Care Home: 72a Broad Street House 1

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What the care home does well The service has a friendly and welcoming atmosphere. People who use the service are clearly the focus of care delivery and it very much their home: bedroom decor and furnishings reflect their tastes and we observed that they run their house as they wish giving direction to the staff. There was evidence that staff seek the views of people and how they are implemented. This is formalised in care plans. Staff have a good insight into individual needs and work hard to ensure that they are met. Each side of 1 Broad Street has a distinct character and it is clear that Ash and Birch have clear identities despite sharing a building. People are assured of staff support in meeting their goals and we saw this in how staff assisted people to manage their dietary needs and weight loss - sometimes in a creative way. People who use the service told us that staff were friendly and kind and staff told us that Ash and Birch had good teams. What has improved since the last inspection? The medication system has been improved to ensure that accurate amounts are recorded and there is assurance that people have received medication when away from the service. The temperature of the medication storage room is better regulated to ensure safe storage. More information is available to illustrate how staff manage leg ulcers and aspects of diabetes. Areas of the home have been upgraded with new fixtures and fittings. This has ensured that the upstairs is less stark and better reflects the personalities of people who use the service. What the care home could do better: The maintenace plan needs to be completed but work is on schedule and vast improvements have been made. The service has 3 vacancies but one will be filled once the assessment process is completed. Staff vacancies should be filled in the near future. Key inspection report Care homes for adults (18-65 years) Name: Address: 72a Broad Street House 1 Ash And Birch Units Clifton Shefford Bedfordshire SG17 5RP     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: Angela Dalton     Date: 0 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 28 Information about the care home Name of care home: Address: 72a Broad Street House 1 Ash And Birch Units Clifton Shefford Bedfordshire SG17 5RP 01462814196 01462850689 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.hft.org.uk HF Trust Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 72A Broad Street (Ash and Birch) was a purpose built house owned by Home Farm Trust situated in a site recessed from the main street in the village of Clifton. On the same site was a second house provided by HFT for eight people with learning disabilities and the two houses shared a common paddock in addition to their individual gardens. The house was divided into two units namely Ash and Birch, each with a lounge, dining room and kitchen. One unit catered for people with Prader-Willi syndrome and the other for people with complex communication needs. Each service user had a single bedroom. In each unit were two bathrooms and a shower room with a total of seven toilets between the two units. Staff were provided with a room with en-suite facilities, which were also used as the main office. This room was situated between the two units and formed the link on the first floor between both units. The Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 2 7 0 4 2 0 0 9 Brief description of the care home ground floor link was the communal laundry. The fees payable do not include newspapers, hairdressers, personal telephone, toiletries, or private chiropodist; these services would incur an additional charge. Care Homes for Adults (18-65 years) Page 5 of 28 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: One inspector conducted this unannounced site visit on 6th April 2010 between 9.25am and 2.40pm. We met with the Service Manager and Senior Support Worker as the manager is currently on sick leave. Two people were case tracked. We followed the care of people who use the service to ensure the care they receive is reflected in the care plan and meets their individual requirements. The case tracking process cross references all the information gathered to confirm that what we are told is happening is actually occurring and reflects the Statement of Purpose, which contains the aims and objectives for the service. We spoke to the people who use the service and members of the staff team. We were present for lunch and observed interaction between staff and people who use the service. We toured the building and examined documentation to check that what was happening in the service was being recorded. Care Homes for Adults (18-65 years) Page 6 of 28 The services weekly fees are under review but currently range from 1022 pounds to 1525 pounds. This does not include toiletries and private chiropody and other personal expenses. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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. Evidence reflected that individual needs are assessed to ensure that they can be met by the service. Evidence: No new service users have moved into the service since the previous inspection. A homely and friendly atmosphere is maintained at the home. The service is working towards filling one vacancy. It was clear that this is being conducted at the individuals pace to meet their specific and complex needs. Staff are working with the service user and their staff in their current environment to enable them to begin transition work and ensure consistency of care. The assessment is in progress and staff were able to evidence that they had sufficient information to enable them to work effectively with the service user. Contracts are user friendly in a pictorial and large type format. They include individual fees and any additional charges. The service user guide is in a similar user friendly format and is made available to each individual. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Staff work with people who live at Ash and Birch to ensure that they involved in meeting people who who may move in and that they feel that everyone will get on together. The manager or service manager write a report at the end of the assessment process to determine whether the needs of a new person can be met and how any potential challenges can be overcome. There is a cabinet in the front entrance of each service displaying useful information. People we spoke to understood that this is locked to ensure that documents do not go missing and that they could access information by asking staff. People had a copy of most of the information displayed such as the service user guide and complaints policy. Care Homes for Adults (18-65 years) Page 11 of 28 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. Service users are the focus of the service and care plans illustrate how social care needs are monitored, managed and met. Evidence: Each person has a support plan detailing their individual needs which are in a consistent format and computer generated using the organisations Support, Planning, Assessment and Recording system People are very involved in devising their plan of care and are passionate about contributing to the information that is written about them. The Service Manager is investigating a way to involve people in having more partnership in their care plans. Where possible staff work alongside people and this can be done jointly on one of the four computers shared by staff and people who use the service. The Service Manager hopes to purchase electronic notepads so that service users do not have to sit next to a computer. Staff enter information electronically and ensure a paper copy is available. Staff told us that a user friendly format is currently being developed. The service also has software to enable text to be translated into pictorial or symbol forms. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The focus of the service is upon enabling people to do things for themselves and being supported to make choices. We followed the care of two people who use the service and they confirmed that they were very involved in the way that their home was run. Their care plans were extremely detailed and informative. Gaps in information that had been identified at the previous inspection have been addressed. Risk assessments remain comprehensive and focus upon how individual risks are managed and the impact upon others e.g. with regard to behaviour. Again where possible, risk assessments are written with service users to ensure that they are aware of how needs can be managed. This is valuable to some people who have specific triggers to behaviour and understand how staff will work with them. The kitchen is locked but this is discussed when people move into the service and is agreed with professionals as part of peoples behavioural management. Risk assessments have been developed to reflect the Deprivation of Liberty aspect of the Mental Capacity Act. Regular reviews take place to ensure that the care plan is still relevant and meets peoples needs. The person centred planning diary that was in place at the previous inspection has been incorporated into the care plan. Each service user has an activity plan to reflect what they want to do each week. There were posters and flyers displayed to advertise what activities are available for people to attend. This enables each person to record what they would like to do and plan it with staff. It also enables people to have hopes and aspirations that staff can assist in realising. Some people meet with an Advocacy Alliance representative each month either as a group or individually. Home Farm Trust also runs a Speak Out group which enables people from across the organisation to meet together with senior managers and discuss issues. Care Homes for Adults (18-65 years) Page 13 of 28 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. The leisure and occupational requirements of people who use the service are met in a flexible way. Evidence: Service users at Birch were away on home leave so we spoke to three people living at Ash. As discussed earlier each service user has an activity plan. The staff team work hard to ensure that service users have a varied leisure programme. This is devised in conjunction with people and changes as necessary. Home Farm Trust have a resource centre locally which is attended for occupational and recreational sessions. One service user told us that they went every week day and that they enjoyed that. A peripatetic support worker was previously employed to promote individual interests Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: such as swimming and snooker. Staff now support people to attend community facilities. Staff promote activities as it is recognised that it leads to increased confidence and improving daily living skills. Staff are creative and incorporate activities into daily routines to assist people in their exercise and weight loss goals. Service users help maintain the garden and mow the lawn. One service user has an exercise bike which was funded by Home Farm Trusts Extra Special Fund and they use this as part of their daily exercise routine. Staff were discussing holiday plans with service users to enable people to go away at a time they wish and enable staff to be given adequate notice. Service users had previously been on holiday to Blackpool, a working farm, Dorset and Euro Disney. Leisure files reflected how holiday choices had been made and why people chose to go to particular places. Some people are supported to attend church and everyone goes out regularly to places of their choice such as bingo. Service users are supported to go shopping for food and decorative items. Areas of the home have been redecorated and service users chose the colours for paint and flooring. People contribute to planning the menus and the methods that are used are tailored to meet peoples needs. Some