Care Home: 60 Langley Road

What the care home does well This is a well run home where residents are provided with good quality care by a team of well trained and professional workers. Staff understand the needs of residents well and are liked and trusted. Residents lead fulfilling lives and have the opportunity to participate in a wide range of activities designed to enhance their knowledge and skills. The home actively supports people to be independent and to make choices about their lives. The written records are well kept and reflect the individual needs of residents. They include communication aides such as photographs and symbols so that residents can take part in planning their care and to aid understanding. Staff are robustly recruited and receive the training they need to be effective carers. There are sufficient numbers of trained staff on duty at all times. Residents like living at the home, which is comfortable and clean. They have their own rooms which are decorated and furnished to their own tastes and liking. What has improved since the last inspection? Since the last inspection the home has improved its laundry facilities to make them more user friendly and safe. The Statement of Purpose and Service User Guides have been reviewed to ensure that they are more accessible to residents. What the care home could do better: There were no new requirements arising from this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 60 Langley Road 60 Langley Road Slough Berkshire SL3 7AY     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: Julie Willis     Date: 1 3 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 30 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 30 Information about the care home Name of care home: Address: 60 Langley Road 60 Langley Road Slough Berkshire SL3 7AY 01753536935 01753536935 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd The registered provider is responsible for running the service care home 5 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 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 60 Langley Road is owned by Milbury Care Services and provides twenty-four hour care and accommodation for up to five people with learning disabilities. The home is a detached house with five single bedrooms, a lounge, kitchen/dining room, staff office/sleep in room, one bathroom and cloakroom. There is a car park to the front of the house and an enclosed rear garden. Staff are able to escort service users to appointments and activities within the Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home community using the homes minibus. Public transport is accessible from the home. 60 Langley Road has a Statement of Purpose and Service Users Guide available on application to the home. Milbury Care Services website address is www.milburycare.com the home does not have an email address. Weekly fees start from 1200 to 1588.19 pounds per week with additional charges for Hairdressing, Podiatrist, Toiletries and Aromatherapist. Care Homes for Adults (18-65 years) Page 5 of 30 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 key inspection took place on 13th May 2009 over the course of five hours. It covered all the core standards for adults. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for the residents, relatives, staff and visiting professionals. Any replies were used to help form judgments about the quality of the service. Consideration has also been given to other information provided to the commission since the last inspection which took place on the 20th June 2007. The inspector toured the building, examined records and met all of the residents. The inspector also spent time talking informally to staff and observing how care was being Care Homes for Adults (18-65 years) Page 6 of 30 delivered to the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. This service is effective at meeting the needs of residents with a range of diverse and complex needs and challenging behaviours. The inspector gave feedback about her findings to the homes acting manager and deputy at the end of inspection. There were no legal requirements made as a result of this inspection. The commission has received no information about complaints about the service since the last inspection. 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 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 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential users of the service have sufficient information to decide if the home is right for them. Prospective residents are fully assessed prior to admission to ensure that the home can effectively meet their needs. Evidence: It was a recommendation of the last inspection that a review be undertaken on how information is provided to potential users of the service. It is clear that the home has worked hard to improve the content. The homes Statement of Purpose and Service User Guides have been produced in a user-friendly pictorial format and there is sufficient information in both documents to help potential users of the service to decide if the home is the right one for them. The admission procedure was examined and one user was case tracked from preadmission to date. It was evident that the residents transition to the home had been Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: managed effectively. The pre-admission assessment carried out by the home was detailed and holistic and kept the service user at the centre of proceedings. The assessment focused on achieving positive outcomes for the resident and ensuring that any equipment or specialist support needed by the resident was available on admission. The cultural and diversity needs of the resident were fully considered and any specific needs were catered for. A multi-disciplinary team of professionals, the users relatives and the user themselves had been involved in the process from the outset. The resident had undergone a staged admission process over the course of several weeks which slowly introduced the home and gave the resident time to adjust to their new surroundings, new staff and other residents. It was evident that significant time was spent planning the persons admission to help it go smoothly. From observation of practice and discussion with staff it was evident that the resident was relaxed and comfortable in their surroundings and had clearly built an excellent rapport with the staff since admission. Throughout the course of inspection staff were able to demonstrate that they were highly knowledgeable about service users rights and understood the need to involve advocates in order to help residents make important decisions about their lives. