Care Home: 9-10 Jutland Place

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What the care home does well People have accessible support and health action plans,which outline how their needs and goals are to be met. Individual activity schedules ensure that people`s recreational and social interests are addressed. People spoken with and surveyed said that they enjoy their activities. One person works in a tea bar and people participate in activities including drama, bowling, swimming, golf and photography. The home supports people to make decisions and choices in their daily lives including the meals they eat, what time they like to get up and go to bed, preferred holidays and decor preferences. A person told us "I am going on holiday to Eastbourne, which I enjoy". The service provides a comfortable and homely environment, which is relaxed, welcoming and friendly . A relative surveyed said on a person`s behalf, "There is a good family atmosphere, I get on well with my friends and the staff are very good, supportive and friendly". A person living in the service said, "The staff are lovely its the best home". Two people told us they were happy using makaton sign "Thumbs up" to indicate this . The service has good systems in place which address any concerns or complaints that people may have. Accessible information is provided to people, which meets their needs. What has improved since the last inspection? The manager has been provided with a job description and now has some supernumerary hours allocated to them to carry out their administrative tasks. The home has carried out a staffing level review, which is based on the dependency level of people living in the service. What the care home could do better: It is recommended that the staff lone working policy includes details the staff cover arrangements should any person be present in the home. It is recommended that arrangements are made for bank staff working in the service to receive formal supervision and that their refresher training is addressed. Key inspection report Care homes for adults (18-65 years) Name: Address: 9-10 Jutland Place 9-10 Jutland Place Pooley Green Egham Surrey TW20 8ET     The quality rating for this care home is:   three star excellent 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: Lisa Johnson     Date: 2 7 0 7 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: 9-10 Jutland Place 9-10 Jutland Place Pooley Green Egham Surrey TW20 8ET 01784436647 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.mencap.org.uk Royal Mencap Society Name of registered manager (if applicable) Mrs Moira Kelly 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: The maximum number of service users to be accommodated is 8. 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 Jutland Place is situated close to Egham town centre, in a quiet residential cul de sac. The home is a detached property formed from two semi-detached houses and in keeping with the surrounding area. The home is within walking distance of local amenities. The premises provide accommodation and care for 8 adults with learning disabilities. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 Brief description of the care home Single bedrooms are situated on the first and ground floor. Communal facilities such as the Lounge, kitchen and conservatory/dining area are on the ground floor and the home has its own private garden to the rear. There is ample car parking at the side of the property. Fees at this home are currently £529.86 per week. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This site visit was part of a key inspection. The visit was unannounced. We arrived at 11.15am and left at 4.55pm. The last key inspection was carried out 26th August 2007. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date and it gave us all the information we asked for. Reference is made to this assessment throughout this report. We received eight feedback surveys from people that live in the service and four were returned from members of staff. During this visit we met with four people who live in the service and two relatives. We met with the registered Manager Mrs. M Kelly and Care Homes for Adults (18-65 years) Page 6 of 29 two members of staff During this visit we looked at staff recruitment, and training records, care plans, risk assessments, menus, Quality assurance systems, medication administration policies, health and safety records and policies and procedures were sampled. 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: 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 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 9 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 considering the service as a place to live are provided with accessible information about the home and their needs are assessed prior to admission ensuring that the service can meet them. Evidence: During this visit we looked at the information provided to people who use the service to see whether it is able to supply information about everything that people or their representatives need to know about the service. There is a statement of purpose and service guide, which is also produced in alternative format,which is currently being updated. There have been no admissions over the last year and some people have lived there for a number of years. The service has a clear admissions procedure, which includes an assessment process, which involves gathering information about the person, their representatives, care management assessments, any relevant health professionals and previous placement. During this visit we viewed the pre- admission assessment, which covers health, personal, communication, daily living needs, social, cultural and Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: religious needs. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a plan of care that that they have been involved in making. Peoples needs and goals are met and they are able make decisions about their life. People are able to take risks as part of an independent lifestyle. Evidence: Each person has a detailed support plan in place. During this visit we viewed three peoples plans, which identified their individual goals and how these are to be met. Information seen demonstrated that these are regularly reviewed in consultation with people. There is an accessible review form, which is formulated with pictures to assist people with this process. The AQAA states that people are supported to take a lead in their support planning and help to arrange their individual meetings to review their plans. A member of staff spoken with during this visit said they are expected to read peoples support plans and if any changes have been made. Another member of staff surveyed said, We update support plans, risk assessments and all health related documents. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: People are supported to make decisions and choices about their lives. The service holds regular house meetings with people where they are able to raise their views. People are supported to manage their finances with support if this is required. A person living in the service participated in a recent staff recruitment exercise and they were provided with the opportunity to ask the candidates a question that was important to them. The service has provided a range of information in accessible formats, which meets their needs including the complaints procedure. Support plans contained information in How I communicate and staff have received makaton sign language training, which meets peoples needs. People are supported to take risks as part of an independent lifestyle. During this visit we sampled some of the risk assessments for three people, which included, managing finances, domestic tasks, using transport, bathing. and epilepsy. All risk plans had been reviewed and were up to date and the manager told us that an accessible risk assessment format is being introduced shortly. Care Homes for Adults (18-65 years) Page 13 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. Peoples preferences, social, cultural, diverse ,religious and recreational needs are met People maintain contact with their family , friends , representatives and the local community. People are supported to exercise choice over their lives and are provided with varied and well balanced meals. Evidence: Each persons support plan outlined their activity programme. On arrival at the home a number of people were away from the home attending day services. In the afternoon a person went shopping to Sainsburys and brought back their favourite cakes. Peoples support plans identified that they attend day services, go swimming, attend drama groups, visit the library, go trampolining and bowling, participate in cookery and one persons plan stated that they work in a tea bar. Two people told us about the social clubs that they visit. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: A staffing level review has taken place which has resulted in increased activities being provided at weekends. Some people like to visit the local golf range and participate in photography. A person told us that like to buy a lottery ticket. The manager told us that have been consulting with employability and a meeting has been arranged for a person to visit to the home talk about college classes. Each person has a photograph album, which displayed pictures of the different of activities that they take part in. People are able to and choose their holidays and one person told us, I am going to Eastbourne and another person had participated in a quad biking and activity holiday. Peoples religious needs are respected. People living in the service said that they enjoy their activities. People maintain links with their family and friends. At the time of this visit one person was being visited by their family. Familys are invited to participate to attend care reviews. A person told us that they have a friend that has been able to visit for a meal. The service respect peoples right to have relationships and a person told us that they have a boyfriend. The organisation has a familys charter, which guides staff in supporting people to maintain and strengthen relationships. People and staff were interacting through out this visit. People were observed to be relaxed and happy. People are supported to participate in household activities, which are recorded in their support plan, which includes cleaning, washing, shopping and preparation of meals. A person told us I do washing up, lay the tables and they showed us a photograph of themselves making a packed lunch.During this visit another person was observed laying the table for tea. A person surveyed said, I think i should be helped more with my washing and ironing The service has a four weekly menu, which is based on peoples choices and preferences. The menu was varied and well balanced and healthy eating is encouraged A person told us that they were having their favourite meal that evening. People spoken with and surveyed said that they enjoyed their meals. The home is intending to provide picture menus. Care Homes for Adults (18-65 years) Page 15 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. Peoples health and personal care needs are met and their preferences for support is respected. The home supports people with their medication in a safe way. Evidence: Three peoples health action plans sampled contained information about their likes, dislikes, preferences, routines and preferred name of address. Care plans detailed how support is to be provided, including preferred gender of staff to provide this support. Health action plans outlined the arrangements for meeting peoples health care needs. People are registered with a local GP, although we were told that two people continue to receive support from their GP that they were registered with before they moved into the service. People are supported to access a range of other health care professionals including, chiropody, optician, dentist, district nurse and one persons plan identified that they receive support from psychology. Detailed records were maintained of all health consultations and health screen checks ,which were up to date. The service has provided each person with a going to the doctor book and hospital book. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: During this visit staff were observed to knock on peoples bedroom doors before entering respecting their privacy. Staff were observed to be attentive and addressed people in a respectful manner. A person living in the service said that staff always respect their privacy and stated, The staff are lovely. A person surveyed said, I am well looked after, it is a marvelous place, the best home. A member of staff surveyed said, The staff respect peoples privacy and to help them gain and feel that their individuality is something to be proud of During this visit we viewed the homes medication administration practices. Medication was stored appropriately. Records were maintained for the receipt and disposal of medication. Medication is dispensed by a local chemist using the monitored dose system (MDS). Staff receive medication training. Medication profiles were in place for each person and homely remedy medicine protocols were available. Currently there are only two people receiving regular medication who require these to be administered. Medication administration records viewed during this visit were appropriately maintained. Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns they know how to complain and they are safeguarded from abuse Evidence: We looked at information provided to people, which tells people about how they can make complaints. During this visit we saw a copy of the homes complaints procedure, which has been adapted to meet the level of understanding for the person by incorperating pictures. There is also an accessible complaints form, which is used to record peoples concerns. People are encouraged to raise any concerns, which can be raised with the manager, staff, at home meetings and one to one meetings with their key workers. Since our previous visit the service has received six complaints. Records were maintained and the outcome of any investigation was documented. Complaints are audited as part of the organisations (mencap) quality assurance framework. Two people spoken with during this visit told us they knew who they would speak to if they had any concerns. One person said, I would speak to the manager. Another person said, I would speak to my key worker. Two people said they were happy and used makaton sign language thumbs up to indicate this. Eight surveys received from people confirmed that they were aware of the complaints procedure. During this visit a relative said that the manager would deal with any matters effectively. Three Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: members of staff surveyed said that they knew what to do if someone raised any concerns about the home. The service has safeguarding vulnerable adults from abuse procedures in place and the local authority procedure was available. Financial procedures were in place and during this visit peoples monies were stored securely and we also sampled finance records for three people, which were appropriately maintained. Accessible safeguarding information about local processes has been brought to the attention of people and discussed as part of the house meeting. A member of staff interviewed during this visit told us that were aware of the procedures, that they had attended training and were clear about their responsibilities should they witness or be made aware of any incident where the safety of a person is compromised. We also sampled training records for three members of staff, which also confirmed that they had received safeguarding training. Since our previous visit one referral was made following the local authority safeguarding vulnerable adults from abuse procedure, which the service brought to the attention of the Commission. This matter has now been concluded. Care Homes for Adults (18-65 years) Page 19 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. People live in a home that is safe, comfortable, homely and clean. Evidence: The service is situated in a quiet cul de sac and is close by to local amenities. During this visit the home was observed to be well maintained and furnished providing a comfortable environment for people living there. The service provides a large lounge, which was decorated and furnished in a modern style. Homely touches were seen including bowls of fruit, which people could help themselves to. The home has a modern, accessible kitchen and meals are taken in the conservatory. Although fans were provided in this room it was very warm and would benefit from blinds being installed, which has been identified by the manager. There is an accessible garden, which has patio area and garden furniture. The manager stated that there is a re decoration and maintenance plan in place. Since our previous visit five bedrooms have been redecorated to individuals taste and double glazing has been installed. Plans are in place for the communal areas to be repainted and a new carpet is to be fitted in the sitting room. One person invited us to see their bedroom, which was comfortable and contained a wide range of their personal possessions including music center and DVDs. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: During this visit the home was observed to be cleaned to a high standard and was hygienic. Sufficient hand washing facilities and equipment were available throughout the building. Staff are provided with protective equipment and infection control procedures are in place. Since our previous visit the environmental health department has visited the home, which was satisfactory. Care Homes for Adults (18-65 years) Page 21 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. People using the service are supported by staff that are competent and trained to meet their needs and they are protected by the homes recruitment policies and practices. Evidence: At the time of this visit the registered manager was on duty with a second member of staff. Information recorded on the rota verified that that two members of staff are provided throughout the day, although on one week day there is only one member of staff on duty after nine am until the afternoon due to there being no people in the service who all attend activities on this particular day. The home has implemented a lone working risk assessment, although it was recommended that this should include information about staffing arrangements should any person remain or return to the home. Since our previous visit the manager has been allocated supernumerary hours to be able to carry out their administrative duties. Staffing levels have been increased to three to support people in accessing more activities. A relative spoken with during visit said that there are always two members of staff in the home when they visit.Three members of staff surveyed said there were enough staff, although one person said,With more staff we could give people more one to one time and this would help people progressing forward in their Independence. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Recently the staffing levels have been reviewed to provide three members of staff at the weekends to enable people to access and participate in more activities. At night time people are supported by a sleep in member of staff and on call arrangements are in place should assistance be required. The service currently employs six members of staff and another member of staff is due to commence shortly. Staff are also provided by the organisations bank system, Two out of five members of care staff have completed National Vocational Qualifications (Level 2 or above) and another member of staff is completing the qualification. New staff receive induction and foundation training following Skills for Care core induction standards. At the time of this visit a new member of staff that was on duty was working through their induction pack. Three members of staff surveyed said that their induction covered everything that they needed to know about the job. During this visit we looked at the training records for three members of staff, which demonstrated that they had received up to date statutory training and specialist training including, epilepsy, makaton and dementia awareness. The manager has attended mental capacity act training. Information supplied in the AQAA states that organisation have linked diversity awareness into their person centered approaches training. Three members of staff surveyed state that they enough support experience and knowledge to meet the differing needs of people who live at the home. One member of staff said, The team goes on various courses to maintain the standard of care. During this visit we spoke with a member of staff that works bank who told us about the training that they had received, but they were not aware who would be arranging their refresher training and who is responsible for their supervision as they are not permanently employed by this service. This matter was discussed with the manager who was aware that this matter needs addressing. Staff recruitment is based on equal opportunities. During this visit we sampled three members of staff personal files, which contained the required information including two written references and enhanced criminal records bureau checks (CRB). We were informed that no staff are employed until this information is received. While looking at the application form for a new member of staff that had been employed it was observed that there was a gap in their work history. This had also been identified in a recent quality monitoring visit conducted by the provider, which the manager was aware of and is going to follow this up. A relative on behalf of a person living surveyed said, The manager always employs good people. Staff receive regular formal Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: supervision, which was confirmed during discussions with staff, records viewed and staff surveys although the formal supervision needs addressing for staff working bank. 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. The home is well run in the best interests of people living there and their wellbeing and safety is protected. Evidence: There is an experienced manager in post, who has recently been registered with us who has had a number of years of experience of working in social care settings. The manager has attended a wide range of training development and is aware that they need to complete their management qualification. The manager was observed to have an open and inclusive approach and made themselves accessible to both people and staff throughout this visit. Three staff surveys received stated they feel supported by the manager. A member of staff spoken with at the time of the visit said, The manager is good.Another member of staff surveyed said. The manager is well organised and supportive to both people we support and staff and it is a nice place to work. Relatives spoken with at the time of this visit spoke positively about the management of the home. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: During this visit we looked at the homes certificate of registration, which was seen on display in the home. The details were correct and confirmed the correct numbers and categories of people that are supported. A new certificate is to be issued now that the manager is registered with the Commission. Monthly quality monitoring visits are conducted by the registered provider(Mencap), which were available for viewing. These were detailed and comprehensive and contained information, which demonstrated that peoples views are sought. Information supplied in the AQAA states that the organisation is currently undertaking a review of the way that information is gained from people and they are moving towards a more flexible process for facilitating and recording discussions with people. The organisation has a continuous improvement framework that sets out how the quality of the service meets the needs of people using the service. This involves regular auditing, action plans and annual reviews looking at specific areas. Staff training records sampled,demonstrated that they had received statutory training including first aid, moving and handling and health and safety. Records were maintained to ensure that water temperatures are regularly checked and monthly health and safety audits were carried out. Hazardous cleaning materials were stored and locked away securely. The service maintains incident and accident records. Routine servicing and maintenance of facilities and equipment were up to date. 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 1 33 It is recommended that the homes lone working policy includes information about the staff cover arrangements should people be present in the home. It is recommended that the refresher training and formal supervision arrangements be addressed for regular bank staff that work in the service. 2 35 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. 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. 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