Care Home: 9 Victoria Street

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What the care home does well Comments received in questionnaires from people who live at the home included: " The staff treat me well, especially my key worker." "It has changed a lot, we have two offices now, so that we can go and talk to the manager privately." Comments received from relatives, cares and advocates included: "All the basics aredone to a very high standard." "My son receives excellent care, and we are very grateful for the assistance he has had." "The service is changing since a new manager was engaged, in a good way." "There are some brilliant staff who are flexible, dedicated and enthusiastic about their jobs, and the care/ support they offer." "I feel that my sister is well taken care of, and that her needs are being met." "I feel that since the new manager has started the home has become more positive and there has been a lot of changes for the better." In addition the care that is given, puts the individual at the centre, and a great deal of emphasis is put on personalchoice, and development. What has improved since the last inspection? A new key worker system has been introduced to offer people better support. People who live at the home have use of a laptop with internet access. Many of the established practices have been changed at the home to avoid institutional practice. Three statutory requirements that were made at the last key inspection have been met. These related to: Updating the statement of purpose, personal service plans for individualsincluding risk assessments and assessed needs, and risk assessments for people who self medicate being introduced. What the care home could do better: No statutory requirements or good practice recommendations have been made as a result of this key inspection visit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 9 Victoria Street 9 Victoria Street New Brimington Chesterfield Derbyshire S43 1HY The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rob Cooper Date: 2 5 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 35 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). 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 CSCI 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 35 Information about the care home Name of care home: Address: 9 Victoria Street 9 Victoria Street New Brimington Chesterfield Derbyshire S43 1HY 01246347590 01246347594 Not given www.derbyshire.gov.uk Derbyshire County Council care home 18 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 18 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care home only - Code 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 - Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home 9 Victoria St is a care home registered to provide personal care and accommodation for up to 18 adults, aged between 18 - 65 and up to 2 adults over 65 with learning disabilities. The home is located in the village of Brimington on the outskirts of Chesterfield. A number of shops, pubs and other amenities are nearby. Derbyshire County Council owns the home. The accommodation is on two floors. There is a stair lift provided. 16 of the bedrooms are single accommodation, 4 of Care Homes for Adults (18-65 years) Page 5 of 35 which provide ensuite facilities. One-bedroom is double accommodation. There are three communal dining and lounge areas. There is also a flat where people can make drinks and snacks. There is a spacious garden to the side and rear of the building. Some limited car parking space is provided, although cars can also park on the road. Each persons contribution for staying at 9 Victoria Street is dependent on their age and their length of stay. Further information regarding these fees can be obtained by contacting the service by Care Homes for Adults (18-65 years) Page 6 of 35 telephone or via Derbyshire County Councils website. As a guide the fees are £69.90 per week, although this figure is means tested, and will vary dependent on the different benefits people receive. There are no extra charges as people access services in the community for hairdressing, chiropody, etc. However people are expected to pay for taxis out of their mobility allowance. The amenities fund usually pays for transport for outings, with meals etc. being paid from personal allowances. Care Homes for Adults (18-65 years) Page 7 of 35 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 Care Homes for Adults (18-65 years) Page 8 of 35 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was an unannounced inspection visit, so that no one at 9 Victoria Street knew that the inspection was going to take place. The inspection took approximately six hours through the middle of the day with one Inspector present. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this Care Homes for Adults (18-65 years) Page 9 of 35 included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and reviewing any notifications made relating to incidents that affect the well being of people living at 9 Victoria Street. The method used to carry out the inspection was to send out an Annual Quality Assurance Assessment (known as an AQAA), which allowed the home to carry out a self-assessment; and provide a range of information relating to their service. The AQAA was returned to the Commission within the time frame asked for, and the information Care Homes for Adults (18-65 years) Page 10 of 35 provided helped to form the judgements in this report. This was followed with a visit to 9 Victoria Street where a method called case tracking was used; this involved identifying four people who live at the home, and looking at their individual files and making a judgement about the quality of care and service they are receiving, and if their needs are being met. This was followed by a partial tour of the building to look at the quality of the activities on offer. Two people who live at the home were spoken with about their experiences. Three members of staff were also spoken with to get their views on how peoples needs are being met. We also sent out ten Care Homes for Adults (18-65 years) Page 11 of 35 surveys asking for views and information to people who live at the home, five to relatives and five to staff. Of these we received five surveys from people living at the home, four surveys from relatives and one from a member of staff, which also helped with the judgements that we made. The Registered manager for 9 Victoria Street: Andrew Kay supplied much of the information during the inspection site visit. Since the last key inspection in September 2007 there have been no further inspection visits of any kind. People who might want to live at the home can obtain Care Homes for Adults (18-65 years) Page 12 of 35 information direct from them, and this would include seeing previous inspection reports prepared by the Care Quality Commission. What the care home does well Comments