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs, goals and choices of residents are recorded within their care plans, which also indicate their preferences regarding how they receive their support. Residents are enabled and supported to make decisions about their daily lives. Residents are supported to take appropriate risks as part of their everyday lives. Evidence: Examination and case tracking of three peoples care evidenced that the records were up-to-date and well recorded. The daily records clearly validated the content of the care plans which were highly detailed and specific to the individual. It was evident from discussion with staff that the care plans are followed routinely on a daily basis and are effective operational tools. The care documentation was personcentred, comprehensive and holistic and provided sufficient information for staff to Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: provide the appropriate level of care. Several of the residents are non-verbal however, staff have tried to involve them in the development of their care plan. This has involved using picture symbols and photographs to aid understanding. Staff confirmed that an effective key-worker system operates at the home and helps individuals make a worthwhile contribution to the planning of their care. If people need someone to advocate on their behalf assistance is sought from appropriate organisations and their input is clearly documented. From discussion with residents and observation of practice it is clear that people are fully supported to make decisions about their every day lives and to achieve their personal goals. From examination of three care files and discussion with staff and management it was evident that the home positively encourages people to develop independence. This has led to a degree of risk taking. Staff confirmed that people are supported to take risks as part of their everyday life style and these risks have been fully assessed. Where necessary behavioural support guidelines are in place to address and minimise any challenging behaviours that may at times be exhibited by the resident. The involvement of psychologists and behavioural specialists to manage and support residents and staff are fully recorded. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to make choices about their lifestyle and are supported to develop life skills and independence. Social, educational, cultural and recreational activities meet individuals expectations. People are provided with a menu that is nourishing, varied and meets their individual and cultural need. Evidence: From examination of documentation and discussion with staff and residents it is clear that the staff fully understand and respect the rights of residents to develop and maintain life skills, including social, emotional, communication and independent living skills. Individuals are supported to identify their personal goals and work toward them. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Residents are encouraged and supported to maintain important family and personal relationships and their contact and involvement are documented fully in their care plan and PCP (Person Centred Plan). From discussion with staff and examination of documentation it was evident that people at the home are provided with the opportunity to engage in activities that are stimulating and worthwhile. Most attend local day centres several times a week where they are encouraged to participate in a range of small group activities or are provided with one to one support. Peoples attendance at each session is well documented and their progress toward agreed goals forms part of their care plan review. At home residents are supported to listen to music, watch television or DVDs, or to go for walks to visit local shops. Daily records of activities evidenced that residents make good use of communal facilities including local restaurants, cinemas, sports facilities, swimming pools, riding stables, bowling alleys and public houses. All residents use the house vehicle or public transport to access the community. The daily routines and house rules promote independence, individual choice and freedom of movement. Any restrictions are underpinned by risk assessment and management guidelines and have been agreed as part of the individuals care plan. The home provides a nourishing menu, which meets the cultural needs of the residents. Residents are provided with choice and variety and are regularly consulted about the menus, which they help to prepare and cook. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and personal support needs are well met at this home and a welltrained staff team deal with medication safely and appropriately. Evidence: It was evident from the staff files and discussion with staff and management that staff are well trained and have received the specialist training they need to meet the needs of the residents effectively. The training provided has included epilepsy awareness, management of challenging behaviours and person centred care. From examination of care records it is evident that residents physical and personal care needs are well met by the home. All care and support provided to individuals is well documented in the daily records. Staff ensure that personal support is flexible, consistent and responsive to the changing needs of residents. Residents personal choice in relation to care provision is fully considered and facilitated. From observation of practice it was clear that residents are supported to remain as independent as possible with personal care, any support or assistance is offered in a Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: discreet and sensitive manner. Practices in this home reflect residents needs under the six strands of diversity, gender, age, sexual orientation, race, religion or belief and disability. Staff ensure that all care delivered is entirely person centred, flexible and consistent. One