Care Home: 92 Black Prince Avenue

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What the care home does well Each person is encouraged and supported to be as independent as possible and encouraged to take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. The people live in clean and comfortable accommodation. The people attend a Sense resource centre and have varied timetables, which further help them develop skills. There are good arrangements to keep them healthy and menus are flexible to cater for individual choices. The home is clean and well decorated. Staff are aware of how to deal with complaints and suspected abuse and the way that staff are recruited ensures that people are safe. People living in the home are cared for and supported by a caring, educated and committed team of staff. Staff are skilled at meeting the special needs of people who have hearing and sight difficulties. They have an excellent knowledge of each person who uses the service as an individual and are able to communicate well using signing and other methods. The people who use the service are encouraged to be as independent as possible and staff are aware of the need to make sure that they are safe when learning new skills. They are lead by an experienced management team who have extensive management and care knowledge about the needs of people who experience sensory impairments. Sense provides a comprehensive programme of education and training for staff which ensures that staff know how to care and support the people who live at the home. The staff feel valued by the management and feel part of a team to improve, help and support the people living in the home. What has improved since the last inspection? They have over the last year reviewed the environment of the home to make it safer for the people living in the home. As a result the newly purchased flat screen television has been sensitively boxed in and pressure light switches have been provided. These adaptations have relieved tension for both of the people living in the home. In addition, new locks have been installed on bedroom doors to make it safer for the people. They are in the process of replacing the 3 piece sofa. They have also improved the communication between the home and local doctors and specialists in order to share information and address the needs of the people. What the care home could do better: Where improvements are identified, they are already being addressed by Sense, the management team or staff in the home. Sense carry out regular quality assurance monitoring audits. We noticed that our new name, address and telephone number was not in their statement of purpose and service user`s guide. The person managing the home agreed to amend this information in the future. Key inspection report Care homes for adults (18-65 years) Name: Address: 92 Black Prince Avenue 92 Black Prince Avenue Market Deeping Lincolnshire PE6 8LU     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: Tobias Payne     Date: 2 3 1 1 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 27 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 27 Information about the care home Name of care home: Address: 92 Black Prince Avenue 92 Black Prince Avenue Market Deeping Lincolnshire PE6 8LU 01778344215 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.sense.org.uk Sense, The National Deafblind and Rubella Association care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: Date of last inspection Brief description of the care home 92 Black Prince Avenue is a four bedroomed end of terrace house with an enclosed rear garden, situated on an estate. Two people live at the home. The home is one of a number in the area managed by Sense, who provide specialist homes for life for people with either single or dual sensory impairment who may also have additional learning or physical disabilities. It is located a quarter of a mile away from a local supermarket, and Market Deeping town centre is approximately one mile away. The town centre contains a range of shops, pubs, banks and food outlets. The home is close to the Peterborough to Bourne bus route with regular services and they also have their own transport. Sense has a model of service which states Sense seeks to acknowledge and respect the individuality of every deafblind person. Each persons combination of disabilities is different. Areas of strength and level of ability vary between individuals. In oder to meet such a variety on individual needs. Sense seeks to develop a unique and Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 2 Brief description of the care home individualised service that can respond to the unique needs of each individual. The weekly fees at the time of our inspection visit ranged from £2,373,42p to £2,469,57p. Information about the home can be made available on request in photographs, icon ,audio tape, PDF, MP3 file and larger print. The font can also be altered to suit the individual person. In addtion, a copy of the statement of purpose, service users guide and last inspection report can also be obtained from the manager. Care Homes for Adults (18-65 years) Page 5 of 27 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 previous key inspection took place on the 23/11/2006. This key inspection used a review of all the information available to the Commission about 92 Black Prince Avenue and included an unannounced visit to the service. It took place over 3 hours. In order to be sensitive to the communication needs of the 2 people living in the home, we used our observations between the staff and the people who live there, information provided by the manager, staff members and records as evidence as to whether standards were being met. This observation also ensured we could use our evidence to judge whether the outcomes experienced by people were what they wanted. Sense had been made us aware that the registered manager of the home had left and the home was being managed by a very experienced manager who was managing the Care Homes for Adults (18-65 years) Page 6 of 27 home from another Sense home 5 minutes away from this home. During this inspection visit we spoke with 2 members of staff and the manager. The main method of inspection used during our visit was called case tracking. This involved selecting one of the two people and tracking the care they received through the checking of records, discussions with the care staff and observation of how staff responded to their needs and that of the other person who lived there. We also looked closely at the annual quality assurance assessment (AQAA) that was sent to us by the manager managing the home before this key inspection visit. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. It was very clear, detailed and person focused. Before making our visit we asked the people who live there to send us comments about the support they receive. We sent one to each of the 2 people living in the home and to 4 staff. However at the time of this report we have received no replies from the people living in the home. We did receive very positive comments from 2 members of staff. Their views are reflected throughout this report. There is as a result of our inspection visit nothing to show that the staff are unable to meet the needs of the people loving in the home. Where the use of we or us is used in this report it refers to the Care Quality Commission. Care Homes for Adults (18-65 years) Page 7 of 27 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 Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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 27 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. Good and clear information is provided in a variety of formats to people to enable them make an informed choice of where to live. They are assessed before they come to the home which ensures that individual needs can be met within the home. Evidence: The manager told us there is an established group of people currently living in the home and that no person had been admitted over the last 6 years. He told us that where a person was admitted Sense had very clear procedures to ensure that a detailed assessment would be carried out to ensure that they could meet all the assessed needs of that person. The manager confirmed that, where appropriate all those involved in the persons life would be consulted to ensure a smooth transition took place. There was a statement of purpose and service users guide. The information was very clear but not up to date as it did not include our new address and telephone number. It did include Senses mission statement, values, aims and objectives together with specific aims and objectives for the 92 Black Prince Avenue. The manager agreed to Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: make this information more up to date. Each person had a contract and terms and conditions of residency. This contained terms and conditions. This was clearly outlined in the statement of purpose and service users guide. The fee included all costs, rent, utility charges, personal care, laundry, food, and comprehensive programme of choices, activities inclusive of a 7 day holiday or equivalent. Care Homes for Adults (18-65 years) Page 12 of 27 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. The health and social care needs of the people are being met in a safe and dignified manner. Evidence: Each person had sensory impairment and communication difficulties and had a person centred plan which gave details about their care and support. We looked in detail at 2 peoples care records. These care plans contained hearing and visual assessments. We found care plans were very detailed and included an information sheet with photograph, terms of residence, description of the premises, their background and family, birthday, mobility, health and professional involvement, personal care, eating and drinking, communication, social and emotional, making choice and specific needs including religious and cultural needs. The manager told us that over the past year care plans have been further improved and now included a capacity assessment for each person and we saw that each person had specific care plans relating to their rights and choices. Each person also had information about how staff could help with their individual needs. There were also very detailed risk assessments covering all Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: aspects of their life. As well as the care plan, files contain health records, concise pen pictures, a person centred plan, identifying future plans and detailed 6 monthly reviews. The manager told us that the people who use the service are unable to participate fully in devising care plans and person centred plans and this we saw clearly documented. The reviews include the persons day service mentor, residential designated support worker and house manager and other people involved in the persons support including the person and their family. The manager told us and we saw staff using a variety of techniques to assist the people in making choices and decisions. A comprehensive My Health Record was kept for each person, which had details about their health needs and any specialist equipment required. These plans were available for each person to access if needed. Sense had detailed policies and procedures about accessing personal records, confidentiality and data protection. Training records also showed staff were trained to respect confidences. We saw that records were kept securely. This makes sure peoples personal information about their needs is private and only used by the staff team to meet their needs. Sense carried out a finance audit in April 2009 and found a good standard of control over benefits receivable, bank accounts, security of cash and recording of transactions. The manager also told us they used the advice and support of a behavioural therapist who visited the home every 6 months. The manager and staff had received training in order to manage challenging behaviours. There were also detailed policies and procedures. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The wide and varied range of social and cultural opportunities ensures that peoples needs are met. Evidence: Both people attend the Bourne Resource Centre during the day which is operated by Sense Monday to Friday between 9.30 am and 4 pm. They are taken there in a car accompanied by staff. A wide range of activities are available at the centre, which include cookery, pottery, horticulture, creative art, office skills, personal and social development, music, numeracy and literacy, local history and citizenship. Each person had their own activity and social programme. Outside activities were very varied and included crafts, painting, tobogganing, sailing, horse riding, games, puzzles, country walks, cinema. The manager told us they also went on holiday to The Lake District this summer which the manager told us they had enjoyed a great deal. The staff also told us that they encourage and promote regular contact with their relatives and staff Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: facilitate contact and visits. Staff encourage the people to make choices about what they wish to do and interpret their responses as communication is not clearly understood. Staff commented, we provide good holidays for them, we manage challenging behaviour well, they eat well and have good choices and We give them a varied social life including good holidays to Disneyland for which staff were willing to fundraise for. Catering arrangements are of a domestic nature. Menus are prepared on a four week rotation are varied and reflect the choices of the people living in the home. The manager told us that the people help with shopping and the preparation of meals. Detailed guidelines for eating and drinking are contained in the care plans, covering posture, equipment, supervision, texture of food and food to be avoided. At breakfast there is a choice including a hot meal. At lunch, when attending the resource centre there is a packed lunch and an evening meal provided a hot meal including a choice. All staff members help and support meal preparation and all had food hygiene training provided. Menus encourage healthy eating and are varied. Care Homes for Adults (18-65 years) Page 16 of 27 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. The health care needs of the people are met in a dignified and supported manner. Medication is given safely by staff who know what they are doing. Evidence: Each persons care records showed information about how any health or emotional needs were being met either by staff, specialist staff from Sense or by their own local doctor. The manager told us that close working relationships had been established with the local doctors and they were working with a psychiatrist, opticians and other specialists where required. Sense also had access to a behavioural therapist, physiotherapist and speech and language specialist. Staffing levels allow for individualised support to be provided for the people. Information about likes, dislikes and preferred routines is contained in care plans. Staff throughout our visit showed they had excellent knowledge of each persons preferences and they communicated effectively with each person to ensure that their wishes are catered for. The staff commented, the staff specialise in managing challenging behaviours and are very good at reading precursors and averting potential problems. They provide a homely comfortable environment for the service users and give them individual attention. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: The manager told us that each person had 6 monthly audiology and dental checks. Where required, staff accompanied the people to these services. Each person had an annual health check. The manager told us that each person had a their own support worker in order to provide consistent support with communication and to give a specific member of staff responsibilities for each person. All of the people living at the service needed support in order to take their medicines safely. Sense had a very detailed and clearly written medication policy. The manager told us that care leaders gave out medication. There was a policy and procedure for this and each person was assessed by the manager before they were considered safe to administer medication. Records we saw were clear and well maintained with a good audit trail. The home also received regular pharmacy inspections. Care Homes for Adults (18-65 years) Page 18 of 27 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. The people who live in the home are supported and know how to make a complaint and feel that staff will listen to their concerns and views. Evidence: Sense have a Resolving Issues policy, which gives written and pictorial guidance about how any person can raise any issues. This can be provided in Braille, tape or other languages other than English. No complaints or safeguarding adults issues have been received by the commission and the home over the last year. During our inspection no person had any complaints about the service. We noted that the procedure was not up to date and did not refer to our new name or have our new address and phone number. The manager agreed to amend this information. There was an up to date copy of Lincolnshire County Councils adult protection procedures. Staff during their induction receive training about safeguarding adults as well as a yearly refresher training programme in the form of a questionnaire about safeguarding people at their appraisal. We spoke with 2 members of staff who confirmed this and told us correctly what they would do if they suspected abuse. Staff also receive a one day non violent crisis intervention training to manage and understand challenging behaviour. Care Homes for Adults (18-65 years) Page 19 of 27 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 safe, comfortable and well maintained accommodation. Evidence: The home is an end of terrace house, situated on a residential estate and within easy access of local amenities. It is well decorated and maintained, and suitable for the needs of the 2 people living in the home. The manager told us that the bedrooms are comfortable and personalised to suit each persons taste. Social tutors are responsible for organising cleaning and domestic tasks, involving service users at every opportunity. There is a weekly environmental checklist which ensures that cleaning and health and safety checks are carried out, and service users have timetabled domestic activities. The manager told that on account of the challenging behaviour from one of the people they had introduced measures to reduce the tension felt by the people living in the home. This had been done after careful consideration and had included boxing in the flat screen television and installation of pressure light switches. Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well trained, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: There are two staff on duty throughout the day,with two staff sleeping in at night. This allows for the people using the service to receive individualised support at all times. The manager told us that 2 new staff had been recruited over the last year from other Sense homes and were therefore very experienced and skilled to give care and support to the people. The manager told us he monitored the dependency of the people in the home and monitored their changing needs. Sense had robust recruitment procedures to ensure that all new staff were recruited correctly and safely with a check by the Criminal Records Bureau. They have an 11 day induction programme to prepare them for their role. This is in line with common induction nationally recognise standards. After this they then completed a Skills for Care certificate and post induction training in the first six months. The manager acknowledged that as a result of there not being a manager for the home not all staff had been receiving regular supervision sessions but was keen to address this and all staff had annual appraisal. All staff had or were being trained to communicate using total communication skills and to understand each persons differences and needs by Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: signing. The manager told us training over the past year had included moving and handling, fire prevention, safeguarding adults, medication, first aid, crisis prevention intervention to manage behaviours safely. In addition, staff are encouraged to study for a nationally recognised qualification in care (National Vocational Qualification). Six members of staff had obtained or were working towards an NVQ level 2 qualification. There were therefore 90 of the staff with or studying for an NVQ. In addtion 1 member of staff was studying for an NVQ level 3. Sense had achieved the Investors in People award as a result of its commitment to staff education and development. All staff were responsible for care, catering, domestic and laundry duties. They were therefore responsible for all services in the home. The staff told us that they felt they could meet the needs of people and had sufficient time to do this. This was observed during our visit by staff taking particular time to communicate with the people in a calm, kind, friendly and sensitive manner. Staff members spoke of the support they received and of working as a team. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people and staff benefit from the positive leadership of the management team. Evidence: Sense had told us that 92 Black Prince Avenue had been without a manager for this home since April 2008 and despite trying to recruit a suitable person they had not found a suitable candidate. However, following this inspection visit we were told that they had appointed a new person who was to apply to us to be registered in the future. In the meantime Sense had arranged for a management team of two deputy managers, one team leader and a registered manager from another home to temporarily oversee the home whilst alternative arrangements were made. The manager was from another Sense home 5 minutes away from this home. He was very experienced and had both a care and management qualification. Staff were very complimentary and satisfied with the management support put into the home. They told us if we need assistance or advice it is there and we always get a quick reponse and it is a great place to work. There was nothing to show that the home was not being managed safely. He showed, as did the staff excellent knowledge about the individual people and their complex needs. Staff we spoke told us there was a good Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: atmosphere in the home. There were regular staff meetings and they said that their contributions were listened to and valued. They told us that they felt valued and supported. Staff were seen to support people in a confident, knowledgeable and sensitive manner. Our observations confirmed they clearly knew the needs of each person and demonstrated excellent communication skills. Throughout our visit there was a relaxed atmosphere. Sense have an established quality assurance system. A 6 monthly review last took place in March 2009 and looked at all aspects in the home including care and support. There was also a detailed independent finance audit in April 2009 carried out by Sense. The report showed There was a good standard of control over benefits receivable, bank accounts, security of cash and recording of transactions. Records showed that Sense made monthly unannounced monitoring visits. We looked at the reports written about the visits made and found them detailed and well maintained. There had been no concerns. Records throughout our visit were available, up to date and on the whole well maintained. There were detailed up to date policies and procedures which enabled staff to deliver care and support the people in the home. Sense have comprehensive health and safety policies which also include detailed and up to date risk assessments. Sense carry out an annual health and safety audit. These include risk assessments covering all aspects of daily living activities. A detailed fire risk assessment was carried out in June 2008. There are regular tests of the fire system as well as regular fire drills. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 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). 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