received in questionnaires from people who live at the home included: The staff treat me well, especially my key worker. It has changed a lot, we have two offices now, so that we can go and talk to the manager privately. Comments received from relatives, cares and advocates included: All the basics are Care Homes for Adults (18-65 years) Page 13 of 35 done to a very high standard. My son receives excellent care, and we are very grateful for the assistance he has had. The service is changing since a new manager was engaged, in a good way. There are some brilliant staff who are flexible, dedicated and enthusiastic about their jobs, and the care/ support they offer. I feel that my sister is well taken care of, and that her needs are being met. I feel that since the new manager has started the home has become more positive and there has been a lot of changes for the better. In addition the care that is given, puts the individual at the centre, and a great deal of emphasis is put on personal Care Homes for Adults (18-65 years) Page 14 of 35 choice, and development. What has got better from the last inspection A new key worker system has been introduced to offer people better support. People who live at the home have use of a laptop with internet access. Many of the established practices have been changed at the home to avoid institutional practice. Three statutory requirements that were made at the last key inspection have been met. These related to: Updating the statement of purpose, personal service plans for individuals Care Homes for Adults (18-65 years) Page 15 of 35 including risk assessments and assessed needs, and risk assessments for people who self medicate being introduced. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 16 of 35 If you want to speak to the inspector please contact Rob Cooper Care Quality Commission Citygate Gallowgate Newcastle-upon-Tyne NE1 4PA 03000 616161 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 17 of 35 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 18 of 35 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 at the home, and those who would want to in the future, have access to detailed information, and will have had their needs assessed before they move in. Evidence: The statement of purpose and service user guide were both seen. The statement of purpose was reviewed and updated in July 2009, and it contains all of the information that Care Homes Regulations say that it should. The service user guide is in the process of being updated, and a widget programme has been purchased for the computer, which will allow signs and symbols to be inserted into the text, making it easier for people who have difficulty with written English to understand. Both documents contain a great deal of useful information about the service being offered at the home. A statutory requirement made at the last key inspection relating to the statement of purpose has been met. Four peoples care files were seen as part of the case tracking process. Each file contained a formal FACE assessment completed by a social worker. The assessments covered a wide range of needs such as communication, mobility, and social skills. In addition there was evidence in the files of the persons needs having been reviewed. Each of the files contained Derbyshire County Council documentation about the Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: persons placement, with an individual placement agreement seen in each file. This documentation outlined the costs involved and identified who would be paying the fees. Care Homes for Adults (18-65 years) Page 20 of 35 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the care home know their assessed and changing needs and personal goals are reflected in their individual plan of care. People are also supported to make decisions about their lives with assistance if needed. Evidence: Each of the care files contained a clear plan of care, based on peoples individual assessments. Documentation within the files was clear, and identified peoples needs and how they would be met. Evidence that care plans are being reviewed regularly was seen. The care plan format is currently under review, with new documentation seen, and discussed with the manager. Care plans were found to be very person centred, with much of the documentation in the first person, talking for example about my weekly timetable and things I like to do. There were also several photographs, to illustrate activities. A great deal of evidence was seen to support the view that people living at the home were supported to make decisions. In the care files there is a clear person centred approach, and care plans have been signed by individuals to show their involvement in and agreement with their care plans. The Derbyshire Advocacy Service is very involved at the home, with involvement in monthly meetings, and currently some people are Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: being supported to take part in the Chesterfield Learning Disability Partnership board elections. Comments received in questionnaires from people who live at the home included: The staff treat me well, especially my key worker. It has changed a lot, we have two offices now, so we can go and talk to the manager privately. Comments received from relatives, cares and advocates included: All the basics are done to a very high standard. My son receives excellent care, and we are very grateful for the assistance he has had. The service is changing since a new manager was engaged, in a good way. There are some brilliant staff who are flexible, dedicated and enthusiastic about their jobs, and the care/ support they offer. I feel that my sister is well taken care of, and that her needs are being met. I feel that since the new manager has started the home has become more positive and there have been a lot of changes for the better. All four files contained detailed risk assessments covering both individual needs and risks, and more general risks related to everyday living. The risk assessments were clear and easy to understand, and followed a logical approach to the management of the risks. Each file had an individual fire evacuation risk assessment, written specifically for that person. In addition there were risk assessments for areas such as: Medication, Traveling in a car, Moving and Handling, Personal Care, Leaving the building, Road Safety and Behaviour. Care Homes for Adults (18-65 years) Page 22 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are able to take part in appropriate activities, and are part of the local community, with their rights and responsibilities being respected by the staff. Evidence: Each file had a what I like to do sheet, which identified activities that people are involved in. Discussions with two people who live at the home showed that they are able to exercise a great deal of control over their lives, and were able to choose what activities they took part in. Timetables of activities in peoples files, showed that for most people they were spending time away from the home during the week either at college, or a day centre, and were attending social activities in the evenings. Recently the home has bought a laptop computer with internet access, for people to use, and this has proved very popular. These included going out to local clubs and groups, going to the pub, listening to music and watching television. With a strong emphasis on personal choice. Evidence was seen on the notice boards of trips out, and activities, and arrangements are routinely discussed at the monthly meetings for the people who live at the home. Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: The home is situated in a residential area, but close to local shops. Chesterfield town centre is a bus ride away, and people living at the home are supported to use local community facilities. During the inspection visit several people were seen coming and going, and discussions with two people who live at the home identified that: We often just pop down to the local shop, or catch a bus into town. In their AQAA the home said: Service users are encouraged to use the amenities within the local community and the use of public transport. Service users are offered a range of support activities, social, educational, & in employment. Service users are supported to go on holiday. Discussions with the manager indicated that some people living at the home have personal relationships, and there are a number of friendships between people living at the home. Discussions with two people who live at the home showed that they felt free to form friendships and relationships with other people without any interference of pressure from the staff. Information is held within the files about family contacts, and discussions with two people showed that sometimes family members visit the home, and sometimes people meet up elsewhere, either at their houses, or in town. Both people said that family members were free to visit without restrictions. The manager said that 9 Victoria Street is not seen as a home for life. It is a stepping stone towards more independent living. Therefore there is a training kitchen to help people develop the skills they will need to live independently, and this includes cooking and washing. In the dining room there is a dry wipe board for the menu, and this is filled in by people living at the home. In addition there is a washing up rota, with people taking turns to wash up after meals. Discussions with people who live at the home showed that this was seen as a part of living there, and no one said they had a problem with doing the washing up. Evidence was seen that an outside agency who are going to be supporting an individual in the future, have been coming into the home to work with the person, as part of the moving on process. There is a basic four week repeating menu, although discussions with staff in the kitchen showed that there is a wide choice, with further alternatives available if required. Two people require special diets, and these are catered for, with information about their diets, and their needs recorded in the kitchen. Two people said that they liked the food, and there was always a choice. Records of choices made, and peoples individual likes and dislikes were also seen in the kitchen. Care Homes for Adults (18-65 years) Page 24 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the care home receive personal support in the way that they prefer, and they are protected by the policies and procedures in place for dealing with medication. Evidence: The care plans within the files had been signed by the individuals to show their agreement with them, and the care plans were very person centred which meant that there were many references within the files and the care plans to personal choice with regard to each individuals care. The input from the advocacy service demonstrated that people living at the home have a voice and are encouraged with outside support to express their views about the care they are receiving. Plans for the future within the files, also demonstrated that people were involved in making plans for their own future, and had a say, in decisions that were being taken. Each file had a range of care plans related to the individuals health care needs. These included: Emotional needs, Oral Health and dental care, Vision, Hearing, Mobility, Foot care, Nutrition and lifestyles, and continence. The care plans had all been signed by the individual, and were written from the point of view of the person concerned, for example: I need glasses, I go to the dentist etc. In addition hospital check sheets are being produced, which give basic information should someone need to go into hospital, as well as hospital grab sheets, which contain all of the key information Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: needed in an emergency situation. Care plans are in the process of being developed and rewritten, and examples were seen on the computer, which demonstrated a thorough and comprehensive approach to the individuals health care needs. The home has its medication supplied by Boots (the Chemists). The records relating to ordering, dispensing, and where appropriate destroying or returning medication to the pharmacy was seen, and all found to be complete and correct, with no obvious errors or omissions. The administration records have photographs of the people concerned, to minimise errors, and copies of medication policies are also to hand to guide staff. Medication was seen to be stored securely. No one at the home currently selfmedicates. The medication systems were found to be safe. Staff training records demonstrated that staff administering medication had been appropriately trained in medication, and administration procedures. Care Homes for Adults (18-65 years) Page 26 of 35 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 living at the care home feel their complaints are listened to and acted upon. The policies and procedures in place ensure people are protected from abuse, neglect and self harm. Evidence: Victoria Street have not received any complaints since the last key inspection in September 2007. The complaints procedure is on display in the foyer, and also forms part of the service user guide. The complaints procedure is available in a signs and symbols version for those people who find written English difficult. Discussions with two people who live at the home indicated that they knew who to complain to, and how to complain, although both said they had never needed to. In their AQAA they said: We have an accessible format for complaints procedure and this being on display around the establishment. Service users have access to the independent advocate as contact details are displayed around the establishment. We respond to comments. Complaints and