Care Home: 8 Thorndale Road (Homefield College)

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What the care home does well The manager and staff find out about the needs of people who come to live in the home and check whether the home is able to give them the support they need.There is some good written information which tells staff about people`s needs and what kind of support and help they want. People are able to look at their records, and are supported to have independence and control.Staff give good support to people. There is a good, easy-going relationship between staff and people who live in the home. People have the confidence to ask staff for what they want.People who live in the home enjoy a good lifestyle - they are able to do different activities that they enjoy, both in the home and in the community. Friends and relatives are welcome in the home.People are enabled to be independent, and take an active part in running the home, doing things like shopping and cooking.Staff make sure that they support people to follow up any health concerns that they have. Everyone has a local GP and has health checks that they need to help them stay healthy.The home is clean and comfortable for people who live there. Everyone can have their own things in their bedrooms. Staff get training in different subjects to help them to do their job well, including in adult protection so they can help to keep people safe from harm. There are policies which tell the staff how to do their job well. Checks are done to make sure equipment is safe.Staff support people to look after their money and to manage howthey spend it.References are collected and safety checks are done, to make sure that people who come to work in the home are safe. The manager is approachable and runs the home well. People whole live in the home are asked for their views and ideas. What has improved since the last inspection? Some actions were recommended after the last inspection and these have been carried out:Care records are now kept in abetter way that means they are more accessible to staff.The home has now been reporting all serious incidents to us and to social services, as they are required to do. This must be done to make sure people who live in the home are safeguarded from harm. There have been some good improvements in the way that the home safeguards people. Staff have had more training, and have been given information to help them. What the care home could do better: While there have been improvements, care plans and risk assessments do not always show all details about what people`s current care needs are - based on what has happened to them or what they have been doing.The manager and staff need to lookat issues about consent, even where action they are taking is about protecting people.Medication is stored in a locked filing cabinet, which does not meet the requirements of the law. The home needs to get a proper medication cabinet.The manager needs to make sure that staff have all the information they need to keep people safe.The provider needs to make sure that people are kept safe from risks created by hot water temperatures in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 8 Thorndale Road (Homefield College) 8 Thorndale Road Thurmaston Leicester LE4 8NQ 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: Chris Wroe Date: 0 4 0 5 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 36 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 36 Information about the care home Name of care home: Address: 8 Thorndale Road (Homefield College) 8 Thorndale Road Thurmaston Leicester LE4 8NQ 01162925340 01509815696 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.homefieldcollege.ac.uk Homefield College Limited Name of registered manager (if applicable) Miss Victoria Margaret Breward Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: No one under the age of 16 years may be accommodated in the home. Date of last inspection 0 8 0 7 2 0 0 9 A bit about the care home 8 Thorndale Road is a 5 bedroomed semi-detached house in the village of Thurmaston. The home can have four young people Care Homes for Adults (18-65 years) Page 4 of 36 living in it. There are four single bedrooms, one of which is en suite, and there is a staff sleeping-in room. Downstairs there is a lounge, kitchen, and a lounge/dining room with patio doors leading onto an enclosed garden. The home is one of seven, which are linked with Homefield College. Young people come to learn at the college, and may carry on living in the homes. The college (and linked houses) provide placements for adults with learning disabilities and people who have autistic spectrum disorder. Fees range from £684 to £1411 per week during term time. Care Homes for Adults (18-65 years) Page 5 of 36 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 36 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 13th April 2010, and also visited the main college office to look at staff records on 4th May 2010. Our inspection lasted a total of five hours. The manager, Nichola Harling, and one member of staff helped us during the inspection. Nichola has taken over management of the home since our last inspection. At the moment, Nichola is going through the process to become a registered manager with us. As part of our inspection, we sent out surveys to the home for people who live there to fill in if they wanted to, so they could tell us what they thought about the home. Three people live in the home at the moment, and they all sent us replies. They all gave us positive answers to our questions, telling us they were mainly happy with the care they received. one person told us: Im happy here. Another person told us what the home does well: Makes me more independent. We also sent out surveys to staff, and we received four responses from members of staff. They gave Care Homes for Adults (18-65 years) Page 7 of 36 us positive responses to our questions, and told us they felt well