resident was able to confirm that their care is provided in a manner, which maintains their right to dignity, privacy, independence and choice. They have freedom to choose what they do and when they do it and any restrictions are agreed as part of their on going care plan. Any aids or equipment are provided to encourage maximum levels of independence and specialist advice and support is sought when necessary. Examination of residents documentation and discussion with staff and management indicated that all residents are registered with a local doctor. Regular health checks and routine screening and treatments are offered by the practice and occasionally residents see the practice nurse for blood tests and other advice and treatment. The doctors also offers residents regular vaccinations against flu and other illnesses and the decision as to whether or not to have treatment is documented in the residents records. There was evidence that residents also have regular dentistry, podiatry and attention to their vision and hearing and their attendance is appropriately recorded in the care records. A number of the residents are regular attendees at hospital. Details of the outcome of these appointments and any changes in treatment or medication are well documented in the care plans and daily records. The home has a medication policy and procedure in place and according to staff training files staff have received the training they need to administer medication safely. Staff have recently been reminded of their responsibilities in relation to the safe administration of medication following a recent incident which was reported to the CQC under Regulation 37. Staff involved in the incident have been retrained and formally assessed and supervised in order to reduce the likelihood of further incidents. None of the current residents self medicate. The system used for the safe administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. All staff have been fully trained in the safe use of the system. Care Homes for Adults (18-65 years) Page 17 of 30 Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are safe and protected by the policies and practices within the home and residents views and comments are listened to and acted upon. Evidence: The home has an easily accessed complaints procedure, which has been produced in easy to read pictorial format. Each resident has been provided with a copy of the homes Service Users Guide that contains details of the complaint process and time scales for action. Staff have received training in how to recognise complaints and how to deal with them effectively. There have been no complaints made to the home and the CQC has received no information about complaints or safeguarding issues at the home since the last inspection. The home has a copy of the local Safeguarding Adults strategy and protocols and from discussion with staff it is clear that they are aware of its content and how to respond to suspected abuse. All staff have received the necessary training to protect users of the service from harm. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: One person at the home told the inspector that they liked living there and felt safe and well cared for. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment which encourages independence. Evidence: A tour of the home evidenced that the home was clean and hygienic throughout. Communal areas were light and airy and pleasantly furnished and decorated. The gardens were well kept and well used by residents. Residents are encouraged to see the home as their own and limits on residents freedom are kept to a minimum, fully risk assessed and are well documented in care plans. The home is designed to provide small group living and residents can enjoy maximum independence in a discrete and non-institutional environment. Staff are mindful of the need to involve residents with the choice of decoration and furnishings in the home. All bedrooms were highly personalised to reflect the individual interests and preferences of the residents. One of the residents showed the inspector their room which had been decorated to their particular colour choice and theme. The Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: resident told the inspector that they liked living at the home, which they said was very good. The kitchen is designed to enable residents to participate in the activities of daily living. It is clearly the centre of activity at this home and is well used. The dining table is large enough to accommodate all residents and staff at mealtimes and it doubles as a meeting and handover area for the staff between shifts. Residents are free to wander in and out at will. The laundry is on the first floor. It is small but functional. At the time of inspection there was no hand wash liquid or towel available and advice was given to ensure that there is always a good stock of hand washing gel and paper towels available to prevent the risk of cross infection. From examination of staff files and discussion with management it is clear that all staff have received health & safety training and infection control. This is refreshed using the on line El-box training provided by Milbury care. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient numbers of staff on duty at the time of inspection to meet the needs of residents effectively. The skill mix of the staff team was appropriate for the size, layout and purpose of the home. Recruitment policies and procedures at the home are robust and transparent and ensure the safety of residents. Evidence: The rosters at this home are designed flexibly to ensure that there are sufficient numbers of staff on duty at busy times of the day or to accommodate the residents busy activity schedules. There are three staff on duty in the morning and in the afternoon and a waking and sleeping in member of staff at night. The rosters indicate that staff numbers are reduced to two staff on duty during the daytime at the weekends. The inspector was informed that this is due to a reduction in residents as two of the residents regularly stay with their family at weekends. Examination of the staff recruitment and training files for three workers evidenced that staff were appropriately recruited, inducted and trained. Staff have recently been provided with