mix of both male and female staff and each resident has a key worker and they have been involved as much as possible in their selection. Personal support is given in private and the preferences of residents on who they prefer to give them the support they need is respected. The home has a policy on Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: cross gender care and if at all possible same sex care is offered and given. All of the residents at the home are registered with the same GP surgery, however they have different GPs. Residents visit a community dentist but one resident has a visiting dentist when required. There is a visiting optician service who call at the home but some residents go to the optician in the local area. Foot care is provided by a local podiatry service and the home is supported by the local learning disability team. Residents are able to access other health care professionals such as district nurses, occupational and speech therapists through GP referrals. A health care form is completed after each health care professional visit to provide clear information about any appointment and treatment given. All staff have received training in the administration of medication and specimen signatures of those authorised to administer medication are kept at the home The home has changed pharmacy since the last visit and uses a monitored dose system for medication. We looked at the Medication Administration Records (MAR) for service users and these were up to date with no omissions. Each service user has a plan to provide staff with clear information on how each service users medication is given. Currently the MAR sheets do not have any information printed on them about any when required medication that has been prescribed by the GP, this medication is mainly for pain relief. The manager of the home has made up his own recording sheet for this medication and there are clear records of any medication administered, however it is recommended that the manager contact the pharmacy and ensure that all medication that has been prescribed by the GP is printed on the MAR sheet. There is a corporatate medication policy and procedure at the home but this is not specific to the service, we discussed this issue with the manager and he must produce an in house policy, which will provide clear information for staff on the procedures to follow for the receipt, administration and disposal of all medication at 53 Cambridge road. There have been requirements made in the past three inspection reports regarding the safe handling of medication and an appropriate procedure, which is specific to the home will help support the sustaining of good practice. The homes medication cabinet was checked and this was suitable for its current purpose. The home does not currently hold any controlled drugs, however the home has purchased a suitable cabinet for the storage of controlled drugs but this has not yet been secured to the wall. Should the home have the need to keep any controlled drugs on the premises the registered person must ensure that the cabinet is secured Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: to ensure it meets the standard set in the Misuse of Drugs (Safe Custody) Regulations 1973. Care Homes for Adults (18-65 years) Page 19 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. There is a clear and accessible complaints procedure, which includes timescales for the process and residents can be confident that their views would be listened to and acted upon. The home has policies and procedures to help protect residents from any form of abuse Evidence: The home has a clear and accessible complaints procedure and this contained all of the required information and gave details of how to contact the CQC. The homes completed AQAA states that there has been no complaint to the home since the last inspection and the manager was able to confirm this on the day of the visit. Residents told us that if they had any concerns they would speak to a member of staff and two staff members spoken to were aware of the complaints procedure and both said they would support residents to make a complaint if they wished to do so. The home has a clear policy on adult protection and also has a copy of the Hampshire Adult Protection Guidelines. There is a whistle blowing policy and procedure and staff also receive training with regard to adult protection and POVA as part of their induction and refresher training is carried out annually. Two staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Financial procedures at the home for service users were in place and there was information in care folders regarding resident financial arrangements and staff support residents to manage their finances and their is a clear audit trail. There is clear information on what each service user has to pay for the lease car and service users spoken with were happy with this arrangement. All service users have their own bank account and on the day of the visit one service users was going out with staff to the bank. The completed AQAA told us that the manager (or delegate) conducts weekly finance checks and the finances are also audited every 3 months by the service manager and are monitored monthly at the providers registered person visits. . Care Homes for Adults (18-65 years) Page 21 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. Residents live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. Evidence: A tour of the home was conducted and the home is laid out over 2 stories. There are two lounge areas, a kitchen/diner, utiity room, bathroom, separate WC and 2 bedrooms. The upper floor contains 4 bedrooms, a bathroom a separate WC and an office. All areas of the home were clean and furniture and fittings were of good quality and homely in appearance. The service was clean and hygienic and there were no offensive odours. The utility room is used as the laundry and this has washable floors and walls. There is an industrial washing machine and tumble drier and residents are supported to do their own laundry, each resident has an allocated day to do their laundry but can use the washing machine at any time if it is not being used. Staff encourage residents to do as much as possible for themselves and provide support as required. 