supported in their work. They told us some good things about the home: Gives [students] more independence in a smaller community; Provides students with a generally safe environment and does whatever it can to support students needs. One person felt that the management could listen to staffs needs and concerns more at times, athough they said for the most part they do what they can. The main way we do our inspections is using a method we call case tracking. This means looking at the care given to people in different ways. The ways this was done are: talking to the people who live in the home - talking to staff and the manager - watching how people are given support - looking at written records. We also looked at information that the provider sent to us, which told us about things they have been doing to improve the home. We spoke with two people who live in the home during our visit. People told us that they were happy in the home and that they felt staff were good and helped them. We spoke to one member of staff during our visit to the home, who Care Homes for Adults (18-65 years) Page 8 of 36 told us about working in the home and gave us their views. They mainly felt very positive about working in the home, and said they felt well supported. We checked all the standards that the Care quality Commission has decided are key standards during this inspection. The information in this report is just about what we checked in this inspection. We have kept details about individual people out of the report, to make sure these things are kept confidential. What the care home does well The manager and staff find out about the needs of people who come to live in the home and check whether the home is able to give them the support they need. There is some good written information which tells staff about peoples needs and what kind of support and help they want. People are able to look at their records, and are supported to have independence and control. Care Homes for Adults (18-65 years) Page 9 of 36 Staff give good support to people. There is a good, easy-going relationship between staff and people who live in the home. People have the confidence to ask staff for what they want. People who live in the home enjoy a good lifestyle - they are able to do different activities that they enjoy, both in the home and in the community. Friends and relatives are welcome in the home. People are enabled to be independent, and take an active part in running the home, doing things like shopping and cooking. Care Homes for Adults (18-65 years) Page 10 of 36 Staff make sure that they support people to follow up any health concerns that they have. Everyone has a local GP and has health checks that they need to help them stay healthy. The home is clean and comfortable for people who live there. Everyone can have their own things in their bedrooms. Staff get training in different subjects to help them to do their job well, including in adult protection so they can help to keep people safe from harm. There are policies which tell the staff how to do their job well. Checks are done to make sure equipment is safe. Staff support people to look after their money and to manage how Care Homes for Adults (18-65 years) Page 11 of 36 they spend it. References are collected and safety checks are done, to make sure that people who come to work in the home are safe. The manager is approachable and runs the home well. People whole live in the home are asked for their views and ideas. What has got better from the last inspection Some actions were recommended after the last inspection and these have been carried out: Care records are now kept in a Care Homes for Adults (18-65 years) Page 12 of 36 better way that means they are more accessible to staff. The home has now been reporting all serious incidents to us and to social services, as they are required to do. This must be done to make sure people who live in the home are safeguarded from harm. There have been some good improvements in the way that the home safeguards people. Staff have had more training, and have been given information to help them. What the care home could do better While there have been improvements, care plans and risk assessments do not always show all details about what peoples current care needs are - based on what has happened to them or what they have been doing. The manager and staff need to look Care Homes for Adults (18-65 years) Page 13 of 36 at issues about consent, even where action they are taking is about protecting people. Medication is stored in a locked filing cabinet, which does not meet the requirements of the law. The home needs to get a proper medication cabinet. The manager needs to make sure that staff have all the information they need to keep people safe. The provider needs to make sure that people are kept safe from risks created by hot water temperatures in the home. Care Homes for Adults (18-65 years) Page 14 of 36 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Chris Wroe CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 15 of 36 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 16 of 36 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 live in this home benefit from a good assessment of their needs and a supportive living environment. Evidence: The manager and staff carry out a full assessment to see whether the college and the home are right for people. They tell people all about the college and the kinds of things they will learn. They also find out which house will be the right place for each person to live - whether it is somewhere quieter or somewhere lively. This kind of matching is good, and supportive to people. The college has improved assessments by sending senior staff out to meet people now to tell them about the college and what it would be like living there. People who filled in our surveys told us that they got information about the home before they moved in, so they could decide if it was the right place