Care Home: 55 Langaton Lane

What the care home does well People who may be thinking about moving in will be given plenty of time, information and opportunities to get to know the home before they decide to move in permanently. The home will take care to get to know the person and find out what support and accommodation they need, and to make certain that 55 Langaton Lane is the right place for them to live.They have good care planning systems in place and they make sure the staff team have all the information they need so that people receive the support they need and want.People are able to choose from a very wide range of opportunities for learning and development. There are excellent day centre facilities offered by the home at a day centre situated in the Heavitree area of Exeter that is available to people who live in homes owned by Regents Park Ltd.People have the support they want with all their personal care needs. The staff have been well trained and there are good systems in place to make sure staff recognise any signs of possible ill health. They will be referred to medical specialists for treatment and advicewhere necessary.The home has a good range of policies and procedures in place to make sure people are protected from harm or abuse. The staff are well trained to recognise signs of of possible unhappiness or possible abuse and are confident that the correct action will be taken if any concerns are raised.The bungalow is spacious, well maintained, attractively decorated, and homely throughout. All areas have been well furnished and people are able to move around the home safely and easily. The home is clean and safe.The staff team have been carefully recruited and well trained. The staff we talked to during our visit told us how much they enjoyed their work, and they were happy with all aspect of the management and support provided.The home is well managed. There is a new manager in post who told us she will submit an application to register in the very near future. The people living in the home are consulted as far as they are able in all aspects of the day to day management and routines in the home. What has improved since the last inspection? This is the first inspection following the registration of the home. What the care home could do better: Information about the medications prescribed to each person could be improved so that care staff have all the information they need at all times. Key inspection report Care homes for adults (18-65 years) Name: Address: 55 Langaton Lane 55 Langaton Lane Exeter Devon EX1 3SP The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Vivien Stephens Date: 1 4 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 32 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 55 Langaton Lane 55 Langaton Lane Exeter Devon EX1 3SP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Regents Park Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 3 0 0 0 0 0 learning disability physical disability sensory impairment Additional conditions: The home will accommodate service users between the ages of 16 to 25 years only. The maximum number of service users who can be accommodated is 3. The registered person may provide the following category of service only: to service users of either gender whose primary care needs on admission to the home are within the following categories - Learning Disability - Code LD - maximum of 3 places Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home 55 Langaton Lane is a detached bungalow situated in a quiet residential road in the Pinhoe area of the city of Exeter. There is parking at the front of the bungalow and secluded level gardens to the rear. There is level or ramped access to all areas. The home can provide accommodation for up to three young adults whose main needs are due to learning disabilities. There are three single bedrooms, a large kitchen/dining room, a separate lounge, a bathroom and a shower room. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home Several weeks before this inspection took place we asked the providers to complete an Annual Quality Assurance Assessment. The form gave us with lots of information about the things that happen at the home every day, and the way the home is managed. The two people who were living in the home were out at school or day centre when we arrived. When they returned home at tea time we sat and talked to them and found out what they liked to do when they are at home. Care Homes for Adults (18-65 years) Page 7 of 32 During the day we talked to the new manager and looked at the records the home is required to keep. We also talked to three members of staff. What the care home does well People who may be thinking about moving in will be given plenty of time, information and opportunities to get to know the home before they decide to move in permanently. The home will take care to get to know the person and find out what support and accommodation they need, and to make certain that 55 Langaton Lane is the right place for them to live. Care Homes for Adults (18-65 years) Page 8 of 32 They have good care planning systems in place and they make sure the staff team have all the information they need so that people receive the support they need and want. People are able to choose from a very wide range of opportunities for learning and development. There are excellent day centre facilities offered by the home at a day centre situated in the Heavitree area of Exeter that is available to people who live in homes owned by Regents Park Ltd. People have the support they want with all their personal care needs. The staff have been well trained and there are good systems in place to make sure staff recognise any signs of possible ill health. They will be referred to medical specialists for treatment and advice Care Homes for Adults (18-65 years) Page 9 of 32 where necessary. The home has a good range of policies and procedures in place to make sure people are protected from harm or abuse. The staff are well trained to recognise signs of of possible unhappiness or possible abuse and are confident that the correct action will be taken if any concerns are raised. The bungalow is spacious, well maintained, attractively decorated, and homely throughout. All areas have been well furnished and people are able to move around the home safely and easily. The home is clean and safe. The staff team have been carefully recruited and well trained. The staff we talked to during our visit told us how much they enjoyed their work, and they were happy with all aspect of the management and support provided. Care Homes for