Care Home: Alpha Community Care

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What the care home does well Potential service users receive a needs assessment, undertaken by staff trained to do so, ensuring that the home can meet the care needs requirements of service users. There have been no new admissions to the home since the previous inspection. Service user plans are in place, which are informative and allows for staff to provide continuity of care. One completed survey that was returned, stated under the section, "what does the home do well" was "give us choices, what to eat, what to wear ". The people who live in the home enjoy a range of activities. The three surveys returned, all contain comments about day care. Under the section "what could the home do better" the comments made are, "to attend a day care centre", "if we can have a day care centre to attend" and "support me to attend day care". There is a motivated and established staff team that consists of nursing and care staff who respond to service users in a respectful and appropriate manner. Daily routines in the home are flexible and people can choose when they take part in activities. The home provides a pleasant and comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. All bedrooms are single occupancy to ensure that the privacy and dignity of people using the service is promoted. The home ensures that people using the service are provided with a choice of wholesome and appealing meals in pleasing surroundings. The home makes sure that relatives and friends are able to visit at anytime within reason. The evidence seen and comments received indicate that this service meets the diverse, racial, cultural, disability of individuals within the limits of its Statement of Purpose. What has improved since the last inspection? Care plans are now up to date so staff can meet the needs of the people living in the home. The home holds residents meetings and make sure that service users are able to make decisions about their lives and staff can show how choices have been made. The home now has a complaints log in place and staff spoken to knew how to deal with complaints. All staff have received an induction to the home and all files contain evidence of these. The homes fire risk assessment has been reviewed and is up to date.Staff working in the home have all completed Basic Food Hygiene training. Improvements have been made to the environment. What the care home could do better: The care plans are disorganised and not user friendly and were not signed and dated by the person completing them. This should be addressed by the home. Daily notes are detailed and informative but some entries are difficult to read and the home should address this. The home`s designated laundry area is in the outside shed, in the garden. There are no hand washing facilities in the shed, the floor finishes are not not impermeable and the wall finishes are not easily cleanable. This does not ensure the control of infection and the provider is required to provide the Commission with details of how they will make the laundry area suitable for its purpose. The Medication Administration Records (MAR) charts show several hand written entries on them. These were not signed or dated by staff. When it is necessary to handwrite on a medication administration record chart in the home, the member of staff writing the chart should sign and date the chart and a second carer should check the entry for accuracy and then initial the chart. In addition the entry should include a reference to where this information was sourced, such as the prescriber`s name. Key inspection report Care homes for adults (18-65 years) Name: Address: Alpha Community Care Green Tiles Home 5 Green Lane Stokenchurch Buckinghamshire HP14 3TU     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: Barbara Mulligan     Date: 1 6 0 6 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 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) 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 29 Information about the care home Name of care home: Address: Alpha Community Care Green Tiles Home 5 Green Lane Stokenchurch Buckinghamshire HP14 3TU 01494482229 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: barbara@alphacomcare.com Alpha Medical Care Limited care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home Green Tiles is a small four bedded home intended to provide long-term accommodation for up to four adults with learning disabilities. The home is run by Alpha Medical Care Limited and is their first venture into provision of residential care. The home is located in a quiet residential area on the outskirts of Stokenchurch, a small village approximately 10 miles from the large town of High Wycombe and 20 miles from the city of Oxford. The home consists of a converted bungalow with four bedrooms; one is an ensuite, large lounge, kitchen, dining room and staff office. At the time of this inspection three people were using this inspection. The home charges in the region of £1500 - £2000 per week for placement, with final figures being dependent on the Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home assessed care needs of individual service users. 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: This unannounced key inspection was conducted over the course of a day and covered all the key National Minimum Standards for Younger Adults. Prior to the visit, a detailed self-assessment questionnaire was sent to the manager for completion. This was returned to the Commission by the day it was due and was fully completed, giving us the information we needed. Information received by the Commission since the last inspection was also taken into account. Surveys were returned by the three people using the service and five were sent to staff, with three of these returned to the Commission. The inspection consisted of discussion with the management of the home, discussion with three other staff, opportunities to meet with the three people who use the service, examination of some of the homes required records such as care plans, risk assessments and staff files, observation of practice and a tour of the premises. A key Care Homes for Adults (18-65 years) Page 6 of 29 theme of the visit was how effectively the service meets needs arising from equality and diversity. As a result of the inspection the home has received one statutory requirements. Feedback on the inspection findings and areas needing improvement was given to the management of the home at the end of the inspection. The management of the home, the staff and service users are thanked for their cooperation and hospitality during this unannounced visit. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? Care plans are now up to date so staff can meet the needs of the people living in the home. The home holds residents meetings and make sure that service users are able to make decisions about their lives and staff can show how choices have been made. The home now has a complaints log in place and staff spoken to knew how to deal with complaints. All staff have received an induction to the home and all files contain evidence of these. The homes fire risk assessment has been reviewed and is up to date. Care Homes for Adults (18-65 years) Page 8 of 29 Staff working in the home have all completed Basic Food Hygiene training. Improvements have been made to the environment. 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. People who use the service have their needs thoroughly assessed prior to admission ensuring that staff are prepared for admission, and given an opportunity to visit the home beforehand to ensure it meets their needs. Evidence: At the time of the visit three people were using this service. There have not been any new admissions to the service in the past twelve months, according to information supplied prior to the inspection. At the last inspection, documents relating to the three people using the service were examined and found to be in good order with a detailed and comprehensive needs assessment which indicated that the service users had been involved in the process. Potential service users are invited to the home for an initial visit and there is a onemonth trial period for parties on all sides to reassure themselves about the appropriateness of placements made. A one-month review is organised to discuss the placement and if this has been successful the home are able to confirm the placement on a long-term basis. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The home does not take emergency admissions and is not registered to provide intermediate care. 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. Detailed care plans are in place, which adequately documents the care needs of people who use the service, and how these are to be met, within a risk assessment framework. People who use the service are enabled to make decisions and be as independent as possible. Evidence: At the previous inspection one care plan was outdated and much of the information in the care plan was no longer relevant to the individual. The two other care plans were in the process of being developed and were not fully accessible to staff. A requirement was issued for care plans to be made available to staff, and these must contain up to date information, to enable staff to fully meet the care needs of service users. The care plans for the three people using this service were examined during this visit. These contained sufficient detail for staff to learn about residents they support. Specific needs have been identified within the care plans and there is an action plan in Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: place to provide staff with the details of how these needs are to be managed and fully met. Individual preferences, likes and dislikes are recorded in care plans and describes how these will be met. The files examined were disorganised and not user friendly and the home should address this. Care plans were not signed and dated by the person completing them and this should be addressed by the home. Visual observations of people using this service showed that people were appropriately dressed and people were seen to be wearing the aids needed,for example clean glasses. The care plans show that that service users, family members or representatives are included in the care planning process. Daily notes are detailed and informative but some entries were difficult to read and this should be addressed. At the previous inspection there was no evidence available in care plans of how information is presented to service users and how they make decisions and choices that affect their lives and the running of the home. A requirement was issued for service users to be enabled to make decisions about their lives and staff should be able to demonstrate how individual choices have been made, and record instances when decisions are made by others and why. During this visit the manager said residents meetings were now held on a monthly basis. Minutes of these meetings are maintained and copies are available to see. These are in the form of a tick list of body language responses. Some of the areas covered in the residents meetings are your health,your food,life skills programme and outdoor activities. It would be beneficial if the care plans contained more information about individuals preferred form of communication. The inspector was told that service users can choose what they prefer to eat on a daily basis. One completed survey that was returned, stated under the section, what does the home do well was give us choices, what to eat, what to wear . There is a list of identified risks and the areas that need to be risk assessed.Risk assessments have been completed for Personal Care, the management of epilepsy, missing persons, behaviours that may challenge and road safety. These show that they are reviewed and updated regularly. 