training in The Mental Capacity Act and Deprivation of Liberty. There Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: was also evidence that they have had training on mental health and learning disabilities. Due to the nature of the current resident group all staff have received training in NCVI (Non Violent Crisis Intervention) and staff routinely follow the detailed behavioral guidelines in each residents care plan to ensure consistency of support. Each member of staff is provided with refresher training in NCVI every 3 to 4 months. Much of the routine training is done on line. Milbury care has invested in a distance learning system and staff are required to refresh their own training on the El box system which has been introduced to every Milbury care home. There was evidence in the training file that all staff are provided with refresher training in core skills at regular intervals, including fire safety awareness, first aid, medication, safeguarding adults, health & safety, first aid, manual handling and infection control to ensure resident safety. Selection and recruitment procedures at this home are robust. Records evidence that all necessary checks are carried out on staff to ensure that they possess the necessary attributes to care effectively for the residents. Records were well kept and met the required standard. The staff team work well together to benefit residents. Staff appeared to have a good understanding of how their individual role benefits the work of the team and a thorough knowledge of the key values that underpin their work with residents. There was evidence that all staff had an up to date training Plan and that staff are properly supported and supervised. The records indicated that the support offered in one to one sessions was frequent, resident focused and appropriate. In addition staff have the opportunity to express their opinions openly in staff meetings and staff hand overs. The inspector had the opportunity to read the minutes of the last two meetings which were entirely resident focused. The staff on duty confirmed that they are provided with plenty of opportunity to express concerns, share information and to feel included and involved in the way the service is delivered. Staff surveys confirm that they are offered opportunities to gain professional qualifications to further enhance their knowledge and skills. Several staff had already achieved a National Vocational Qualification at Level 2 & 3 or 4 and a number of staff are near completion. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Observation of practice concluded that the staff teams approach was consistent, professional and based on establishing and maintaining the residents independence and autonomy. Staff supported and enabled residents to maximise their quality of life, to take risks and to make appropriate decisions. It was evident that the residents have confidence in the way that staff care for them. One resident said staff are good. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. There are effective quality assurance systems in place which seek and focus on the views of residents. Evidence: The home has had a vacancy for Registered Manager since 2nd April 2009. At the time of inspection the inspector was assisted by Iona Campbell who was the previous manager of Langley Road. She has been overseeing the home since she moved to its sister home which is close by. The staff on duty were able to confirm that the temporary manager fosters an atmosphere of openness and respect and is experienced and competent. Staff say that management values their thoughts and opinions. The home has an ethos of being person centred and staff have been recruited and trained to a good standard to support the aims and objectives of the home. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The Organisation has a wide range of policies and procedures in place which are regularly updated and reviewed to ensure they continue to meet current legislative requirements and good practice guidance. The manager is responsible for ensuring that the policies are followed routinely by the staff. Practice and performance are monitored and discussed during supervision, staff training events and team meetings. Quality monitoring systems and observation of practice are used to confirm compliance with procedures on a daily basis. Quality assurance is monitored through regular resident meetings, staff meetings, key worker meetings and monthly auditing of the home by senior management during Regulation 26 Proprietors visits. The home had an annual service review carried out by its senior management in August 2008. The review helped to identify any shortfalls in the quality or consistency of the service and to identify areas that need improvement. In addition the Head Office regularly survey all stakeholders to ensure that the service is continuing to meet residents needs. Details of their findings are collated and shared with all stakeholders and a copy is sent to the home. The home has efficient systems in place to ensure the safety and security of residents money and valuables. Examination of three residents cash accounts indicated that a safe procedure is followed for deposit or withdrawal of residents monies. Receipts are kept of all cash spent on behalf of residents and there are dual signatories to all transactions. All of the residents monies are audited at regular intervals by senior management to ensure that it is kept safe. Examination of a number of health & safety records including the fire records and hot water temperature records indicated that all necessary checks and servicing of equipment is routinely undertaken to safeguard the health and welfare of people using the service. Servicing and safety certificates were available on file. The AQAA completed by the home gave full details of all of the maintenance and servicing of essential equipment and this was up to date and accurate. Unnecessary risks to residents are identified using a comprehensive risk assessment. So far as possible the risks are reduced or eliminated by putting in place effective guidelines, policies and procedures. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 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 30 of 30 - 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!