Care Home: Alderson House

Similar services:

• Thornham Grove
• Thistle Hill Hall
• Conifer Lodge
• Westwood Lodge
• Egerton Lodge Care Home
• Alfred Minto House Care Home
• St Matthews Unit
• Trevayler Residential Care Home

What the care home does well The home provides a comfortable and clean environment for the people who live there, where they have opportunities to develop their independence. People told us they felt safe at the home, their privacy and dignity was respected and they were able to make their own decisions and choices. People made positive comments about the care and support they receive, such as, "you can make your own decisions", "the food is excellent" and "the staff are excellent". They told us they can have visitors or make visits to their friends and relatives when they wish and they said that they knew what to do if they had a concern or problem and felt staff would listen to them and try to resolve any matters. There is an ongoing staff training programme so that their knowledge and skills are kept up to date. There have been few changes to the staff team and people who use the service were complimentary about staff. For example, "they put us first". The home is being well managed. People who use the service told us they thought the home was well run and things like the way in which medication and money is handled is "done very professionally". What has improved since the last inspection? We made some requirements at the last key inspection. These are matters that we said they must address to make sure they meet the required standards. They concerned making sure they confirmed to people after assessment whether or not they could meet their needs, making sure there were always sufficient staff on duty to meet peoples needs, making sure staff were recruited safely and that they notified us of significant events that may affect the health and welfare of people who live in the home. We know from information they have sent us and what we saw on the day of the visit that these have been addressed. We also said they had to make sure that they included information in care plans about peoples capacity to make decisions and they have started to make sure this information is included. They have also developed a procedure to be followed for those people that need medication to be given on an occasional basis but know that this needs more work. There have been improvements made to the environment for example the redecoration and refurbishment of some bathrooms and toilets and a bedroom and they told us more work is planned over the next year. They have obtained better facilities for making sure peoples belongings such as medicines and money are kept safe and people told us it was their choice whether or not they asked staff for help with these matters. They are developing more links within the local community so that people can have more opportunities to develop their skills, for example some people attend a cookery course. They are also increasing the ways in which people who live in the home can participatein its running, by nominating representatives to be part of the staff recruitment process and to be included in staff meetings. What the care home could do better: There were some matters we said they must address to make sure they were meeting standards. We said they must make sure that care plans are reviewed and contain full information about peoples needs and how they are to be met. We also recommended that they included details of risk assessments to support the care practises in place. For example those that may be associated with daily living tasks and promoting peoples independence. We said they must make sure this information is included in people`s care and support plans so that staff have clear guidance about how people prefer their care to be delivered. We said that they should make sure that medication procedures are more explicit so that staff can be clear about when to use them and for how long before seeking medical advice. We also recommended as good practise they review care plans to show that peoples capacity to make choices and decisions has been considered and to protect their rights. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Alderson House Saltfleet Road Theddlethorpe Lincs LN12 1PH     The quality rating for this care home is:   two star good 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: Sue Hayward     Date: 1 7 0 6 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. 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. 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. 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 30 Information about the care home Name of care home: Address: Alderson House Saltfleet Road Theddlethorpe Lincs LN12 1PH 01507338584 F/P01507338584 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alderson Limited Name of registered manager (if applicable) Mrs Victoria Baker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:- Mental Disorder, excluding learning disability or dementia (MD) - 18 The maximum number of service users to be accommodated is 18 Date of last inspection Brief description of the care home Alderson Limited owns Alderson House. The manager has since the last inspection visit been formally registered by us to manage the service. The home provides care for people with mental health needs. The building has been adapted from formal commercial premises. It is now a large detached 2-storey building with accommodation for 18 people in 16 single rooms and one double room. It is situated on the edge of the village and is set well back from the road. Ample car parking is available to the front and side of the property. As the care home is situated Care Homes for Adults (18-65 years) Page 4 of 30 care home 18 Over 65 0 18 Brief description of the care home in a rural area, transport is provided for recreational, vocational and educational purposes. People who use the service pay for the use of transport. They attend various work and vocational placements within the area. The coastal resort of Mablethorpe and the town of Louth are within easy travelling distance. The care home has a statement of purpose and service users guide, which sets out the resources of the home and the facilities offered. These documents are shown to all visitors who are considering coming to stay at the home. Information about the dayto-day operation of the home and fees, as well as a copy of the last inspection report, is available from the manager. The manager confirmed that the current range of fees is from £374 - £479 per week. Hairdressing, chiropody and social and leisure transport costs are additional to the fees. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This was an unannounced inspection, which focused on key standards which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). The visit lasted six hours and took into account previous information held by us including the previous key inspection report, the history of the service and records of any important events we have been notified of since our last visit. The manager sent us an Annual Quality Assurance Assessment (AQAA) questionnaire before we visited. This gave us some information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent out surveys to a sample of people living in the home and included one for them to give to Care Homes for Adults (18-65 years) Page 6 of 30 their relatives or friends if they wished. We also sent out surveys to staff. The comments from those we received are included in the report. The main method to carry out the inspection is called case tracking. This includes following the care of a sample of people through their personal records and assessing their care. We spoke to four people who use the service and saw the rooms of those who said we could. We also spoke to two members of staff who were present. The manager was present throughout the visit. We had discussions with her and gave general feedback on the outcomes of the visit before leaving. What the care home does well: What has improved since the last inspection? We made some requirements at the last key inspection. These are matters that we said they must address to make sure they meet the required standards. They concerned making sure they confirmed to people after assessment whether or not they could meet their needs, making sure there were always sufficient staff on duty to meet peoples needs, making sure staff were recruited safely and that they notified us of significant events that may affect the health and welfare of people who live in the home. We know from information they have sent us and what we saw on the day of the visit that these have been addressed. We also said they had to make sure that they included information in care plans about peoples capacity to make decisions and they have started to make sure this information is included. They have also developed a procedure to be followed for those people that need medication to be given on an occasional basis but know that this needs more work. There have been improvements made to the environment for example the redecoration and refurbishment of some bathrooms and toilets and a bedroom and they told us more work is planned over the next year. They have obtained better facilities for making sure peoples belongings such as medicines and money are kept safe and people told us it was their choice whether or not they asked staff for help with these matters. They are developing more links within the local community so that people can have more opportunities to develop their skills, for example some people attend a cookery course. They are also increasing the ways in which people who live in the home can participate Care Homes for Adults (18-65 years) Page 8 of 30 in its running, by nominating representatives to be part of the staff recruitment process and to be included in staff meetings. 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 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessment process makes sure peoples needs can be met and they have the information they need to decide whether the service is suitable for them. Evidence: They have told us that they have policies and procedures about the referral and admission of people to the service. People who returned surveys to us indicated that they were all asked whether they wished to move into the home. All but one were of the opinion that they had sufficient information about the service to help them decide whether it was the right place for them or not. We were told by a person who has recently come to live in the home, they showed me around and gave me pamphlets and asked me if I wanted to know anything, I came for a weekend and it went extremely well. People who live in the home told us that they have a key worker this is a member of staff who has specific duties for a specific person who lives at the home, such as making sure care plans and records are kept up to date. We saw from the care records Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: we checked of two people who had been recently admitted to the home that they had had their needs assessed and information had been obtained about aspects of their lives such as their religion and nationality as well as health and social needs which may be important to them and their care. For example, we saw that an assessment showed that it was an aim for someone to be taken to the gym, to learn how to cook and to be taken bird watching. All three of the records we checked showed that care plans had been drawn up from assessment information they had gathered, which also included obtaining information from other professionals as well. Staff comments showed they had a good awareness of peoples needs and the care necessary to meet them. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples need are met in the way they want them to be and they have choice and control over their daily lives. Care plans have improved, but do not fully identify peoples person centred needs and wishes. Evidence: People told us they were aware that the service holds records about them and had been involved in drawing up their care and support plans. We saw that each person had a care or support plan in place, which had been reviewed and was well organised. Staff had a good knowledge of peoples needs but care plans did not always fully reflect some of them. For example staff told us a persons nicotine intake needed monitoring and that some people needed supervision when using kitchen facilities. These needs were not fully incorporated into the care and support plans. The manager told us that she is aware that the care and support plans need further review to make sure they are more person centred. She showed us the information and forms she had obtained which she intends to adapt for use with people who live in the home. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: We did see on one of the personal files we checked, that it contained information about assessing peoples capacity to make significant decisions and how this was to be managed, but some other files checked did not. We also saw records to show that staff had had training about peoples capacity to make decisions and choices. That said, people who live in the home told us their needs were being met at the home and their privacy and dignity was respected. They also told us that they felt they were able to make their own decisions for example yes I can do what I want, you can make your own decisions and they (staff) dont force you to do anything. We saw from the records kept of the meetings held in the home for the people who live there that they are told about advocacy services and an advocate had been invited and attended a meeting in February 2009. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the flexible mealtime arrangements and enjoy the range of social, recreational and vocational activities. Evidence: People told us they are able to make their own decisions and they are able to be independent. For example they receive support to prepare their own meals and do their own laundry. People told us that they were not forced to do anything they did not want to and that staff do it for you if you are having a bad day. People told us that there were a variety of leisure and social activities which go on in the home and in the community. For example eight people go to a cookery class in Mablethorpe. People also said parties are held in the home and they go out shopping and on trips. The manager said that they had established links with a voluntary Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: organisation where two people attended. We saw from the records kept of meetings, which people who live in the home attend, that people are involved in decisions about what they do. For example, they discussed where they would like to go on holiday and we were told that some people chose to take a holiday in a caravan and some in a hotel. One person told us he had decided not to go on holiday, but stressed that was his choice. People told us they could have visitors anytime and one person said she had just returned from visiting her boyfriend. We were also told that if you wanted to go to Church or Chapel you would be taken. Peoples comments about the food were positive. Since the last visit changes have been made so that people who live in the home can prepare their own meals with the support of staff, for example, people choose what they want to eat and make their own lunch. We saw that staff are available to support them to do this. There is some flexibility with meal times so that people can choose when they have their breakfast and lunch and peoples comments confirmed this. Staff prepare the main meal with assistance from people who use the service. We checked the records kept of the meals provided, but they did not contain sufficient information. For example they did not show the range of lunchtime options. The manager agreed to make sure this was recorded in future so that they can show the full range of meals available. However, peoples comments confirmed the choice of foods available for example the foods excellent, we get plenty of it and theres always a choice. You can have what you want basically, particularly at lunchtime. People also told us that they were consulted about the menu and that any specific diets such as vegetarians were catered for. Staff comments showed they were aware of peoples specific dietary needs and knew the manager was trying to arrange a training session about diabetes. Staff records showed that training in basic food hygiene was included as part of the training programme. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are happy with the support they receive for their personal and health care needs and their independence in these areas is promoted. Evidence: People told us that they were able to to see health professionals such as doctors, chiropodists and social workers when they needed to. They said that staff supported them to do so and gave them the support and help they needed, for example people told us the staff are great, they put us first and the staff are excellent. We saw the arrangements which are in place to store and administer medication. They have a system in place were the majority of medication is pre-dispensed by a pharmacist. We also saw since the last inspection a refrigerator has been purchased specifically to store medication that needs to be stored at a lower temperature. We observed part of the lunchtime medications being given to people. A safe process was followed. Medication records were well maintained and contained photographs of people who use the service so that any new staff could easily identify them. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Comments from people who use the service showed they are able to take responsibility for administering their own medication after being assessed as safe to do so. For example we were told I dont look after my tablets myself yet but we have agreed I will start when my key worker returns from holiday. Another person told us that she had started to administer her own tablets but had not yet reached the stage where she looked after them herself yet. She said that she did go to the medical room and dispense the tablets herself with staff supervision and signed her medication record herself. Staff told us they had had training prior to dispensing medication and we saw the report from the last visit to the service of the local pharmacist who checks the medication systems in place and comments on them. We noted from the pharmacists last report of 19/03/09 that no issues had been raised in respect of the checks made and comments included training recently with Boots went well. We saw that they have medication policies and procedures in place and have since the last visit also developed a procedure for staff to follow in relation to medication which is for administration on an as needed basis. However, it did not include sufficient detail to inform staff about its use. For example, it did not include sufficient information about the circumstances when it should be used or for how long. With regard to the latter, unprompted the manager said that staff had been told the doctor needed to be contacted if medication was being used regularly over a period of a week to discuss whether it needed to be prescribed on a daily basis. She also agreed to make sure the protocol contained fuller details for staff to follow. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory processes are in place, which help to make sure people feel safe, know how and feel comfortable to raise concerns. Evidence: People told us that they knew who to speak to if they were unhappy and how to make a complaint and they felt staff and the manager listened and acted on what they said. They showed us that they had been given a copy of the complaints procedure to keep. The service has a record for noting any complaints or praise received. This showed that no complaints had been made in the past 12 months. We have not received any complaints about the service either. They have shown us that they take seriously any matters that have arisen which may indicate people who use the service may be vulnerable and at risk of abuse and have appropriately referred two matters to the Local Authoritys Safeguarding Adults team. Safeguarding vulnerable adults training is part of the staff training programme and they told us this is refreshed annually. Additionally there are policies and procedures in place about handling complaints, concerns and allegations for staff to refer to if needed. Staff discussion showed us that they knew the forms of abuse that can occur and of their responsibilities to report any concerns they may have in order to protect Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: people who use the service. The storage arrangements for safekeeping money and valuables has improved since the last inspection. Records are kept of any money held in safe keeping and those we saw were well maintained, balanced appropriately and contained two signatures whenever transactions had occurred. We saw that people who use the service had access to any money they had in safe keeping when they wanted it. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience 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 comfortable and homely environment which is suitable for their needs. Evidence: We saw the rooms of two people who said we could. One person did not wish us to. Both rooms were comfortably furnished and people who use the service had been able to make them more homely with their own personal effects. People told us they are able to arrange their rooms as they wish. Bedroom doors are lockable and people said they had their own keys to them. People told us that they felt safe in the home. We also saw the lounges and dining areas, some bathrooms and toilets as well as the kitchen and kitchenette. There have been some improvements to the facilities since our last visit. For example, we saw a ground floor toilet had been refurbished and redecorated. A bedroom has been redecorated and both the manager and staff said that further bedrooms are scheduled for this. All areas of the home we saw were clean and tidy although there was signs of wear and tear, for example in one bedroom we noticed a stain on the ceiling and upstairs toilets did not have toilet roll holders. There is a record in place to report any maintenance issues and both staff and people who use the service said they were Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: generally dealt with promptly. The home is visited from time to time by an Environmental Health Officer. We saw the report of 31/01/2009 when an inspection of the kitchen was undertaken and a food safety check carried out. The report indicated that the service was compliant. There have been no recent fire safety officer visits, but we saw that fire equipment had been serviced within the past year. People told us they are able to do their own laundry with staff support. Staff were aware of the procedures in place to make sure good hygiene practises are followed and said they had equipment such as gloves to use. Their comments and training records showed that health and safety is part of the staff training programme. They have told us they have a range of procedures for staff to follow about health and safety matters such as infection control. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by a well trained staff team and a satisfactory staff recruitment procedure. Evidence: The comments we received from people who live in the home were positive about the care they received and the staff team. For example, they said they were well treated by staff, they are excellent, they put us first, if we wanted them they would come straight away and I havent found a bad one, they are pleasant and efficient and if you have had a bad night theyll make you a cup of tea and have a chat. Staff told us that they felt staffing levels were sufficient to meet the needs of the current people who live in the home. Some people who use the service have specific time where a staff member supports them on an individual basis. We saw that the staffing arrangements of the home enable them to have this time, for example one person was supported by a staff member to attend the gym during our visit. Staff rotas we checked showed that there are always a minimum of two staff on duty and sometimes three. The manager works additionally to the staff rota and there is an administrator employed. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Comments from staff and training records we saw showed that there is an ongoing training programme to make sure that peoples knowledge and skills are kept up to date. For example, we saw that the majority of staff had achieved a nationally recognised vocational qualification in care and there had also been refresher training arranged this year about manual handling, health and safety, the Mental Health Act and peoples capacity to make decisions and choices. Staff told us they felt well supported in their work. We saw that records were in place to show when staff had received supervision and appraisal from the manager and when staff meetings had been held. We were told and records showed that a representative of people who live in the home are invited to attend staff meetings and be part of the staff recruitment process. We checked the records kept of the staff recruitment process. We saw that they contained application forms references, proof of identity, a medical questionnaire and a record of the interview. They also included information to show when checks such as criminal records bureau (CRB) and protection of vulnerable adults (POVA) checks had been carried out. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is being well managed and people can feel confident that their views will be listened to and their health and welfare promoted. Evidence: There has been no changes to the management arrangements of the home since the last inspection, other than the manager has successfully completed our processes to become the registered. We saw from the training records kept and from discussion with the manager herself that she keeps her training updated by attending sessions along with other staff members. She has a relevant management qualification and a NVQ at level 4 and is also working towards becoming a NVQ assessor. People living in the home knew who was in charge. Comments such as shes the best gaffer weve had and I know she will run the home correctly indicated peoples satisfaction with the management arrangements. We asked people in our surveys what the home does well and could do better. The comments we received were that the home did everything well, they look after you Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: well and protect you from people who do not understand mental illness and with the exception of the tables and chairs in the dining room felt there was nothing the home could do better. People also told us that they felt staff and the manager listened to them. People told us that they felt involved in how the home was run through attending the meetings that are held for people who live there. We saw from the records kept that people who live in the home have been made aware of advocacy services and that they are given questionnaires periodically as another means of obtaining their views about the quality of the service. This had included for example, obtaining their views about the cleanliness of the service, privacy and respect, spiritual needs, activities and complaints. We also saw a questionnaire had been completed by another professional who had visited the home in June 2009 and their comments indicated they too were satisfied. They have told us that a company representative visits the home and any matters highlighted are dealt with on a monthly basis, we saw there were reports in place to show when these visits had taken place. They also told us that they have a range of policies and procedures in place about health and safety matters and that they carry out checks on various equipment and systems in the environment to make sure they are safe. During the visit we saw for example, a certificate to show that fire equipment had been serviced within the past year, the boiler this year and although a certificate was not seen, a record was in place which showed that the electrical wiring system had last been checked in January 2008. There are also systems in place to quality audit aspects of the service such as medication and health and safety. We have been appropriately informed of any events that affect the health and welfare of people using the service and they have responded promptly when we have requested information, such as providing us with an action plan as to how they planned to address matters that were raised at the last key inspection. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Care plans must be reviewed 03/09/2009 to make sure they fully identify peoples individual needs and how they are to be met. This is so that staff have clear and consistent guidance about peoples care needs and how they prefer care to be delivered. 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 6 It is recommended care plans be reviewed to make sure they include reference to the Mental Capacity Act 2005 and show that peoples capacity to make decisions and choices has been considered. More detailed risk assessments should be written to support the care plans and care practises in place. It is recommended that the protocol in place concerning medicines to be given on an as needed basis are reviewed so that they contain fuller information about how they are to be monitored and reviewed. This is so that medication is Page 28 of 30 2 3 9 19 Care Homes for Adults (18-65 years) given in a safe and consistent manner. Care Homes for Adults (18-65 years) Page 29 of 30 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. 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. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!