Care Home: 74 Sir Evelyn Road

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What the care home does well There is a relaxed and homely atmosphere. People say that the support workers give them the assistance they need in ways that are right for them. One person says that the support workers, `help me do things I want to do`. There are interesting occupational and social things that people can do. One person says that an event they have recently taken part in was `good, good`. People are helped to stay in good health. This includes keeping an eye on how everyone is and then calling doctors as soon as they are needed. People are helped to lead normal lives through responsible risk taking. People are served with good quality meals. One person says, `the food fills me and I like it`. There are reliable health and safety arrangements in place. What has improved since the last inspection? A number of improvements have been made since our last Key Inspection and since the last Annual Service Review. The individual plans of care and support have been made more detailed. This has been done to help support workers assist people in a more consistent way. Also, parts of the plans have been made more user friendly. This has been done so that people who live in the Service will find it easier to be actively involved in making their own decisions. Extra steps have been taken to help people say what they want through the use of photographs and story boards. The range of occupational and social opportunities has been extended. More support workers have completed key training courses including achieving a relevant National Vocational Qualification. Various improvements have been made to the accommodation to make it more homely and easier to keep clean. Three bedrooms have been redecorated and some new easyclean flooring has been laid. All of these things contribute to the Service being better able to support people in ways that are right for them. What the care home could do better: One part of the medication system needs to be checked more closely. This is to make sure that there is a suitable record of each medicine that can be dispensed. Some minor improvements need to be made to the building and to the garden. The Registered Manager is not in day to day control of the Service. This is a legal requirement. The quality assurance system does not fully involve all of the people who live in the Service. They are not directly told about what has been said about their home and about what improvements the Registered Provider intends to make as a result of the comments that have been made. Key inspection report Care homes for adults (18-65 years) Name: Address: 74 Sir Evelyn Road 74 Sir Evelyn Road Rochester Kent ME1 3LZ     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: Mark Hemmings     Date: 1 8 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 74 Sir Evelyn Road 74 Sir Evelyn Road Rochester Kent ME1 3LZ 01634828779 01634828779 sir.evelyn@robinia.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Robinia Care Group Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. 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 Up to six people who have a learning disability can make their home in 74 Sir Evelyn Road (the Service). The property is a modern, detached house. Each person has their own bedroom. Four of the bedrooms have a private bathroom and all of them have their own wash hand basin. There is one shared use bathroom and two shared use toilets. There is also a main lounge, a second conservatory lounge and a dining room. At the back of the building there is quite a large garden that is on two levels. The Service is in a residential street and is about two miles from Rochester town centre. There is adequate on street and private care parking. There is a bus stop nearby. The nearest train station is in Rochester. There is a general store only a short walk away. The Service has its own vehicle. The Registered Provider is a private Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home limited company. The weekly fee for living in 74 Sir Evelyn Road runs from £1000.00 to £1634.00. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 Star. This means that the people who use this Service experience good quality outcomes. The previous Key Inspection was completed on 22 February 2008. The previous Annual Service Review was completed on 3 November 2008. The Annual Service Review is when we complete an office based review of how things are going in the Service. It is based on what we have been told by people who live in the Service, the Registered Provider and by our partner agencies. For the present Key Inspection, we arrived unannounced at the Service at about half past eight in the morning and we were there for about six hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received this on time and it is adequately detailed. Care Homes for Adults (18-65 years) Page 6 of 29 Further, we considered any information that we have received about the Service since the last Key Inspection and the last Annual Service Review. During the inspection, we spoke with two of the four people who currently live in the Service and we spent time in the company of all of them. The Registered Manager is not currently at work. In his absence the Service is being overseen on a temporary basis by the (acting) Manager. We spoke with her. We also spoke with three support workers. We looked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of care, medication records, the activities plan, the menu, the complaints documents, the staff roster, personnel files, staff training records, financial records and various health and safety certificates. After the inspection we needed to ask some more questions about some points of detail. We did this by corresponding by email with the Area Manager. Before we visited the Service, we asked all of the people who live there and all members of staff to fill out a questionnaire for us. We wanted them to tell us what they think of 74 Sir Evelyn Road. Three people who live there and seven members of staff kindly completed them for us. Later on in our report, we will tell you the main things that people are saying in these questionnaires. The Registered Provider has also recently asked the support workers what they think about the Service. As we go through our report we will tell you some of the things that they are saying in their replies. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: One part of the medication system needs to be checked more closely. This is to make sure that there is a suitable record of each medicine that can be dispensed. Care Homes for Adults (18-65 years) Page 8 of 29 Some minor improvements need to be made to the building and to the garden. The Registered Manager is not in day to day control of the Service. This is a legal requirement. The quality assurance system does not fully involve all of the people who live in the Service. They are not directly told about what has been said about their home and about what improvements the Registered Provider intends to make as a result of the comments that have been made. 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving in are asked about what support they need and how they want this to be done. They are encouraged to visit the Service to get a first hand feeling of what it is like. Evidence: No one has been admitted to the Service since our last Key Inspection. The Manager says that she will ask people who are thinking of moving in about what support they need and want. She will also invite the person to visit the Service, usually on more than one occasion. This is done so that they can be confident that moving in to 74 Sir Evelyn Road is the right thing for them. She will also talk with family members and with people like care managers (social workers). All of this will help her to build up a really good picture of how the person can best be supported. In their replies to our questionnaire everyone says that they were asked if they wanted to move into the Service and that they were given enough information to enable them to make an informed decision. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The Manager says that when someone does move in, she will share the information she gets with the support workers. This is so that they know what support they will need to provide. We asked two support workers about how all of this works out in practice. They say that they are indeed told about people who are about to move in. They say that as a team they discuss how best to help the person in the first few days, while they get to know them better. The Service does not offer short term care. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are actively involved in deciding what support they need and they receive it in ways that are right for them. People are helped to manage their financial affairs. There is a sensible approach to risk taking. Evidence: The people who live in the Service say that the support workers offer them all the assistance they need. Each person has an individual care and support plan that they have contributed to preparing. Recently, parts of these plans have been made more detailed. This has been done so that support workers have more guidance about how to help people express themselves without getting into potentially difficult situations. We looked at two of these plans in some detail. They give a clear account of who needs to do what and why. For example, there is useful information about things such as helping someone when they become anxious about things. In another instance there is information about the sorts of activities the person likes to be supported to do. In their answers to our questionnaire everyone says that they receive the care and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: support they need. One person says, help me do things I want to do. Most of the people who live in the Service do not rely upon the spoken word to express themselves. They use a combination of things such as single words, sounds and signs. The support workers have a good understanding of how each person says what they want. They also help by having photographs of things like meals and activities. People who live in the Service can refer to these to show support workers what they want to say. Three support workers told us about the individual ways that people who live in the Service like to be helped. They have a good knowledge of each persons individual requirements. They understand the ways in which each person is different. They know how important it is for everyone to be respected as an individual. The support plans are kept up to date so that they are accurate. This involves people who live in the Service taking part in occasional reviews of how things are going. Sensible steps are taken to support people to lead everyday lives of their own choosing. This includes support workers helping people to take sensible risks and to avoid situations that might be harmful. The Registered Provider acts as the appointee for three of the people who live in the Service. This means that it receives their income and manages things like paying bills. Each person has agreed to this arrangement as has their family and care manager. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are interesting occupational and social things for people to do. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is a range of occupational things that people can do if they want to. These include doing household tasks and helping out with the shopping. In the past year or so, three people have finished courses in things such as swimming and needlecraft. The Manager hopes to arrange for people to be able to do some more college courses in the near future. There are also social things to do such as taking part in games and going out to places of interest. When we were in the Service, one person was helping hang the washing out and then they helped getting things ready for a picnic. Later in the day, everyone went out for the picnic. When they got back everyone seemed to have enjoyed the Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: event. Recently, the Service has bought an easy to use camera so that people can take pictures of what they have done and where they have been. In their answers to our questionnaire, people say that they are happy with what they do each day. One