for them. They told us they were asked if they wanted to move into the home. We saw that people who live in the home are comfortable and relaxed with each other and with staff. Page 17 of 36 Care Homes for Adults (18-65 years) Evidence: Staff have ongoing training to help them to meet peoples needs. The college makes sure that people keep up to date with their training. Care Homes for Adults (18-65 years) Page 18 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home mainly benefit from good attention to their needs, but there needs to be a focus on consent and on recording. Evidence: We looked at written care plans, which give information about peoples care needs and how they are supported. These are mainly kept on the computer, so that they are readily available for staff. People who live in the home can have access to records kept about them, and they can use the computer in the home. The staff are going through training about person centred planning at the moment - this is a way of making records more about each individual person, from their own point of view. We talked to the staff and manager about peoples care needs. They showed us that they understood what was important for each person, and how best to give them support. We saw that there are good relationships between staff and people who live in the home. Sometimes staff have to think about how to keep people safe from harm. We found that Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: for one person, staff were having to put some restrictions on what they did, because of concerns that had previously come up about safety and wellbeing. But written records did not talk about what the issues were, and what needed to be put in place to make sure everyone was kept safe who needed to be. The manager said this is because they had to keep things confidential. Whilst we understand the importance of confidentiality, we feel that staff cannot support people properly if they do not understand why or how to protect someone. Records need to show why there are restrictions, and staff need to understand how to give the right kind of support. Staff in the home make sure they keep people safe. For one person, a listening monitor is used to make sure that they are safe and well. Whilst the person has expressed no problem with this, the manager said that they had not given their informed consent. The monitor links through to the lounge area, where staff and other people who live in the home gather, so the person does not have full privacy. We think that the manager and staff should look at this, to see if it is the only effective way to keep the person safe, and to make sure there is proper understanding and consent. At the moment there is no written risk assessment nor any information in care plans about this. The home uses the system of sanctions and rewards that is used throughout the college. People can get points for good behaviours and have them taken away for negative behaviours. If people lose a lot of points they get a sanction, like being unable to go to a club they enjoy. The manager told us that sanctions are hardly ever used. People like the rewards system, where one person is named student of the week and gets a money prize. The college managers are looking into the whole system of rewards and sanctions at the moment, to make sure that people do consent and that they understand and agree to the idea. Reviews are held in the home, to make sure that people are supported in the way they want and that their needs are being met. Staff pay good attention to making sure that people get the right kind of support. One person told us Im happy here. People told us that staff listen to them and act on what they say. People who live in the home are supported to look after their money, and to buy what they need. An assessment is done for each person to see how far they are able to look after their money by themselves and how much support they need. Each person has a bank account, and signs for their money if they take it out for spending. The staff are going to support people to do their own money checks and learn to budget. Care Homes for Adults (18-65 years) Page 20 of 36 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home enjoy a very positive lifestyle, with support and encouragement from staff. Evidence: We found that everyone in the home does different things each day. The students are all learning at the college. People have certificates of achievement for things they have learnt. Other activities and events are organised, such as youth and social clubs, discos, shopping. Everyone has their own plan of activities so they can remember what they are doing each day. People have jobs - one person works in Asda, and the students work in the college cafe in Barrow on Soar. Students learn a range of different subjects, from computers to sport. One person told us that they like sport, especially football. People told us about the different things they like to do. One person told us in our survey that they would like to do more bowling and have more barbeques. When we talked about this during our visit, we found that the students have been bowling more, and that Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: there are plans to get a barbeque for the garden, so that on nice days they can have barbeques. While we visited, one person went onto the computer to check their e mails and respond to them. People have their own bedrooms, with their own possessions, so they can listen to their own music, and have private time if they want. All students are able to attend their chosen place of worship if they want to. The students and staff celebrate Christmas, Diwali, Chinese New Year and Eid, and the college has a team of staff who find out more about these celebrations. Students have their own front door keys, and staff are supporting people to build up their independence so that they can come into the house themselves. One person walks to work