people have Prader-Willi syndrome and one aspect of the syndrome is an obsession with food. Staff are skilled and sensitive in managing potentially challenging situations and menu planning and meal times are dealt with in an appropriate low key way. Care Homes for Adults (18-65 years) Page 15 of 28 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. The medication system ensures the safety of people who use the service. Evidence: People living in Ash and Birch receive support from a variety of health and social care professionals. The service is supported by Twinwoods and there was evidence to show that regular assistance was given by the psychology team. Because of the associated needs that people with Prader Willi syndrome have support is provide from the dietician and other professionals as required. Care plans detailed how dietary needs were being met and how weight loss plans were supported. One service user manages their own diabetes with staff overseeing the process. Great improvements have been made since the previous inspection. There is now evidence to reflect how competence of self medication is assessed and reviewed to ensure the safe administration of insulin. Staff had received training to support someone with diabetes in the administration of insulin and any associated complications which they did not have previously. Staff have a better insight into managing blood sugar readings and high and low blood sugar levels. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: An extractor fan has been fitted to the medication room. This ensures medication is stored within the correct temperature range. The service manager will continue to monitor its effectiveness. Diabetes information was in user friendly language and symbols on the wall of the medication storage room and staff plan to transfer this into the care plan. At the previous inspection sterilising tablets were being stored on the desk in the medication room. A steam steriliser has been purchased to replace this practice. We checked Medication Administration Record (MAR) sheets for 2 people. All medication amounts we checked reconciled and records were accurately and effectively kept. This is an improvement since the previous inspection when medication amounts did not match those recorded on Medication Administration Record Sheets. There is a designated person responsible for checking in and reviewing medication and another person who covers their absence. Amounts of medication are recorded when leaving and returning to the home. Records are now kept to reflect medication that is taken during the time people spend with their families. This is an improvement since the last inspection as there was an issue that with regard to medication not tallying which has been resolved. Copies of prescriptions are kept and this ensures that there is a receipt for the medication that has been prescribed. There are currently no controlled drugs prescribed but the storage facility exists if necessary. The service has now obtained the current guidance in place from the Royal Pharmaceutical Society relating to administration of medication in care homes. Each person has a health action plan detailing how individual needs are managed. One service user receives treatment from the district nurse at a clinic to treat leg ulcers. Information is in the care plan about skin care. The senior support worker plans to expand skin care assessments to assist staff in monitoring any changes in symptoms but clearly, regular clinic visits take place. There is no District Nurse care plan kept in the home because individuals attend clinic appointments so a record is required. At the previous inspection a service users family nominated the home for an award with the Coeliac Society to reflect the hard work that staff had done to assist with managing coeliac disease. Care Homes for Adults (18-65 years) Page 17 of 28 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 service has a clear system in place to enable people to express their concerns. Evidence: There is a complaints policy in place which every service user has a copy of. This is displayed in the cabinet in the hallway. The people we spoke to confirmed that they knew who to raise any concerns with informing us that they would talk to their keyworker or the manager. A member of staff from Advocacy Alliance visits each month and acts as an independent representative for people who use the service. Records reflected that staff had attended Safeguarding training and staff have attended a refresher recently. A safeguarding incident is being appropriately dealt with and records have been updated accordingly. Staff told us that they felt well supported in dealing with the ongoing issues and had been given the opportunity to meet as a team to discuss an approach. Copies of compliments and complaints are kept and also recorded on care plans where appropriate. We saw evidence of what action had been taken in relation to concerns and complaints raised by service users. This illustrated how concerns or allegations are dealt with effectively and they do not escalate into complaints. It also ensures that the process of any investigation is recorded. The manager has also led in house SOVA workshops for both staff and people who use the service to ensure that it is a subject that everyone is familiar with and discuss any questions. Training on the Mental Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Capacity Act has occurred and elements have been incorporated into peoples care plans. We checked two peoples financial records and there were no issues. The service uses a specialised system (Versapak) which has a separate number for a lockable tag. Each time finances are checked a new tag is issued with a corresponding number. Care Homes for Adults (18-65 years) Page 19 of 28 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. Improvements have occurred to ensure that the environment meets the needs of service users. Evidence: There have been vast