Adults (18-65 years) Page 10 of 32 The home is well managed. There is a new manager in post who told us she will submit an application to register in the very near future. The people living in the home are consulted as far as they are able in all aspects of the day to day management and routines in the home. What has got better from the last inspection What the care home could do better Information about the medications prescribed to each person could be improved so that care staff have all the information they need at all times. Care Homes for Adults (18-65 years) Page 11 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Vivien Stephens Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 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 12 of 32 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 13 of 32 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. People who are thinking about moving in can be confident they will be carefully assessed and given information and plenty of opportunities to visit and get to know the home before any decision to move in permanently is made. Evidence: Two people were living at 55 Langaton Lane at the time of this inspection. They had previously lived in other homes owned by the same company and moved to this home when it opened 6 months ago. As they were already known to the service their care needs did not have to be re-assessed before they moved in. We were satisfied that their move had been carefully considered and planned and they had been given plenty of time and opportunity to get to know the home and decide if it was suitable before they moved in. The home told us about the assessment process they will follow in the future for any new people who may be thinking about moving in. We saw evidence to show that people have been given plenty of opportunity to visit and get to know the home, and they will be given information and opportunities to stay for as many trial visits as they feel are necessary. The home has good assessment procedures in place to help them gather the Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: information they need to confirm they will be able to meet the persons care needs. Care Homes for Adults (18-65 years) Page 15 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident they will be supported by staff who know them well and understand their care needs. People are given the support they need to help them lead lead independent lifestyles. Evidence: We looked at the care plan files for the two people living at the home at the time of this inspection. Each file contained a copy of the current medication administration record, emergency contact details for people and services who are important to the person, daily care recording sheets, and the care plan. One persons care plan did not appear to have been updated for 2 years, while the other persons care plan had been updated in January 2010. We talked to the acting manager of the home who thought that one care plan was in the process of being updated and may have been at the main office. We discussed the importance of having up to date information available to care staff at all times. However, through discussion with the staff on duty that day we were satisfied that the staff team had a very good understanding of each persons care needs and there were good communication systems in the home to Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: make sure staff were kept up to date with any changes in care needs. Following this inspection we have received further communication from the manager to confirm that the updated plan has now been placed in the house. They also told us they were working with the Additional Support Team to draw up a person centred plan. The care plans were written in a straightforward and easy to read style. The information in each section was fairly brief, and, given the limited communication skills of each person, the plans could have been expanded to give greater information and explanation about how the staff should support each person. This was discussed with the acting manager and the staff team, and we recommended that the plans are expanded where necessary. The daily reports completed by care staff gave good information about the care tasks completed by the care staff each day, and about any temporary changes to the care plans. We observed staff supporting the two people who live in the home on their return from the day service and saw them looking relaxed and cheerful. They were given choices about the things they wanted to do, and the things they wanted to eat. Care Homes for Adults (18-65 years) Page 17 of 32 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. People are given the support they need to lead interesting and stimulating lifestyles. People are encouraged to be active members of the local community and to keep regular contact with friends and family. The home provides people with a balanced and healthy range of food to suit all tastes and dietary needs. Evidence: The home told us in the annual quality assurance assessment (AQAA) completed before this inspection took place: We work very hard to ensure that the lifestyle that people have whilst in our care is not one that in any way resembles institutional care. We aim to give people the opportunity of doing normal things in normal places, whilst recognising and responding to their need for support in order to do this. We encourage service user involvement in both the fun parts of life (such as leisure activities) as well as the not so fun, but necessary aspects of life (i.e.housekeeping, washing, cleaning etc.) It is the choice of the service user to attend church and so they are supported individually to do Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: that. The home is owned by a small company that also owns a few other small homes nearby. They also run a day centre that is situated in the Heavitree area of Exeter, and people who live in homes owned by Regents Park Ltd are able to attend the day centre every weekday if they wish. This day centre is known as The Hub. At the time of this inspection one person living in the home attended school during term times, and The Hub during school holidays. The other person attended The Hub every weekday. The Hub is a large house offering a wide range of learning and leisure opportunities including computers, cooking, arts and crafts, gym, cinema, and animal care. There is a large vehicle to provide transport for the people living in the home. In addition people also have bus passes, and integration in the community is actively promoted. The home