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 a stable staff team in sufficient numbers to meet the needs of service users. Staff employed at the home have the competencies required to meet residents assessed needs and residents are protected by the homes staff recruitment procedures and are supported by trained staff. Evidence: The homes completed AQAA told us that the home employs a total of fourteen permanent care staff and there are also bank staff that cover for holidays and sickness, we were able to confirm this on the day of the visit. Currently there are seven members of staff who has completed a minimum of NVQII. The manager informed us that staff are encouraged and supported to undertake NVQ qualifications. There are no domestic staff employed at the home and care staff carry out all domestic duties with the residents. The staff Rota was looked at and this showed that there is a minimum of two staff member of duty at all times during the day and the rota showed that for the majority of the day there were 3 staff members on duty. At night there is one staff member onduty who is awake throughout the night. Staff spoken with said that the staffing levels were sufficient and that the manager arranges extra staff at weekends when Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: there was no day service and this allowed for spontaneous activities to take place. Residents told us that there was always staff around and that if there were any problems or if they needed any assistance there was always someone to help. We looked at recruitment records of two staff, although the organisation has an agreement that recruitment records could be held centrally for staff, the manager had copies of these records at the home and these showed that all of the required recruitment records were kept at the home and were locked away for confidentiality reasons. The completed AQAA told us that residents at the home are involved in interviews for staff and residents have been supported to write individual job specifications for staff who they would like to provide support for them. There is a training co-ordinator employed by the organisation who arranges training for all staff employed at the home. A training prospectus is sent out each year with the dates of relevant courses that have been arranged throughout the year, the manager then identifies training needs with staff and books them on courses as appropriate. The manager showed us a training matrix and this showed that staff had received training in; health and safety, food hygine, moving and handling, first aid, medication, and adult protection. Additional training is also carried out for managing challenging behaviour, learning disability and care practices. All new staff have an induction, which is based on the skills for care induction and foundation standards, there is a corporate induction to the organisation and also an in house induction to inform staff about issues in the home. The homes completed AQAA stated that staff receive regular training and the homes staff training matrix seen confirmed this. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an effective manager in place and the home is run in the best interest of residents and the health safety and welfare of residents and staff are promoted and protected. There is a quality assurance system and this takes into account the views of residents and other stakeholders into how the home is operated. Evidence: The manger of the home has been in post for over 3 years and he has obtained the registered managers award but has not yet achieved NVQ4 in care, he told us that he intends to enrol on a suitable course later this year. The home has developed a quality assurance procedure and the organisation carries out an annual quality assurance audit of the service, there are also 3 monthly audits of budgets and financial arrangements. Questionaires are sent out to residents and staff and these are returned to the head office and the manager told us he is made aware of the results of these questionnaires. There are regular resident and staff meetings and we saw evidence in the minutes of these meetings that staff and residents views are taken into consideration. The registered providers also carry out Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: monthly registered person visits in accorance with Regulation 26 of the care home regulations. The homes fire log book was inspected and all of the required training and testing is carried out and there is a fire risk assessment for the building. The Gas safety certificate was out of date, however the manager informed us that an engineer had visited, but as yet the certificate had not been sent to the home, we were able to see in the homes diary a record of this visit and the manager needs to follow this up with the housing association to ensure that an in date certificate is obtained for the home. Routine maintenance and any major repairs are carried out by the housing association that own the building. There was a defect book where any defects are recorded and they are signed of, as work is completed. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must ensure that there is a clear policy and procedure in place with regard to the receipt, storage, administration and disposal of all medication at the home This will ensure that staff have the information and guideance they require with regard to all medication procedures, including any when required medication 29/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 It is recommended that the manager contact the pharmacy and ensure that all medication that has been prescribed by the GP is printed on the medication administration record sheet. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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