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. Service users have an active lifestyle which reflects their interests, provides them with nourishing meals and have contact with family, friends and the community. Evidence: There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences. Three people who use the service attend activities that are tailored to meet their individual needs. Some of these include trips to the local swimming pool, walks, shopping in the town and visits to a youth club. At the previous inspection one person using this service was waiting for the opportunity to attend a day care centre. During this inspection it was apparent that this has not been dealt with to a satisfactory outcome. The manager said the individuals care manager is still pursuing this. The three surveys returned, all contain Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: comments about day care. Under the section what could the home do better the comments made are, to attend a day care centre, if we can have a day care centre to attend and support me to attend day care. This was discussed with the manager who said this is determined by the individuals care managers but the home are still pursuing this. Daily notes show that on the majority of days people living in the home go for a walk and use the indoor activities. At the previous inspection it was identified that each person using the service requires a one to one staff ratio when attending activities outside of the home. The staffing rota showed only two staff on duty. The manager said that there are now three staff on duty and the staff rota confirms this. There are no restrictions about family and friends visiting and people who use the service are supported to maintain family relationships and have regular visits from and to their family. From observations on the day of the inspection visit, staff members were seen to treat the people living in the home with respect and patience. Records are maintained of service users diets and these demonstrate that individual needs, such as healthy eating are being met. Monthly weights are recorded in a separate book and nutritional screening is evident in files. The home will offer drinks and snacks throughout the day in accordance with needs of each individual. 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. People who use the service have their needs outlined within their individual plans, ensuring that the manner in which they are supported and cared for by staff is appropriate and promotes their preferences. Evidence: Care plans provide detailed information about the type of support and assistance people using the service need. TWe were told that the three people who use the service are supported to choose when they like to go to bed, have a bath, have their meals and take part in other activities.There are preferred routines in the care plans for breakfast preferences, lunch and dinner preferences. There is evidence of health care screening in care plans. Each file contains an appointment record sheet. Staff record all health care appointments attended by service users. For one individual who has epilepsy there is a detailed support plan in place regarding the management of the individuals epilepsy. There are support plans in place for working with autistic spectrum disorder, oral hygiene, personal care and maintaining a healthy weight. All service users are registered with the same GP practice but have different doctors. The home uses an NHS dental service that visits Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the home regularly and other specialist services such as physiotherapy, occupational therapy and psychology are accessed via the Community Learning Disabilities Team. The procedures for the administration of medicines were examined during this inspection. At this visit we looked at the medication administration record (MAR) charts and care plans for the three people using this service. None of the service users are able to administer their own medicines so care staff are responsible for the administration of all medication. Medication administration records (MAR) were in good order with staff signatures alongside prescribed dose times. The MAR charts show several hand written entries on them. These were not signed or dated by staff. When it is necessary to handwrite on a medication administration record chart in the home, the member of staff writing the chart should sign and date the chart and a second carer should check the entry for accuracy and then initial the chart. In addition the entry should include a reference to where this information was sourced, such as the prescribers name. All handwritten entires must be legible. There is good information in the medication charts about the medicines people take. There is information about when as needed (PRN) medicines should be given and why they should be given. Training records for staff expected to administer medicines were examined and it was noted that all staff have completed medication training. 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. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. Evidence: The service has a complaints procedure in place and this includes the timescales for responding to a complaint. The complaints procedure is not available in any other format that may be more suitable for people who use the service. The home should address this. The AQAA tells us that the home has not received any complaints since the previous inspection. At the previous inspection a requirement was issued for all staff to be aware of the complaints procedure and how to record any complaints and the complaints log must be accessible to staff. The home has now implemented a complaints log and staff spoken to on the day of the inspection were aware of the homes complaints procedure. Procedures are in place for safeguarding vulnerable adults (SOVA) and staff have access to a whistle blowing policy. The home has a copy of the local authority SOVA policy. Training records demonstrate that staff have completed Safeguarding training and this is regularly updated. The Annual Quality Assurance Assessment tells us that there has not been any safe guarding referrals in the previous twelve months. The home has continued to keep the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Commission informed of any safeguarding incidents. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clean, comfortable and homely environment has been created for people who use the service, ensuring that they have appropriate surroundings in which to live. The laundry needs to be sited in a suitable area to reduce the risk of the spread of infection. Evidence: The home is suitably equipped in terms of space and facilities to meet the needs of the planned service user group. It is comfortably furnished throughout and maintained to an adequate standard. Improvements have been made to the home to try and make it look as homely as possible. We were informed that this is an on-going process and slow steps are being made with service users accepting changes to the environment. Service users are able to personalise their rooms and can use their own furniture if they wish. There are adequate toilet and bath facilities available thoughout the home. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The homes designated laundry area is in the outside shed, in the garden. There are no hand washing facilities in the shed, the floor finishes are not impermeable and the wall finishes are not easily cleanable. This does not ensure the control of infection and the provider needs to address this. 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 staffing numbers and skill mix is satisfactory and staff training is sufficient and up to date to ensure that people who use the service benefit from staff who are who are competent to do their job. Recruitment procedures are undertaken to ensure staff have the right skills and competencies to support the people who live there. Evidence: The homes staff rota demonstrates that there are adequate numbers and skill mix of staff on on duty at all times. The manager confirmed that there were additional staff on duty at busy times of the day. On the day of the inspection the home was conducting interviews for a deputy manager and had recently recruited one full time and one part time carer. At the time of the inspection there were eight care staff employed at the home. One carer has obtained a National Vocational Qualification and one staff member had registered to commence this training. The recruitment files for a selection of staff were examined including those people new to the service. All files looked at contain the necessary documentation. There is evidence that all staff CRB checks had been obtained and references had been Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: undertaken before the staff member started work. The inspector was told that all new staff undertake an induction, and this incorporates the common induction standards. Evidence of induction is available in staff files and staff spoken to on the day of the inspection said that they had an induction to the home which covered everything they needed to know to do the job and the AQAA stated that staff receive annual updates in all mandatory training. This includes moving and handling training, fire, basic food hygiene and infection control training. 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 new management has been proactive in meeting requirements to improve and monitor the quality of the service provided and to ensure the health, safety and welfare of service users. Evidence: The home has a newly appointed manager who has been in post since April 6th 2009. They are in the process of registering as a manager with the Care Quality Commission. The manager has trained as a teacher and taught children with special needs. They have worked as a Deputy Manager and then the Manager of a residential care home for people with learning disabilities and has worked as a manager of a Domiciliary Care Agency. The manager has obtained a National Vocational Qualification, level 3 and has completed the Registered Managers Award. The organisation & home has a clear and accountable management structure and the manager is supported by the organisation. The inspector noted good teamwork in progress and all the staff spoken to had a good working knowledge of the individual residents and their care needs. The organisations management system includes a quality assurance module which Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: includes a satisfaction survey. These are due to be sent out by August 2009. Service user meetings and staff meetings are held monthly. The manager has contacted the relatives of service users to introduce themself. Senior managers from the organisation undertake regular monitoring visits. Reports of these visits are kept at the home and are open to scrutiny. These follow a detailed format and show that speaking with staff and service users is a regular feature of the visits, plus good practices such as examining a sample of staff training records. A range of health and safety checks are in place at the service, carried out on a daily, weekly or monthly basis. Portable electrical appliances had been checked in August 2008. There are service certificates for fire equipment and emergency lighting. There are records of weekly fire alarm testing and staff training is up to date for all care staff working in the home. Fire drills are carried out with the full involvement of the service users and these are recorded in the homes fire safety records. There is evidence of water temperature recording, work placement risk assessments, accident and incident reports and health and safety risk assessments. 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 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 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). 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