themselves and catches the bus by themselves to the cafe in Barrow. The home has a garden, which people are able to sit out in and enjoy. Families, relatives and friends are welcomed in the home, and staff support people to keep in touch with families. We saw during our visit that people who live in the home are comfortable in their environment and able to spend time where they choose. Members of staff showed good understanding of peoples needs and likes and dislikes. Meals are prepared by people who live in the home, with support from care staff. During our visit we saw one person preparing their evening meal of curry and rice. Everyone has a say about what they would like to eat. They help to plan the menus and to shop for food. While we were in the home, one person was looking through stocks of food, to see what they needed to buy. Everyone has a folder with information about the kinds of food that are healthy and how to eat a balanced diet. People also put recipes in of meals they have enjoyed and things they want to make. Care Homes for Adults (18-65 years) Page 22 of 36 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 who live in this home benefit from good attention to their personal and healthcare needs. Evidence: People have access to a local GP, and they are supported to have ongoing health checks. We found the home keeps good records about peoples health needs and contact they have with professionals who help them. Everyone has just been given a health passport, which staff are going to support them to fill in. These will belong to each person, and be about them, and be something they can add to when they want to. People who live in the home are mainly independent in carrying out personal care. We saw that staff support them and give them encouragement in this area. Two people who live in the home are in a group where they are learning about relationships, sexuality and safety. This is very positive. Staff showed good understanding of peoples needs, including their emotional needs. People who live in the home have differing skills and abilities in communication - staff aid communication by using prompts, symbols, and Makaton to enable students to make their own choices and help others to understand their needs. Communication is a key Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: part of peoples care plans, and links with their health and wellbeing. Two people who live in the home are supported by staff to take their medication. We checked a sample of medication stocks and records. Systems for storing and giving medication are safe. Staff have a good understanding of the importance of making sure the right medication is given to people when they need it. At the moment, medication is kept in a locked filing cabinet in a room which is used as a staff sleep-in room. The home should have a proper medication cabinet that meets the requirements of the law. Care Homes for Adults (18-65 years) Page 24 of 36 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from having well trained staff who know how to give support, and from strengthened safeguarding systems. Evidence: There is a complaints procedure in the home, and if people have any concerns they can make a complaint. People who live in the home told us in our surveys that they know how to make a complaint. During our visit to the home, one person told us they would talk to the staff or the manager if they have any problems. We have not received any complaints about the home in the time since the last inspection. The college managers have been making some improvements over the past six months to safeguarding processes in the college homes. It was good to see that these had come through to this home. Staff now have fold-up cards that they have with them while they work, which gives information about what to do if they have a concern about harm to someone. It also has the phone numbers of managers and social services. Staff were able to tell us about action they would take if someone was at risk. Staff and managers have recently had training to make sure they know what their responsibilities are in safeguarding peoples wellbeing. The manager has made sure that any incidents of concern have been reported to us, as they are supposed to do. They have made sure that social services have been told about safeguarding issues, so that these can be looked into properly. Under section 2 we have raised the issue about staff not being told enough information Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: about incidents, and this needs to be sorted out. Social services have made clear to the home how information should be shared, and the manager has told us she will ensure this is followed in future. What is good is that the home has been reporting concerns and has stayed focussed on making sure people are protected from harm. Care Homes for Adults (18-65 years) Page 26 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from having a generally good, homely, clean and comfortable living environment. Evidence: We looked around parts of the home during our visit, and we found that it was clean, fresh and comfortable. There is a homely feeling and the home has a reasonably-sized garden for people to sit out in and enjoy. People who live in the home are able to personalise their bedrooms with their own things. One bedroom on the ground floor has an en-suite shower, toilet and hand basin. All students rooms are lockable and students have their own key. Since the new manager came into post, a health and safety audit has been held in the home, and the manager has made sure that areas needing attention have been dealt with. Proper checks of equipment are carried out in the home, to make sure it is safe for people to use. There is good access from the house to the local community. The house is close to Thurmaston town centre. There is a fire risk assessment in the home to make sure people are kept safe from risks. Tests and checks are