person says, that things like the picnic are good, good. People are helped to keep in touch with members of their families, if this is necessary and if this is what they want. This includes support workers driving people to where their families live so that they can stay with them. Family members and friends are welcome to call to the Service at any reasonable time. The Manager keeps in touch with family members so that they know how things are going. People are encouraged to make their bedrooms their own private space. They are helped to arrange them as they want them to be. People can use their bedrooms whenever they want. They can choose to have private time on their own or to be in company. There is a telephone that people are supported to use. Support workers help people to deal with any mail they get. There is a varied menu and good quality meals are served. People who live in the Service consider meal times to be a relaxed and pleasant affair and the like the meals. One person says, the food fills me and I like it. One support worker says, the food is good really. It certainly gets eaten up because all of the people are so active and they need lots of energy. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped in ways that are right for them. They are helped to stay well. There are generally safe systems to manage medicines. Evidence: The support workers are relaxed and informal in how they are. They help people to organise themselves without being bossy. People are helped to wear neat and clean clothes so that they can look how they want. In their answers to our questionnaire people say that the support workers listen to them and act on what they say. We saw lots of examples of this. Support workers helped people to get themselves ready to go out for the picnic by reminding them what they needed to take. Once they were back from the picnic, people were helped to do different things. One person showed that they wanted to do some art work while another wanted to spend time in their bedroom. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last Key Inspection, people have seen their doctors as and when necessary. Support workers then help people to follow any treatment advice they have been given. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: People can manage their own medication if they want to and if it is safe for them to do it. At the moment, everyone who lives needs to have support workers doing it for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, medicines are stored securely. The Assessment says that all members of staff who give out medication have been trained so that they know what they are doing. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. These are being completed correctly. However, one of the records did not list a particular medicine that can be given to the person concerned. The Manager corrected this error straight away. There should be an audit system to identify and resolve issues such as this. People are also helped to take care of their health in a positive way. For example, they are encouraged to watch their weight. They are also supported to eat fresh fruit and lower fat foods. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a user friendly complaints procedure. There are arrangements to make sure that complaints are dealt with properly. People are kept safe. Evidence: There is a user friendly complaints procedure. In their answers to our questionnaire, people say that they can make a complaint or raise a concern if they want to. They are confident that they what they say will be investigated. Since our last Key Inspection, the Registered Provider has looked into a number of concerns about how well someone was being supported. The Area Manager says that all of the matters raised were thoroughly investigated. She also says that all of the issues have now been resolved. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. In their answers to our questionnaire, everyone says that support workers treat them well. The support workers are confident that people are being kept safe. One support worker says, all of the people are treated really well here. This is their home and they need to feel safe here and that we will understand their needs and genuinely take care of their needs. I have never seen anything at all that has worried me. They are all fine here. Another support worker says, the residents are very well cared for. We are all on their side here and we make sure that they lead good lives. Ive never worried about that at all since Ive been here. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The Assessment emphasises the importance that is attached to promoting equality and diversity. This means that there is a commitment to respecting peoples cultures and beliefs. It also means that there is a commitment to making sure that people who live in the Service and members of staff do not experience any form of discrimination. Support workers help each person to manage their personal spending allowance. They hold small amounts of money for them and then help them to buy things they want. There is a record kept of the various transactions and there are receipts each of the purchases made. The records accurately show how each persons money is being spent. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is comfortable. There is a modern fire safety system. The kitchen is well equipped. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. The building is well maintained on the outside. One part of the garden is overgrown. The Manager says that plans are in hand to deal with this problem. On the inside, the accommodation in general is well decorated and furnished. Recently, more pictures have been put up to make the atmosphere more welcoming. Also, new laminate flooring has been fitted in several areas. Three of the bedrooms have been redecorated. Some of the uPVC window frames need attention to make sure that they give a weather-tight seal. The Manager says that the necessary repairs are about to be done. There is a modern automatic fire detection system. This is checked regularly to make sure that it continues to meet the national standard. The kitchen is clean and well organised. The records show that the fridges and the freezers keep foods cold enough. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: There is also a system to make sure that foods are used promptly once they are opened. The support workers know about good food hygiene practices. For example, they know about the need to make sure that hot foods are well cooked through. People say that the accommodation is kept comfortably warm. The radiators are fitted with guards. This has been done to reduce the chance that someone will be burnt if they fall against them. Support workers check that baths are not too hot so that people do not scald themselves. The laundry has a washing machine and a dryer. The laundry is well organised and clean. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough support workers on duty. Support workers have the necessary skills to support people in ways that are right for them. Security checks are completed on new members of staff. Evidence: The records show that there are three support workers on duty from early in the morning until later in the evening when the night time support workers come on duty. There are no housekeeping staff and there is no cook. In their answers to our questionnaire and to the Registered Providers, most support workers say that there are usually enough members of staff on duty. When we were in the Service, we kept a look out for things that might give us a clue about how well the place is being staffed in practice. We noticed that when one person became anxious about going out support workers quickly reassured them so that they could get themselves ready. The records show that the Registered Provider completes a number of security checks on new support workers. These include things such as confirming their identity, taking up references and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The records show that support workers are doing quite a lot of training. This includes introductory training for new members of staff. After their introduction, there is ongoing training in key subjects such as first aid, health and safety, autism, epilepsy, communication and responding to difficult situations. The records show that most of this training is up to date. In their answers to both our questionnaire and to the Registered Providers one, support workers say that they are confident that they know what they are doing. All but one of the support workers have completed or they are about the start studying for a relevant National Vocational Qualification (NVQ). Our observations show that support workers are well supported by the training they receive so that they can appropriately support the people who live in the Service. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is no registered manager in day to day charge of the Service. There are interim management arrangements in place. There is a quality assurance system. There are sensible health and safety arrangements. Evidence: The Manager has a good knowledge of how things are going. She also holds one of the two qualifications recommended for her role. She is about to start studying for the second of the awards. The Registered Manager for the Service has not been at work since April 2009. We have asked the Registered Provider to confirm to us in writing what steps it intends to now take to ensure that a registered manager is in day to day charge of the Service. We need to receive this information by 1 November 2009. The support workers say that there is good team work between them. There are handover meetings at the beginning and end of each shift. One support worker says, we all get on quite well and organise ourselves so that each shift the residents get the support they need. We know what each person likes to do and what help they need so we can organise our time to the best way. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: People who live in the Service are regularly asked what they think about their home as part of everyday life. About once a month there are residents meetings. These are where the people who live in the Service get together with a support worker to review how things are going and to suggest any improvements. Each year the Registered Provider also asks the people, their relatives and support workers to complete questionnaires. The Manager says that the results of the questionnaires are then used to plan improvements to the Service. However, there is no organised system to feed back to people what has been said in the questionnaires and what is going to be done to introduce any suggested improvements. The Registered Provider arranges for someone senior to call to the Service once a month to check how things are going. The records of these visits show that the visitor in question speaks with people who live in the Service and with support workers. They also look at various records and documents. The records show that the visitor prepares an action plan. This lists the improvements that need to be made. There is evidence that these improvements are being put into effect, although some of them in the past have been a bit delayed. The records show that there are fire drills. The Manager says that since our visit to the Service, the frequency of these has been increased. This has been done to make sure that everyone knows how to follow the Registered Providers fire safety procedure. The records show that all items of equipment used in the Service remain in good working order. The records show that there have not been many accidents in the Service since the Key Inspection. Most of them have been minor bumps and bruises. The Manager says that she monitors the occurrence of accidents. This is so that she can see if there is anything extra that can be done to help prevent them from happening again. The Registered Provider completes a detailed annual health and safety audit. This is done to help make sure that there are no hazards that might result in someone having an accident. The records show that things are being dealt with promptly. We did not notice any particular hazards in the Service. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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