suggestions with an action plan on resolving any issues. Staff attend Safeguarding Adults training. A review of the staff training records in relation to safeguarding adults, showed that the majority of the care staff had undertaken this training in the last twelve months. Three members of staff were asked about safeguarding adults training and they said that they were aware of the issues, and had undertaken this training. The home have not had made any safeguarding adults referrals to Social Services since the last key inspection. Care Homes for Adults (18-65 years) Page 27 of 35 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 safe, homely and comfortable environment, with bedrooms that suit their needs and lifestyle, while promoting their independence. The home is clean and hygienic. Evidence: A partial tour of the building showed it to be comfortable and well maintained. A number of individual bedrooms were seen, and these had been well personalised, and people who were asked said that they had everything that they needed, and their bedrooms met their needs. Currently there are discussions about redecoration taking place, and new colour schemes are being discussed at the monthly meetings. On the day of the inspection the home was found to be clean and tidy, with no unwanted odour. Staff were seen cleaning and hoovering throughout the inspection, and the impression created was of a pleasant homely environment. In their AQAA they said: Items within the establishment are maintained via inspection and regular testing/maintenance. Service users have input into the decoration of the establishment. We have three domestic staff within our team. Service users are encouraged to personalise their rooms. Service users are offered a key to their room. We have communal areas large enough to support the occupancy of the building. Care Homes for Adults (18-65 years) Page 28 of 35 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 living at the care home have their needs met by appropriately trained and well supported and supervised staff. Evidence: The staffing rota was seen, and this showed a good skill mix through the staff team, and a level of different staff with levels of seniority and experience. Discussions with the manager identified that usually there are three care staff to each shift, which is currently adequate to meet peoples needs, however it is hoped that a review of staffing levels will see an increase, due to the intensive nature of working with people moving towards independence. Comments received in questionnaires from relatives and advocates about staffing levels included: Staffing levels are sometimes difficult, this is being addressed by the manager, but the evenings can be a problem for some people at the home. Offer more one to one support to enable him to develop his independent living skills and to attend outside activities. The files of four members of staff were seen, to check that they contained all of the information that would show that staff had been recruited in a safe manner, namely that applicants had filled out an application form, provided two written references and had had a Criminal Records Bureau check. The documentation showed that the recruitment policy and procedure had worked to protect the people living at the home. Discussions with three members of staff about their recruitment showed that they had gone through all of the pre-employment checks, and had not started working until those checks had been completed. Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: Staff training files were seen, and these showed that there was a good training programme in place for all staff, covering training issues relevant to the work being undertaken, including the mandatory training in areas such as fire safety, moving and handling and health and safety. Further discussions with two members of staff around training issues identified that they thought they had been well trained and had access to on going staff training through Derbyshire County Council. Formal staff supervision is organised in three teams among the senior staff, and staff supervision records showed that staff have a regular formal supervision session with a senior member of staff on approximately a four weekly basis. Discussions with three members of staff confirmed that there is regular, approximately monthly staff supervision. The staff members spoken with said they felt well supported within their role, and that additional support was always available. Care Homes for Adults (18-65 years) Page 30 of 35 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 benefit from a well run home, and are confident that their views underpin all self-monitoring, review and development at the home. The health, safety and welfare of people living at the home and the staff are promoted and protected. Evidence: Andrew Kay is the registered manager, he is suitably qualified and experienced to be running the home, and has been through the Commissions own screening process. Andrew has been in post approximately four months. 9 Victoria Streets quality assurance system relies on questionnaires being filled in by, people living at the home, relatives and visitors. Currently the advocate from Derbyshire Advocacy Service is helping those people who require help to fill in their questionnaires. Copies of these questionnaires were seen and the results will be evaluated shortly, when the questionnaires have all been completed. There are regularly monthly meetings for the people who live at the home, and the minutes were seen, copies of the last meeting are pinned to the notice board. The advocate is again very involved in these meetings. Regulation 26 visits (these are monthly audits by a representative of Derbyshire County Councils management team) are taking place, with copies of reports seen; these also form part of the homes quality assurance Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: system. With a new manager in post there are a number of changes taking place, and new systems being introduced, with evidence of development within the home. A range of different health & safety records were seen, including the fire safety records, water temperature checks and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up to date, which shows that people are living and working in a safe environment. every person living at the home has a fire evacuation risk assessment signed by them, and detailing their strengths and needs should there be a fire. Care Homes for Adults (18-65 years) Page 32 of 35 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 35 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 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 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 34 of 35 Helpline: Telephone: 03000 616161 or Textphone : 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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