told us people regularly visit local places such as the library, cinema, pubs, local shops and other facilities. We saw evidence of recent outings to places of interest including Crealy Park, Exmouth, train and bus rides, and swimming pools. There was a pack giving a range of activity and outing suggestions for staff. Each person had an individual plan of the activities they regularly choose to do each week. We looked at the meals offered to people living in the home. There were printed menus covering a 3 week rota. The menus offered a good variety of meals taking into consideration individual likes and dislikes and dietary needs. We were assured by the staff that people are always given choices before each meal, but the choice is limited by peoples individual communication skills. The staff described the way they offer choices and we were satisfied they followed good practice methods. The home has promoted good communication with families and friends. Visits to and from families and friends have been encouraged and staff have kept in touch with families by telephone. Care Homes for Adults (18-65 years) Page 19 of 32 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. People are well supported by staff to meet their personal and health care needs. Medications are stored safely and well recorded. Evidence: The care plans we looked at explained the support each person needed with personal care tasks such as washing, dressing, hair, teeth etc. Each person was dressed in modern, age appropriate clothing and they had attractive hairstyles. The staff team talked about trips to the hairdresser and helping people to choose the clothes they wanted to wear, and they showed that they cared about the way people looked and wanted them to have a pride in their appearance. At the time of this inspection all of the staff were female, although one person living in the home was male. The acting manager told us they were in the process of recruiting a male member of staff, and this would help to improve the ratio of male/female staff and provide greater opportunity for people to be supported with personal care tasks by a member of staff of the same sex if preferred. Since this inspection the manager has told us they have recruited a male member of staff. The care plan files provided good information about the health care needs of each person. We saw letters on file showing the appointments with relevant health specialists and the Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: advice and treatments provided. There were good risk assessment methods in place to make sure that staff are able to recognise early signs and symptoms of potential illnesses and we were satisfied that medical advice and treatment has been sought appropriately. There were forms in the care plans to record all medical appointments. The homes diary provided evidence of future appointments with medical professionals including opticians, dentists, and epilepsy specialists. We looked at the way the home stored and administered medicines. There were secure medication storage facilities suitable for all medicines held in the home, including any controlled drugs that may be prescribed. The records of medicines administered had been well maintained and the home had recently started a monthly medication audit to check amounts held were correct. The home had some information about most of the medications prescribed to people. However, some aspects of the medications were not documented fully, for example pain relief prescribed on an as required basis, or creams and lotions. We talked to the acting manager about ways of expanding and improving the information to ensure that care staff have easy access to good information about each prescribed medication, why it has been prescribed, any possible side effects, and, in the case of creams and lotions, how, when and where to administer. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns or complaints will be taken seriously and acted upon promptly and appropriately. There are good procedures in place to protect people from the possibility of harm or abuse. Evidence: We saw a copy of the homes complaints procedure. It was thorough and has been written in a clear style, using signs and symbols to help people with poor reading and communication skills to understand their rights. We were satisfied that people have good support from a range of people outside the home who can speak out on their behalf if they have any concerns about the care provided by the home. Staff have received a good range of training and induction including topics covering all aspects of abuse and safeguarding. The staff we talked to assured us they felt entirely satisfied that they could raise any concerns or suspicions of abuse with the management team and these would be treated seriously and acted upon promptly and correctly. They also talked about the open atmosphere within the home where staff felt able to speak to colleagues to discuss any aspect of practice they felt was not appropriate and to continuously improve their practice to ensure people received exactly the right support. We looked at the way the home handles cash and savings on behalf of people living there. Each person had a bank account and the records were held at the company’s main Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: office. These were checked and doubled checked on a regular basis by several members of the senior management team, and were also checked independently by the companys accountant. Each person was also given amounts of cash to be held in the home to cover day to day expenses such as outings, clothing and personal requirements. All transactions were well recorded and receipts were held to provide evidence of all purchases. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a modern, comfortable, well maintained and homely environment to suit the individual needs and preferences of the people living there. All areas are clean, and safe. Evidence: The bungalow is detached and situated in a quiet residential road in the Pinhoe area of Exeter. It is in easy walking distance of local shops, bus and trains, and other local facilities. There are level gardens surrounding the property. In a tour of the property we found that all areas of the bungalow, both internally and externally, have been decorated and maintained to a very high standard. There was a large kitchen/dining room with large dining table and also an area with comfortable chairs giving people with a choice of areas to sit and relax, or for leisure activities. The main lounge was comfortable and stylish, and the furniture had been carefully chosen to suit the people living there. The chairs and sofa were of varying heights to give people alternative choice of chairs to suit their individual needs, while at the same time the furniture was domestic, homely and modern. This demonstrated the care and attention given by the providers to create a homely atmosphere while at the same time offering facilities to suit people with disabilities. There was level and easy access throughout the bungalow. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: There were three good sized bedrooms, each had been individually furnished and decorated to suit the preferences and interests of the people living there. The bedrooms did not have washbasins (as recommended in the National Minimum Standards). However, we had considered that the large bathroom and the level access shower room provided adequate washing and toilet facilities for up to three people living in the home. All areas of the home were clean, bright, and airy. There were good laundry facilities in place and the home was able to demonstrate good standards in relation to infection control. Care Homes for Adults (18-65 years) Page 25 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by sufficient staff who have been carefully recruited and trained to ensure high standards are maintained at all times. Evidence: We looked at the homes current staff rota. It showed that at least two staff were always on duty whenever people were at home. This provided a ratio of 1 to 1 staff cover for the two people living in the home at the time of this inspection. This level of staffing was entirely satisfactory. Staffing rotas for the periods while people were at the day centre were not seen, but we were satisfied through our discussions with the staff team that people received good support at all times. There was a core team of 5 care staff who worked at the home. Some of these also worked at times in other homes owned by the providers. In addition there were a few staff who mainly worked in other homes, or at the day centre, who sometimes provided cover when the home was short staffed due to sickness or holidays. Some staff had been employed by the company for a number of years, and their recruitment records had been checked at inspections of the other homes they had worked in. We looked at the recruitment files of two staff who had been recruited in the last year when the home first opened. We found that the providers had taken care to obtain all relevant information Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: about the staff, and to obtain at least two satisfactory references and a criminal records bureau check before the staff began working. This demonstrated good practice. The home told us that all new staff have undertaken induction training to meet nationally recommended standards. All staff have a development programme that identifies their training needs and meets health and safety requirements. The new staff employed by the home have been put forward for training to obtain a nationally recognised qualification known as NVQs. Those staff who have been employed by the company prior to the home opening have already gained these qualifications and therefore the home exceeded the recommended level of staff with a relevant qualification. We received four completed survey forms from staff before this inspection took place. Three staff told us they were happy about all aspects of the homes management, but one person said they thought communication could be improved. We talked to the acting manager about communication and support for the staff. She said she had only been employed by the company for a few months, and in that time she had been increasing the level of support to the home and said she felt that communication had improved since the surveys had been completed. During our visit we talked to three members of staff and we were completely assured that there were good systems of communication and support within the home. The staff were happy in their work and demonstrated a sense of pride in the home and a determination to provide the highest standards of support and services to the people living there. Care Homes for Adults (18-65 years) Page 27 of 32 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 home is well managed and safe. People have been consulted and included (as far as they are able or wish) in all aspects of the management and decision making process in the home. Evidence: Since the home was first registered the manager has left and a new manager appointed. This person is responsible for the management of two other small homes and the recently registered domiciliary care agency. She told us she will submit an application to register as manager in the very near future. This will enable us to check on her experience and qualifications and to ensure she is fit and capable to manage the home. The two people living in the home at the time of this inspection had limited communication skills and they were unable to complete survey forms before this inspection. We were told that people have been consulted and included in all aspects of the management of the home, including staff recruitment, staff meetings, and discussions about future plans for the home. People have been encouraged to express their views about the home in their care review meetings by using symbols and pictures. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: We looked at some of the records held in the home relating to health and safety, including the fire log book and cleaning routines. We found that the home followed safe procedures. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 30 of 32 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 Description 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 Description 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 1 9 The plans should be expanded where necessary to ensure the care staff have clear and detailed information about how each person should be assisted and supported. The level of information provided to care staff on the medications each person has been prescribed should be improved to ensure they understand what each medication is for, when as required medications should be given, and clear information about the administration of creams and lotions. An application to register the manager should be submitted as soon as possible to enable the Commission to check her fitness and suitability for the post. 2 20 3 37 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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