Care Home: 9 Portland Road

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What the care home does well 9 Portland Road is a progressive service which supports people wherever possible to build upon their skills and confidence and move onto more independent living. In achieving this result, the service has a good track record of success. Feedback from the local Residential Services time states that the home has a very "client centred approach" and that "the service provides support which is very much in line with the Recovery approach". Each resident has a care plan in place that provides staff with guidance about how they should provide support and identifies both short and long term goals and objectives. The care plan is based on the Care Programme Approach and heavily involves the resident in the planning of their own support. Communication at all levels throughout this service is maintained effectively. Staff hand overs are conducted three times every day and fortnightly staff meetings provide the forums where everyone is encouraged to learn from and challenge each other to ensure that care is delivered in the most effective and consistent way. Residents are supported to be fully involved in the running of the home and their rights and responsibilities as adults living together are fully respected. Residents have access to opportunities that develop their educational, vocational and social needs. 9 Portland Road has an inclusive atmosphere where individuals are encouraged to air their views to develop the service, whilst also ensuring that everyone is respected and treated as equals. Residents have the freedom to go out independently and spend their day as they choose. Each resident has their own key to the front door as well as to their bedroom. The Registered Manager is experienced and competent and leads a team of committed and well trained staff. What has improved since the last inspection? No requirements were made at the time of the last inspection, however the Registered Manager confirmed both in the AQAA and at the time of the inspection that the home has continued to improve and identify those areas where further improvements are still necessary. Ongoing maintenance and refurbishment to the environment remains one of the largest areas for concentration and the Inspector was able to evidence that this continues to get better. The ways of recording information has also improved and in particular the records pertaining to care are now more accessible. What the care home could do better: The home has good systems in place to self monitor and improve and the Commission is therefore confident that the internal mechanisms in place are sufficiently robust to identify its own areas for improvement as such only two requirements have been made as a result of this inspection.In line with changes to legislation, the home must purchase a controlled drugs cupboard so that it would be able to safely store any such medicines that may come into the care home in the future. The organisation must also make further efforts to ensure that the visits conducted in accordance with Regulation 26 are undertaken at least once a month. Key inspection report Care homes for adults (18-65 years) Name: Address: 9 Portland Road 9 Portland Road Hove East Sussex BN3 5DR     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: Lucy Green     Date: 1 5 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 30 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 30 Information about the care home Name of care home: Address: 9 Portland Road 9 Portland Road Hove East Sussex BN3 5DR 01273822103 01273726706 geraldine.ohaire@bht.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brighton Housing Trust care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 9 The registered person may provide the following category 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 category: Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home 9 Portland Road provides residential support for up to nine adults who have mental health disorders. The home is owned and managed by Brighton Housing Trust who also run another small home for people with mental health disorders at 57 Sackville Gardens, Hove and supported accommodation services in Westbourne Gardens, Leybourne Road, Buckingham Road and Sackville Gardens. The main purpose of the home is to enable residents to develop personal independence and confidence in their daily lives. The home is situated in an end of terrace fourstorey house where single bedrooms are located on the third and fourth floors. The Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 9 Brief description of the care home home is located very close to local transport, shops and other amenities. Further information about the services provided at 9 Portland Road, including the current range of fees can be found in the homes Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the Provider. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term service user to describe those living in care home settings. For the purpose of this report, those living at 9 Portland Road are referred to as residents. This report reflects a key inspection based on the collation of information received since the last inspection, a site visit and a review of the homes Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The AQAA was completed by the Registered Manager and returned when we asked for it. The site visit was carried out over four hours between the times of 10:00am and 2:00pm on Wednesday 15th July 2009. We had a look around the home and examined Care Homes for Adults (18-65 years) Page 6 of 30 some care, medication and staffing records. We observed the interaction between staff and residents during our visit.. During the visit we met with the nine people currently living at the home and five of these people spent time talking with us in private. The Registered Manager facilitated the inspection and we were also introduced to the Deputy Manager, three care workers and a volunteer. One care worker spent additional time talking with the Inspector on an individual basis. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The home has good systems in place to self monitor and improve and the Commission is therefore confident that the internal mechanisms in place are sufficiently robust to identify its own areas for improvement as such only two requirements have been made as a result of this inspection. Care Homes for Adults (18-65 years) Page 8 of 30 In line with changes to legislation, the home must purchase a controlled drugs cupboard so that it would be able to safely store any such medicines that may come into the care home in the future. The organisation must also make further efforts to ensure that the visits conducted in accordance with Regulation 26 are undertaken at least once a month. 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are protected by a comprehensive admission process that ensures their individual strengths, needs and expectations are assessed prior to moving into the home. Evidence: There are five people currently living at 9 Portland Road, four of whom have moved into the service since the last time we visited. We examined the assessment information for two of these individuals and spoke with them about the way they were admitted into the service. There was documentary evidence that the home had obtained copies of the relevant professional reports, including, the latest Care Programme Approach assessment (CPA) and discharge information from previous placements. For these two people, there was also evidence that the home had conducted its own assessment on the basis of the Registered Manager and Deputy Manager visiting the person in their former environment. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: There was evidence that information gathered at the assessment stage has been used to develop a plan of care, set of risk assessments and identify goals. The home actively encourages prospective residents to visit the home prior to admission to assess the suitability of the placement and to begin to get to know the people they will be living with and supported by. The Registered Manager confirmed that trial periods, including overnight stays are always offered, but that the transition process is always led by the choice and needs of the individual moving in. Feedback from management and staff was that the most recent admissions to the service had been successful and that the people concerned had made good progress since coming to live at 9 Portland Road. Discussion with three of the people who have moved in since our last feedback confirmed that they had settled in and that their placements were working well for them. Copies of licence agreements were found in the three care plans viewed. Two of these documents had been signed by both the Registered Manager and the resident. The third licence agreement had been signed on behalf of the home and will be confirmed by the resident once they are legally able to do so. Discussion with five residents confirmed that they understood the rights and responsibilities attached to their placement at 9 Portland Road. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support is planned and delivered in a way that enables and protects residents. Residents are fully involved in all decisions about their lives and understand the rights and responsibilities attached to their placement at the service. Evidence: Through discussion with management and staff and observation of their practices and feedback from residents, it was demonstrated that they have positive relationships with the people they support and a good understanding of their needs. The Inspector tracked the care of three people, which included a partial examination of their care plans, discussion with the staff and a private discussion with the resident. The three care plans viewed were each found to comprehensively outline care needs in a transparent and accessible way. Care plans are working documents that are referred to and utilised every day. The good communication systems in place ensure that staff support residents in a consistent way. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Goal setting and monitoring are fundamental principles in the way care plans are constructed. The three care plans viewed contained individual goals for each resident based on objectives set in their Care Programme Approach assessment. The focus of goals is wherever possible to enable individuals to achieve maximum independence and develop their skills. Goals are monitored and discussed at regular meetings between the residents and their primary workers. Full care reviews are conducted every six months and the records of these meetings were found to be detailed, focused and multi-disciplinary in their approach. The home has a positive approach to risk taking and residents are supported to take risks to maximise choice and independence. Risk assessments were found to be in place for each of the residents whose care was tracked. 9 Portland Road is a progressive service where individuals are given the opportunity, support and autonomy to develop the skills they need to live independently again. Evidence gathered from documentation and observation of staff supporting residents during the inspection, highlighted that the home provides a service where residents are encouraged and supported to lead independent lives. It was noted that where rights have to be limited for the wellbeing of residents these are fully agreed with residents. Feedback from residents confirmed that they understood the responsibilities and in some cases restrictions on their placement. Two residents discussed the restrictions placed on their stay and stated that they felt the rules were fair. Another resident said they had challenged one of the homes policies and that some things had been changed as a result, they went on to say that they accepted why some of the rules needed to be there for the safety of everyone. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to lead their own lives and to develop their life skills and independence. Residents have the opportunity to plan and prepare their own meals if they wish. Evidence: Residents at 9 Portland Road are free to spend their time how they choose. All residents have a key to the front door and the five people spoken with confirmed that they are able to come and go as they wish. Throughout the visit, residents were observed to have control over their daily routines. Each day a house meeting is held at 10am and residents are encouraged to attend to discuss chosen topics and air their views about life at the home. On the day of the visit, a trip out had been arranged for those who wished to attend. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The philosophy of this service is to develop individuals life skills and support residents to achieve maximum independence. For the majority of people who live at 9 Portland, it is a stage in their recovery and the aim is to live independently in the community. During the inspection, it was evident that residents have the freedom to live their lives as they choose, whilst understanding the need to be respectful to the other people they live with and to maintain their safety. Residents are encouraged to be fully involved in the running of the home and consequently they are expected to build time into their schedules to undertake household tasks. The Registered Manager and staff spoken with expressed flexibility in their approach towards individuals, depending on what stage they are with their lives. The home has a positive approach to enabling residents to maintain contact and relationships with families and friends. Mealtimes reflect the needs and wishes of individuals. Breakfast and lunchtimes offer free choice with each resident preparing these meals at times that suit them either with or without support. The main meal is served each evening and four residents are involved in cooking meals for the whole group. As such, main meals are decided on a daily basis and the individual allocated to cook that day has responsibility for the purchasing of ingredients, preparation and cooking of the main meal. Where residents have specialist dietary needs and cultural preferences, these are fully catered for. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive appropriate levels of support to meet their personal and healthcare needs and are enabled by the systems in place to manage medication. Evidence: Residents at 9 Portland Road largely manage their own personal care. Staff support is provided by verbal prompts as necessary. The philosophy of the home is to support residents to achieve maximum independence and systems are in place to assist residents to take full responsibility for their own personal and health care needs as appropriate. Care plans provide guidance for staff as to the support they should provide to each individual. Where individual mental health needs affect personal and healthcare issues there is evidence that the home takes appropriate action to ensure such issues are addressed. Care plans contain a record of any visits or contact with health care professionals and there was evidence through discussion with management and staff that they accompany residents to their appointments if needed and attend multi disciplinary meetings as appropriate. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Systems are in place to ensure medication is managed safely. Staff receive appropriate training in the management of medication. The home supports residents to work towards managing their own medication within a risk assessment framework. At the current time, the risk assessments in place identified that one resident self medicates on a weekly basis with daily checks to ensure they are administering their medicines appropriately. Due to recent changes in legislation, a requirement has been made in respect of making provision for the safekeeping of any controlled medication that may be brought into the home. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit an open culture where they are encouraged to discuss their views and are protected by the proactive systems in place to safeguard them and ensure mutual respect at all times. Evidence: The home has a complaints procedure which is available for residents and visitors to access. The home has received one complaint from a resident in the last twelve months. The complaint was in relation to the way a resident viewed restrictions placed upon them by the missing persons policy. The resident had raised their complaint with the Director of the organisation and had received a written response. There was evidence that the matter had been thoroughly discussed with the individual and some changes to the policy made. This example reflects the assertions of staff and management that the home operates an open culture where residents are encouraged to air their views and that any complaint or comment is treated seriously. Discussion with residents and observation of their interaction with staff highlighted that they feel confident to state their opinions without fear of reprisal. During the inspection, residents frequently approached the people who support them and freely expressed their needs and views. A house meeting is held daily at 10am. The purpose of this meeting is for residents to share their thoughts and views. Staff reported that these meetings have proved to be Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: a positive way of resolving any tensions in the house. The home has a number of systems in place to protect residents from abuse. New staff are employed subject to the necessary checks being undertaken. There are systems for supporting residents with their finances, which ensure that money held on behalf of residents is regularly audited and checked. The training files identified that all staff have received training in the safeguarding of vulnerable adults. The home has current policies and procedures in respect of the safeguarding of vulnerable adults. Discussion with staff and management identified that they have a good understanding of safeguarding and that staff support residents to be mutually respectful of each other. There was documentary evidence that where differences between residents had led to tensions, appropriate action was taken to ensure that residents took responsibility for their behaviour and respect other people they live with. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to an environment which meets their short term needs. The Commission supports the organisations intention to source better premises, but in the meantime some maintenance issues are impacting on the homeliness of the service. Evidence: 9 Portland Road is conveniently located near shops and a short walk from the seafront, public transport links and access to Brighton town centre. The home itself is in need of ongoing refurbishment. Resident accommodation is laid out over four floors and provides single bedroom accommodation and shared access to a communal lounge, dining area, kitchen and laundry. The Inspector undertook a tour of the communal areas. In respect of resident choice and routines, it was not possible to view the bedrooms at the time of this visit. Discussion with five residents provided feedback that they had access to sufficient space and described their bedrooms as adequate and I like it. There is some evidence of redecoration and maintenance, although the Registered Manager stated in both the AQAA and at the time of the inspection that upgrades have to be planned in consideration of current financial situations. The long term plan is to source a larger property and the Inspector agrees with the advantages of doing so. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Residents are supported to take responsibility for maintaining their bedrooms and a cleaner is employed part time to look after the communal areas. There are environmental improvements which would benefit this service, but these are not currently impacting on health and safety and the Inspector is satisfied that there is an appropriate plan in place. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the support of a dedicated and competent team of staff who have both the skills and support to enable them to perform their roles effectively. Evidence: At the time of the inspection, the atmosphere was observed to be friendly and relaxed and the positive relationships between staff and residents were obvious. The home was staffed by the Registered Manager, Deputy Manager and a care worker on the morning of the inspection. A review of the rota and discussion with the Registered Manager confirmed that staffing levels provide a minimum of two care staff during the day and one person sleeping in at night. The minimum number of staff during the day are frequently exceeded. As the people living at 9 Portland Road very independent, staffing levels were deemed adequate for the needs of the residents at the time of the Inspectors visit. Discussion with the Registered Manager, a care worker and examination of two staff files identified that staff training is ongoing. Brighton Housing Trust has its own training package that covers both mandatory and specialist training. The course list is also available electronically and staff are individually e-mailed regarding their updates. A training matrix was available which showed that staff receive refresher training as Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: necessary. The recent emphasis has been on ensuring all staff complete National Vocational Qualifications (NVQ). The Registered Manager reported that all permanent staff are now qualified to NVQ Level 3 in Care and herself and the Deputy Manager have undertaken NVQ Level 4. There have been no new staff join the team at 9 Portland Road since we last visited. A spot check of two staff files provided ongoing evidence of a robust system of recruitment being in place, with all the correct documentation and checks being in situ. Staff meetings are held every two weeks and formal supervisions are undertaken every four to six weeks. The records of these meetings were not viewed. Comprehensive staff handover sessions take place three times each day. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home being run by an experienced and committed Registered Manager who ensures that the home is run safely and in the best interests of the people who live there. Evidence: 9 Portland Road is managed by an experienced and competent Registered manager who has completed NVQ Level 4 in Care and is currently working towards the Leadership and Management Award. During the inspection, it was observed that the Registered Manager has a good relationship with both staff and residents feedback from both confirmed that they found her to be approachable and supportive. The home has a system of quality monitoring in place with the Registered Manager of a sister home conducting regular visits in accordance with Regulation 26. It was however identified, that these visits are not currently occurring every month and recognising the workload pressures for these two individuals, the Inspector discussed Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: different ways with the Registered Manager of ensuring this Regulation is met. Annual satisfaction surveys are sent out to stakeholders, including a service user involvement survey. A review of the surveys returned from other professionals provided the following feedback the service provides support which is very much in line with the Recovery approach. The Registered Manager has to complete a variety of reports and audits for different stakeholders, including Supporting People & the Primary Care Trust. The home has various systems in place to ensure the health and safety of the home are maintained. The information provided by the Registered Manager in the AQAA confirms that the home has satisfactory recording and monitoring systems in place. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Regulation 13(2): The 01/10/2009 Registered person must ensure that medication is stored in accordance with current regulations and guidance issued by the Royal Pharmaceutical Society of Great Britain. The Registered Person must ensure the safekeeping of all medicines, including making provision for the safe storage of any controlled medication. 2 39 26 Regulation 26(3): The Registered Person must ensure that the monitoring visits on behalf of the organisation are conducted unannounced on a monthly basis. To ensure that the organisation has systems in place to regularly self monitor and improve. 01/09/2009 Care Homes for Adults (18-65 years) Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!