Care Home: 94 Tennyson Road

What the care home does well An assessment is completed before people go to live at the home; this is to make sure staff there are able to care for them. The service is particularly focused on the individual living in the home, thus ensuring that they are fully involved in matters affecting their life. The resident is well supported in making decisions and choices. The staff members worked together well to provide appropriate support to the residents. The standard of care provided to people who live in the home was good. Staff members continually sought opportunities for the personal development of each resident. Residents spoken with praised the manager and staff and confirmed that their views were listened to and acted on. `I think that the staff care about you` and `My social life has improved a lot here`, are example of comments from residents. Activities to suit the taste and preference of residents are facilitated and this maintains a good level of stimulation. Residents are encouraged and are fully involved in the planning of menu, shopping and cooking with appropriate support from staff. The relationships between the staff and the residents were positive. Staff appeared committed and they demonstrated a good awareness of the identified needs of each resident, including equality and diversity issues. The resident`s privacy is respected and their dignity, upheld by staff at all times. The registered manager demonstrated a good knowledge of the required statutory procedures. She has established good systems so that care and support could be delivered in a sensitive, efficient and safe manner. Staff members reported that good management support was available. NVQ training for staff is being given a high profile. What has improved since the last inspection? There were four requirements made following the previous inspection in May 2009. These are being implemented to good effect. Arrangements have been made to ensure structured menu planning and nutritional information is in place so as to promote the health and wellbeing of people who use the service. The home has been decorated and furnished to create a homely environment for people living at the home. Appropriate actions have been taken to prevent water pooling in the bathroom floor, thus ensuring the health and safety of residents and staff. Effective quality assurance systems have been introduced to seek the views of the residents, their representatives and other stakeholders, in order to improve the quality of service delivery at the home. A comprehensive fire risk assessments of the building has been completed by the manager. This ensures that avoidable risks are identified and eliminated, and the safety of residents and staff is protected. There has been continued improvement in the quality of service for residents. The manager and staff help the residents to be as involved in the day-to-day running of the home. The residents were very relaxed and treat 94 Tennyson Road as their home. The regular meetings for residents help them to have a say in the running of the home. Each person meets regularly with their key worker (link worker) and this ensures that they are getting the right support they need. What the care home could do better: There are two requirements and one recommendation arising from this inspection report, which need addressing. Requirements: Old and damaged carpets in identified areas must be replaced. This will promote a more domestic atmosphere for the people in residence. Staff recruitment files maintained at the home must include a current photograph and a copy of their birth certificate, in all cases. This would ensure the protection of residents and staff. Recommendation: Given the mental health history of the resident, it would be good practise to also obtain the name and signature of the resident`s representative on the placement agreement. Key inspection report Care homes for adults (18-65 years) Name: Address: 94 Tennyson Road 94 Tennyson Road Luton LU1 3RR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Neil Fernando     Date: 1 5 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 94 Tennyson Road 94 Tennyson Road Luton LU1 3RR 01582725735 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ann.dalton@advanceuk.org Advance Support Ltd Name of registered manager (if applicable) Ms Ann Dalton Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Conditions of Registration 1. The registered person may provide the following category/ies 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: Mental Disorder, excluding learning disability or dementia - Code MD 2. The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home 94 Tennyson Road is a semi- detached house situated in a quiet residential road in south Luton. The home is owned by Advance Housing and Support Limited. It offers residential care for four people with mental health needs. The ground floor contains a lounge, dining room, toilet, laundry room and a kitchen. The first floor offers four single bedrooms and a bathroom/ toilet. The staff office is situated on the second floor. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home The people use the garden at the rear of the house during the warmer months. There is a parking area at the front of the house. The home is within walking distance of the town centre and two local parks and the bus stop. A copy of the service users guide and statement of purpose is displayed on a notice board in the dining room for any one to read. The fee charged is £630.57 per resident, per week. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service has improved from 1 star to 2 stars. This means the people who use this service experience good quality outcomes. We, the Care Quality Commission, undertook this unannounced key inspection on 15 April 2010. We spoke with three residents, the manager and two staff members. We had a look round the home and viewed a range of records the home must keep. At the time of the visit, there were three residents accommodated with one vacancy. We have received a completed AQAA (Annual Quality Assurance Assessment) a document, which gives the manager the opportunity to tell us how the home is meeting the standards and regulations. We have also received surveys from three residents and three staff. This was a positive inspection. Overall, residents expressed a good deal of satisfaction Care Homes for Adults (18-65 years) Page 6 of 29 with the quality of the service offered to them. Their comments including those of staff have been included throughout the report. The manager was present for the duration of the inspection. The last key inspection was undertaken on 15 May 2009. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? There were four requirements made following the previous inspection in May 2009. These are being implemented to good effect. Arrangements have been made to ensure structured menu planning and nutritional information is in place so as to promote the health and wellbeing of people who use the service. The home has been decorated and furnished to create a homely environment for people living at the home. Appropriate actions have been taken to prevent water pooling in the bathroom floor, thus ensuring the health and safety of residents and staff. Effective quality assurance systems have been introduced to seek the views of the residents, their representatives and other stakeholders, in order to improve the quality of service delivery at the home. A comprehensive fire risk assessments of the building has been completed by the manager. This ensures that avoidable risks are identified and eliminated, and the safety of residents and staff is protected. Care Homes for Adults (18-65 years) Page 8 of 29 There has been continued improvement in the quality of service for residents. The manager and staff help the residents to be as involved in the day-to-day running of the home. The residents were very relaxed and treat 94 Tennyson Road as their home. The regular meetings for residents help them to have a say in the running of the home. Each person meets regularly with their key worker (link worker) and this ensures that they are getting the right support they need. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed information about the prospective resident is obtained, prior to a placement being offered. This is so that their identified needs and aspiration can meet. Evidence: The AQAA tells us Through our Application and Selection process all potential Service Users needs and aspirations are fully assessed by a multi-disciplinary team to ensure that an appropriate and effective service can be provided. A copy of the statement of purpose and the service users guide is available to current and prospective residents, and their representative. A copy is also displayed in the dining room. All three residents who were spoken to said they had visited the home before moving in. I definitely enjoy living at this home, said one resident. All three residents have lived at this home for a number of years; indeed, the last person admitted to the home was on 29 October 2007. Care files examined for two people show that when the home receives a new referral, a detailed assessment of needs is completed Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: involving the manager, the prospective resident, family and the placing authority. Staff members and the manager told us that the prospective resident and their representative have the opportunity to visit the home for a cup of tea, a meal or over night stays until a decision could be made about whether they could live at the home. This is because of the challenging behaviour experienced by people who live at 94 Tennyson Road could sometimes mean that even if individual needs could be met, this would not be in the best interest of people already living at this home. A copy of the the placement agreement is kept in the residents file and this is noted to have been dated and signed by the individual resident and the home manager. Given the mental health history of the resident, it would be good practise to also obtain the name and signature of the representative of the resident in the placement agreement. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have good opportunity to make everyday choices and they are encouraged to achieve independent lifestyles. Their preferences and requests are respected. Evidence: The AQAA states The organisation has a comprehensive policy and procedure and training program re developing Person Centred Individual Plans and Risk management assessments with each Service User. These describe the services and facilities to be provided and also addresses the needs and aspirations of the individual. The care plans for two residents were viewed. Each care plan contains a good level of information about the residents personal routines and likes and dislikes, so that staff are able to support them in the way they like. The current residents have very good verbal communication skills and abilities, and they are therefore able to express themselves quite well. The content and details in the care plan is based on contribution from the resident, their relative, staff and information from the social worker and other professionals. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Evidence of internal and external reviews to ensure that needs are being addressed and unmet needs monitored, is available. We spoke with two staff members and they demonstrated a good knowledge of the identified care requirements of each of the residents. They provided examples of established ways of ensuring that residents are offered choices, as appropriate. They decide what to do, what clothes to wear and what to eat, they are in control of their lives, said a staff member. There is a good network of support available from various health care agencies as reflected in care files maintained at the home. Two staff interviewed said and all three residents confirmed that they are able to express their wishes, feelings and preference. Staff take our views very seriously, you know, said a resident. A copy of risk assessments has been completed for each person, which is dated and signed by the key worker and the resident. These are updated as and when required. All three residents expressed a high level of satisfaction with the manner staff support them with their care. I think that the staff care about you and My social life has improved a lot here, are example of comments from residents. We have received completed surveys from three residents and they are all very positive about the care they receive. There are no concerns raised by any residents in the surveys. We saw that residents related well to staff. They were noted to be happy, comfortable and relaxed in the company of staff and their physical environment. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of social and recreational activities being facilitated assist in the development and promote the welfare and independence of the people in residence. Evidence: The AQAA tells us The Person Centred Individual Planning framework includes assessment of peoples needs in terms of lifestyle and personal development. Service users are enabled by staff to access community activities, both cultural and spiritual and learning and work opportunities where desired. Service users are supported to explore appropriate personal relationships, with family and friends of their choice. Each resident has a care plan that reflects their identified needs, including social and recreational, race, gender identity, disability and culture and religion. Clear information is available with respect to the mental health needs and any disabilities of each resident and how staff adapt their practise to meet the persons specific needs Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: and promote their abilities. For example, residents attend mental health centres and regularly meet representatives of their faith. Staff interviewed and records viewed for example monthly summary reports from the key workers demonstrate that staff work very closely with each resident, in order to ensure consistency and continuity of care delivery. The activities programme for residents was scrutinised and information from residents and staff spoken with evidence that a range of activities to suit the individual person is facilitated. Activities, which occur with some regularity include swimming, football, local events, visits to the local pubs, eating out, visiting family and friends and shopping. Individuals follow their own routines when they are at home including cooking, watching television, music,reading and being involved in household tasks. Residents are encouraged to maintain meaningful relationship with their peers and friends; staff were clear that residents wishes and feelings would be respected and they would be treated with dignity and respect at all times. Residents maintain good contact with their family and friends. Menus are planned with the residents and staff assistance is available to guide them make decisions. Consideration is given to individual nutritional needs so that residents have access to healthy options. Residents are pro-actively encouraged to eat together and make meal time an enjoyable social occasion. Residents are fully involved in shopping and cooking with staff assistance. All residents spoken with expressed a high level of satisfaction regarding the services offered to them at this home. I cook with staff and I love the food here and We grow our own tomatoes sometimes and I love gardening, said one very confident person. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Evidence indicates that the identified health and personal care needs of the resident are being addressed in a manner that assures their well being. Evidence: Responding to How we have improved in the last 12 months, the AQAA states We have updated our documentation that enables evidence of support and activities. We have changed our supplier to improve our medication systems and the standard of training received, now using Boots recognised by CQC. We do not keep unwanted medication in the home. The care plans for two residents were viewed and they provide good details of each persons personal and health care needs. Their preferences about how they wish to be supported are also included in the plan. We observed a good relationship between the staff and the people who live in the home. Detailed recording of each persons health care includes health notes for hospital visits and contact with GPs, Psychiatrist, Community Psychiatric Nurse, optician and other health professionals. Good procedures for the receipt, storage, handling and recording of medicines brought into the home are in place. These procedures were reviewed in November 2009. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Evidence demonstrates that all staff receive medication training both in house and annually from the community pharmacist. Regular checks are made, in order to ensure that medicines have been administered and recorded safely. Medication administration record charts (MAR) for all residents were examined and these were noted to be in order. One resident is able to self-medicate and a risk assessment has been carried out before he started to self-medicate. Two residents confirmed that they receive their medicines on time and as prescribed. I receive my medicines every morning and evening, said one resident. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding procedures are available; thus ensuring that residents are listened to if dissatisfied with any aspects of the service and they are protected from harm. Evidence: The AQAA states Service users are provided with information on what constitutes Abuse and Harassment via their Support Files and are provided with accessible information on how to raise concerns or make a Complaint. This is reinforced regularly at House Meetings. The homes policy and procedures on complaints were reviewed in April 2009 and are available to staff and residents. This ensures that any concerns are dealt with and actioned appropriately. The home has received one minor complaint from a resident since the last key inspection in May 2009. This complaint was dealt with speedily and to the satisfaction of the complainant. The Commission has not received any complaints regarding any aspects of this service. All three residents spoken with told us that they would not hesitate to speak with a member of staff or the manager if they had any concerns. You bet I will speak to the staff if I am unhappy, said a resident. The home has a copy of the procedures on Safeguarding Adults. Staff spoken to Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: confirmed that they are familiar with the procedures. Discussion with the manager and training records viewed showed that all staff have received training on the safeguarding of vulnerable adults, provided by the Luton Borough Council. An element of adult protection is also covered in the induction programme for all new staff members and those people undertaking the NVQ assessment. Staff are aware of the Whistle Blowing Policy.There were no safeguarding matters pending at the time of the inspection. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The domestic style furnishings and fittings helps to create a homely environment for the residents to live in. A good standard of cleanliness was evident. Evidence: The AQAA indicates All works identified by CQC is or is in process of completion. We undertook a brief tour of the premises to include all four bedrooms, the lounge, the dining room, kitchen and sanitary facilities. The standard of decoration in in all areas is of a good standard. The quality of furniture and fittings is satisfactory. However, the carpets in two bedrooms are old and stained, and the carpet by the office door is frayed. These require a replacement. There is adequate space for residents to sit quietly and or meet with their friends. There is some evidence to show that the resident is consulted on furniture and decoration for their room to suit their taste and preference. Personal possessions can be brought into the home to help the resident make their room as personal as they would wish. However, staff ensure that they comply with the health and safety and fire regulations. Each resident has a key their bedroom and main entrance door. Residents said that staff do not enter their room in their absence, unless it is an emergency. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The bathroom and toilet facilities are adequate to meet the needs of the current residents. All areas viewed were noted to be clean and tidy. Domestic waste is disposed of in an appropriate manner. Fire risk assessment for the building has been completed. Residents spoken with expressed a good deal of satisfaction with their physical environment. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff recruitment policies and procedures, training and supervision of staff should protect residents from harm. Evidence: The AQAA tells us Careful consideration is taken to ensure that services have sufficient numbers of staff with the right skills to enable the service to meet the needs and aspirations of the individual service users. Rotas are devised to reflect the lifestyle needs of the service users. This service is registered to accommodate up to four residents with mental health needs. There is currently three people in residence. The home has a small staff team that currently includes the manager and five staff. In the main, they have considerable professional experience in the mental health field, which means the staff have the skills to deliver good quality service for residents. The registered manager works full time and she has the management responsibility for this home and another, at 83 Tennyson Road. There is one staff available during the day between 8 am and 9 pm and there is no staff in the premises overnight. However, a member of staff from 83 Tennyson Road is available if any resident needs assistance. When the manager is off duty, a member of the management team Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: provides an on call facility for advise and support in an emergency. Each staff member has completed induction training that covers mandatory health and safety training. This is followed by training that takes place over a period of time, which is specific to the needs of residents at this home. Specific courses completed include Safeguarding vulnerable Adults, Nutrition, Medication, Race Awareness, Stroke Awareness, Violence and Aggression, Professional Boundaries and the Mental capacity Act. All five staff hold an NVQ level 2 or equivalent in care, which means that the home has achieved a 100 ratio of staff with an NVQ level 2 or equivalent qualification. The home has good procedures for the recruitment and selection of staff members. We viewed the recruitment records for three staff including the most recently recruited member. These showed that all required checks had been undertaken, bar one case where a current photograph and birth certificate was not available. The manager has agreed to take remedial action. Staff receive regular supervision; they have good opportunity to raise any practise issues. Staff who spoke with us said they were satisfied with the amount and quality of supervision they get. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team is well supported by the manager; this ensures that the residents receive good quality care. Evidence: The AQAA tells us The registered manager completed her RMA/NVQ4 in health and social care and the Foundation degree and is currently finishing the last part of the degree in Care Management. Regular staff meetings, supervisions and training updates for all staff. The manager has been registered with the Commission as manager for about seven years. She has an NVQ level 4 in Management and Care and she is currently undertaking a degree in Care Management. The manager has completed her mandatory training and she is capable of managing this home well. The staff members are working well as a team and morale is good. The manager works closely with the residents and staff team. Staff reported that they receive good management support. I think its good, staff are able to speak with her, said a staff and I feel comfortable discussing any issues with her, commented another member. All three residents also Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: spoke positively about the manager -Very very kind, said a resident. Observations of various care practices in the home evidence that care and staff management systems, including health and safety are being implemented to good effect. Thus ensuring that the identified needs of the residents are addressed. Monthly visits by a designated person to ensure appropriate standards are being maintained have been carried out; reports on the visits undertaken are available at the home. Good quality assurance systems have been introduced since the last key inspection on 15 May 2009. Surveys have been undertaken in July 2009 to seek the views and experience of the residents, their representatives and professionals regarding the quality of service offered at this home. A report on the outcomes together with remedial actions taken, was shared with the residents and other stakeholders participating in the surveys. The manager is aware that a copy of the survey report must be sent to the Commission. A daily record of relevant occurrences is maintained as part of the care plan; this was noted to be in good detail. Other records viewed were in good order. Regular meetings between the resident and staff ensure that views are shared and fire and accident procedures discussed. The records of routine servicing, maintenance, fire equipment checks and fire drills were up to date. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 23 Old and damaged carpets in identified areas must be replaced. This will promote a more domestic atmospthere for the people in residence. 15/06/2010 2 34 19 Staff recruitment files maintained at the home must include a current photograph and a copy of their birth certificate, in all cases. This would ensure the protection of residents and staff. 03/05/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 5 Given the mental health history of the resident, it would be good practise to also obtain the name and signature of the residents representative on the placement agreement. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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