improvements in the environment since the previous inspection. Previously there was a stark contrast between upstairs and downstairs. This has bee addressed: new flooring has been fitted to bathrooms and they have been redecorated. Radiator covers have been replaced and bath panels and showers have been renewed. Pictures have been purchased to personalise the bathroom areas. This has improved the clinical and neglected feel to the upstairs bathroom areas. Toilet roll holders have been fitted and bathroom bins are now provided. They have been tailored to meet the behavioural needs of a service user who previously disposed of tissue items in the bathrooms. The purchase of specialist holders has overcome this challenge. New flooring has been fitted to the downstairs hallways and dining suites have been replaced in Ash and Birch. Pictures have been put up around the home in a manner that they cannot be removed as this was previously an issue. The distinct difference between the communal rooms downstairs and upstairs has Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: been overcome with the redecoration. Downstairs is warm and friendly and clearly reflects the personalities and choices of people who use the service, and personal touches are being introduced upstairs to improve the environment. Bedrooms reflect peoples personalities. Some people with complex needs require that their belongings are replaced on an ongoing basis if they are damaged or destroyed. Service users help to maintain the garden and have access to a patio area as well as a large grassy area with a summerhouse. The laundry meets the needs of people who use the service and there was adequate protective clothing available. There are dissolvable alginate bags for use with soiled laundry if needed. All service users have access to a computer as there are 3 at fixed locations and one lap top. Staff and service users discuss when availability is required to ensure access when needed. Care Homes for Adults (18-65 years) Page 21 of 28 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. People who use the service are supported by an effective staff team. Evidence: We checked recruitment records on the companys computer system and found them to be satisfactory. The manager was not present during the inspection to access to paper records was not possible. The senior support worker told us that there is currently a waking night vacancy for which there will be interviews in the coming weeks. As the service has 3 service user vacancies the staffing level currently meets peoples needs but levels will be increased following new admissions. A comprehensive training programme is completed by staff. Although staff do not complete the Learning Disability Qualification they obtain the companys equivalent and complete a 3 day induction. All staff have obtained or are working towards NVQ Level 2 and 3. We were told in the Annual Quality Assurance Assessment that 100 completion or working towards level 2 or above NVQ qualification. In addition to mandatory training staff attend specific training relating to Autism, Dementia, Person Centred Planning, Safeguarding and The Mental Capacity Act. We saw evidence of the training plan for the previous and coming year. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Two staff had attended a four day course on first aid. Many of the staff have worked in the service for a number of years and stated that they enjoyed their job. One staff member told us Ash and Birch are a good team whist a service user told us Its friendly and happy. Staff receive supervision every six weeks which enables staff to set their goals with regard to training and performance. In the absence of the manager they are being conducted by the service manager and senior support worker. People who use the service were complimentary about the staff and said that they knew who their keyworker was and who they could talk to regarding any concerns. Care Homes for Adults (18-65 years) Page 23 of 28 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 views of people who use the service are incorporated into the running of the home. Evidence: The manager has worked at 1 Broad Street since October 2007 and have received confirmation of their NVQ 4 and Registered Manager Award since the previous inspection. They are currently on sick leave so the inspection was conducted with the service manager who has recently joined the organisation and senior support worker. There was evidence that the manager had worked hard to ensure that the requirements related to medication, health and environment made at the previous inspection have been met. The AQAA (Annual Quality Assurance Assessment) was completed prior to the inspection by the manager to demonstrate how the service had reviewed the care they delivered and identified any improvements required. Staff confirmed fire inspections took place regularly and records were in good order. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Health and safety records are maintained and reflected that necessary safety checks were being conducted. Maintenance issues are now reported via the companys intranet site and this has ensured issues are dealt with more effectively as the faults can be tracked on the computer system. The practice of soaking dishcloths in sterilising solution has ceased since the previous inspection. The service sends out a quality assurance questionnaire to families, people who use the service and to professionals. A report is published and sent out to all participants and reflects what action will be taken. The company meets with the Family and Friends Association quarterly, which enables the management team to address any concerns and provide an update of any developments within the service. The manager also attends these meetings. Regular house meetings are held to ensure peoples views are considered and implemented. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. 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