carried out, and fire evacuation practices, so people know what to do if there is a fire. Water temperature tests are carried out, but information is not clear Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: for staff about what safe temperatures are, and what to do if they have concerns. Some of the recorded temperatures were high and could be unsafe. We asked the manager to make sure risk assessments were done without delay, relating to the risks for each person of using sinks and baths. The manager told us within a few days of our inspection that this had been done. The manager also told us that work is being done to ensure safe temperatures of water are maintained. Care Homes for Adults (18-65 years) Page 28 of 36 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 live in this home benefit from having a well trained and supportive staff team. Evidence: Staff in the home are responsible for caring for people who live in the home, and for supporting them to do cleaning and cooking and keep their house tidy. More staff work at times when it is busier in the home. At night a member of staff sleeps at the home to be available if anyone needs them. The provider (owner) makes sure that checks are carried out for new staff who come to work in the home, such as Criminal Records Bureau (CRB) checks, and collecting references. They also repeat checks every five years. Staff have had training to help them work well, and to help them meet the needs of people who live in the home. Areas of training include National Vocational Qualifications (NVQ) in care, levels 2 and 3, epilepsy awareness, Makaton, health and safety, safeguarding and equality and diversity. Staff have supervision from the manager, to look at how their work is going. One member of staff told us in a survey that they feel the provider could listen more to staffs needs and concerns sometimes. We talked to staff a bit more about this when we visited. Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: We have looked at this in section 2 and section 5 of the report, and the manager is now clear about making sure staff have proper information to help them to support people. Staff are generally very positive about the home. One staff member told us what they feel the service does well: support and understand all the needs of our students and help them become more independent, and develop the skills they are learning to the best of their ability. Care Homes for Adults (18-65 years) Page 30 of 36 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. People who live in this home mainly benefit from good management systems, which will be further strengthened when the manager is registered. Evidence: The manager of the home has come into post since our last inspection, and she is beginning the process of registration with us. She has achieved level 3, National Vocational Qualification (NVQ) in Health and Social Care, and will be studying towards NVQ level 4 in health and social care, and in leadership in care. One member of staff we spoke to told us that they found the manager supportive and approachable. Members of staff who filled in our surveys told us that they feel supported by the manager. The manager is available to staff if they need anything, and also gives them supervision and appraisals. Staff meetings are held regularly. The college offers different ways of finding out the views of people who live in the home and go to the college. All students have a personal and support tutor, who is a member of staff. They have weekly meetings to talk about how things are going and about any worries or problems. Every Sunday there is a student meeting in the house, so people Care Homes for Adults (18-65 years) Page 31 of 36 Evidence: can give their ideas about things. Every half term students are given a questionnaire to fill in, to give their opinion about the college and where they live. Staff also keep contact up with relatives to make sure they are happy with how things are going. There are also different groups for people to be involved in, to give their ideas and make changes. There is a student council. Students help with recruiting new staff. The manager and provider carry out checks to make sure the home is providing a service which is of good quality and safe. All staff have a first aid qualification. Staff carry out safety checks of different equipment, to make sure it is fit for use. Members of staff have had training to make sure that they know how to work safely. Staff are given equipment they need, like safety gloves, to help them to prevent the spread of infections. Care Homes for Adults (18-65 years) Page 32 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action 1 24 13 The provider must ensure 31/07/2010 that risks to people from hot water temperatures are eliminated. This is to ensure that people are kept safe from harm. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 6 12 The provider must ensure 31/05/2010 that a review is carried out relating to use of a listening monitor to ensure someones safety, taking into account issues of consent, right to privacy and liberty, and ensuring that care plans and risk assessments reflect action taken. This is to ensure that peoples rights are protected. 2 7 13 The provider must ensure that care plans and risk assessments give sufficient detail to show why actions 31/05/2010 Care Homes for Adults (18-65 years) Page 34 of 36 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action are to be taken by staff to protect or restrict someone. This is to ensure that peoples rights are protected. 3 20 13 The provider must ensure 30/06/2010 that medication is stored in a lockable cabinet which meets the requirements of current legislation. This is to ensure that medication is kept as safe as possible in the home. 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 35 of 36 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. 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