Care Home: Anchorage House

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well People receive the support they need in ways that are right for them. One person says, `yes, it`s good here. I`m okay here. I do what I want, which isn`t much I suppose. I have my own things to do. The staff are good and I get on with them. I`m okay here, no complaints`. People can do occupational and social things that interest them. One person says, `I`ve got lots of things to do, I like being at home and going out`. People are supported to manage their personal spending money so that they have enough cash to buy things they want. People say that they are provided with good quality meals. One person says, `I like the meals and I help a bit with doing them. We have good things to eat and I help out with the shopping`. People are helped to stay in good physical health. This includes being supported to obtain medical assistance as and when it is needed. There are reliable arrangements for handling and dispensing medication. There are enough staff on duty to respond to people`s current needs for support. Half of the support workers have acquired a relevant National Vocational Qualification (NVQ). Accidents and other untoward events are recorded fully. Steps are taken to help prevent them recurring. What has improved since the last inspection? The Assessment says that a number of improvements have been made since our last Annual Service Review. These include the following things: People have been supported to undertake a wider range of occupational and social activities. Each person can have one to one time with a support worker to enable them to do particular occupational and social activities. Each person has a user friendly Health Action Plan. Support workers have undertaken relevant specialist training and more of them have acquired a National Vocational Qualification (NVQ). All of these things enable the Service to better meet the needs of the people who live there. What the care home could do better: People do not have access to essential written information about the Service and about their rights and responsibilities. The individual plans of support are not presented in a user friendly way. This might make it more difficult for people to be fully involved in making decisions about things that affect them. Two of the support plans are not sufficiently detailed. This may contribute to support workers not being wholly clear about how best to provide parts of the personal care these people need. There is no written account of the arrangements used to fund the operation of the people carrier vehicle. Therefore, we cannot be sure that any payments made by people who live in the Service are appropriate. There is no written complaints procedure that explains what steps stakeholders can take. There are significant shortfalls in the fire safety regime required by the Kent Fire and Rescue Service. These may reduce the level of fire safety protection provided in the Service. There is no written evidence that some of the necessary security checks have been completed for one support worker. There are some shortfalls in the training that the Registered Provider considers that support workers need to receive. These may reduce their opportunities to develop further their skills and knowledge. The Registered Provider is not in day to day charge of the Service. Management systems are not always identifying and rectifying problems with the running of the Service. There is no clear system to implement suggested improvements to the Service. There is no written evidence to show that the Service`s electrical wiring installation remains in a safeworthy condition. There are nine Requirements at the end of this Report. Key inspection report Care homes for adults (18-65 years) Name: Address: Anchorage House 12 Margaret Street Folkestone Kent CT20 1LJ     The quality rating for this care home is:   one star adequate 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: Mark Hemmings     Date: 0 9 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 31 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 31 Information about the care home Name of care home: Address: Anchorage House 12 Margaret Street Folkestone Kent CT20 1LJ 01303211180 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Tina Dennison Name of registered manager (if applicable) Manager post vacant Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies 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 categories: Learning disability (LD) Date of last inspection Brief description of the care home Up to six people who have a learning disability can make their home in Anchorage House (the Service). The premises are a detached three storey house. On the ground floor there is a lounge, dining room, kitchen, toilet, office and laundry/conservatory area that leads out through patio doors into the garden. On the first floor there are four bedrooms, a toilet and a shower room. On the second floor there are two more bedrooms, a shower Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 6 Brief description of the care home and a toilet. All of the bedrooms are single occupancy. They are laid out as bed sitting areas. There is a bed, bedside table, wardrobe and comfortable chair. People can use the Services telephone free of charge. There is an enclosed garden at the back. This has some flower beds and a lawn area. The Service has the use of two people carrier vehicles. The Registered Provider is a private individual. The Service is in a residential street. There is a corner store nearby. There is a bus stop within easy walking distance. There is off road parking. It is very close to Folkestones town centre. There is a mainline train station in the town. We do not know what is the current weekly fee for living in the Service. If you want to find this out please contact the Registered Provider. Care Homes for Adults (18-65 years) Page 5 of 31 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: one star adequate 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 is 1 Star. This means that the people who use this Service experience adequate quality outcomes. We arrived unannounced at the Service at eight oclock in the morning and we there for about five hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in her self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since our last Annual Service Review. We completed this on 5 June 2009. The Review was an office based activity when we examined all of the information we had at that point about how things were going in the Service. During the present Key Inspection, we spoke with four of the five people who currently live in the Service. We spoke briefly with the Area Manager and in much more detail Care Homes for Adults (18-65 years) Page 6 of 31 with the Senior Support Worker and with two support workers. We looked around parts of the accommodation. Also, we looked at a selection of key records and documents. These included things like the individual written plans of support, medication records, the activities plan, the menu, the staff roster, staff training records, financial records, policies and procedures and various health and safety certificates. The Registered Provider has asked relatives to complete questionnaires about the Service. Later in our Report we will tell you some of the main things they say in their replies. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? The Assessment says that a number of improvements have been made since our last Annual Service Review. These include the following things: People have been supported to undertake a wider range of occupational and social activities. Each person can have one to one time with a support worker to enable them to do particular occupational and social activities. Each person has a user friendly Health Action Plan. Support workers have undertaken relevant specialist training and more of them have acquired a National Vocational Qualification (NVQ). All of these things enable the Service to better meet the needs of the people who live there. Care Homes for Adults (18-65 years) Page 8 of 31 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 31 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 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who might want to move in can visit beforehand to see what the Service is like. People will be asked about what support they need and how they want this to be done. The written information that people should have about what is on offer in the Service is not available. Evidence: No one has moved in since our last Annual Service Review. The Senior Support Worker says that the Registered Provider will meet with someone who might want to move in. This is so that she can find out what support they need and want. She will also talk with health and social professionals such as doctors and care managers (social workers). All of this will be done to help her to build up a really good picture of how the person can best be supported. The person will be invited to visit the Service, usually on several occasions. This is so that they everyone can be confident that moving into Anchorage House is the right thing to do. One person says, I remember a bit about coming (here) ... I looked and met people and was helped to find things. How old are you? I met people and saw my Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: room and stuff. We understand that the Registered Provider keeps a written record of all this information. We could not find any of this. Without these records it is more difficult for her to demonstrate to us that enough information is being collected. There should be other written information that is designed to give people a good description of the facilities and support provided in the Service. There should be a Service Users Guide. This is a brochure. There should also be a Statement of Purpose. This is more detailed than the Guide. Another thing that there should be is a written statement of the rights and responsibilities people can expect to have when they move in. None of these documents were available for us to inspect. There is a Requirement in relation to this matter at the end of this Report. All of the people who live in the Service at the moment are quite settled in their home. The Senior Support Worker says that if someone wants to move on they will be supported to do this. This may include liaising with family members and with care managers to make sure that the person has the help they need when they leave. Care Homes for Adults (18-65 years) Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the support they need in ways that are right for them. People are supported to manage their personal finances. There is a sensible approach to risk taking. Evidence: Each person has an individual plan of support. These plans help support workers provide the right assistance for people. The plans are kept up to date by the support workers making daily notes. The Assessment says that parts of the plans are presented in a user friendly way and that they have been made more person centred. There is no evidence for this claim. The plans we saw are written in a standard management style. This might make it more difficult for people to be actively involved in decisions that affect them. One support worker says, none of the service users use them and none would really understand whats in them. One person says, theres words written about me but I dont know whats what with it. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: The plan for Person A is not sufficiently detailed. This may contribute to one of the support workers not being completely clear about the best way to provide special assistance to the person in question. There is a Requirement in relation to this matter at the end of this Report. One support worker says, we know all of the people really well. Its a settled way of life. Each person is different and over time each person has developed a routine of things they like to do and things that they can do. Im certain that the residents do come first and in general they get on with each other. One person says, yes, its good here. Im okay here. I do what I want, which isnt much I suppose. I have my own things to do. The staff are good and I get on with them. Im okay here, no complaints. In their questionnaire replies most relatives say that good support is provided in the Service. In practice, sensible steps are taken to support people to lead everyday lives of their own choosing. This includes support workers helping people to take reasonable risks and to avoid situations that might be harmful. For example, people need to be supported so that they are kept safe when they are out and about in the local area. Everyone is supported to manage their own bank account. We understand that people are asked to make a contribution to the cost of running one of the people carrier vehicles. There is no written information in the Service about how these payments are organized and who has agreed to them. There is a Requirement in relation to this matter at the end of this Report. Care Homes for Adults (18-65 years) Page 14 of 31 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 can do occupational and social things that interest them. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There are occupational things that people can do if they want to. These include things like gardening and various life skills such as shopping and personal budgeting. There are also social things to do such as going out to places of interest and meeting up with friends at local functions. People now receive periods of one to one support to enable them to undertake activities of their choice. One person says, I like the gardening centre and do lots of things. I go into town shopping with staff and stuff. Someone else says, Ive got lots of things to do, I like being at home and going out. The Assessment says that the range of activities that people can choose to do has been extended. It also says, we encourage our clients to lead a full and active social Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: life. Each client has an individualised care and activity plan which has been developed with their full input. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service at any reasonable time. People are encouraged to make their bedrooms their own private space. One person says, I like my room how it is and I spend a lot of time in there. Its my own place. Someone else says, okay, okay when asked about his bedroom. The records show that people are provided with a normal menu of meals in which there is sufficient choice and variety. One person says, I like the meals and I help a bit with doing them. We have good things to eat and I help out with the shopping. Another person says, I have lots to eat and the meals are good. I only have what I want. Care Homes for Adults (18-65 years) Page 16 of 31 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 helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: The support workers are relaxed and informal in how they are. They help people to organise themselves without being intrusive. People are helped to wear neat and clean clothes so that they can look how they want. One person says, I watch tele in the evenings in the lounge or in my room. I go to bed when I want to and sometimes stay up later. One support worker says, I have never seen anything wrong here for the service users. They all get treated good. They are out and about and they are okay. They can say no if they dont want something. Another support worker says, the chaps all are okay and really do have good lives. They do what they want to and theres no fuss. Ordinary lives like the rest of us. People are helped to keep healthy. The records show that support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. People are supported to attend medical appointments and they are supported to follow any treatment regimes that might then be necessary. Each person now has a Health Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Action Plan. These describe in a user friendly way how people are going to be supported to promote their good health. Person B is being supported to manage a special healthcare need. There is not sufficient written information about how this support needs to be provided. Some support workers are not clear about parts of their role in relation to this matter. There is a Requirement about this matter at the end of this Report. At the moment support workers manage nearly all of the medication. Several people might be able to take a more active role in doing this for themselves. There is a system to check that the correct medicines are received from the chemist. There is also a system to return unused medicines. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is filled out on each occasion that a medicine is given. These systems are working in a reliable way. Care Homes for Adults (18-65 years) Page 18 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel confident about making a complaint. The written complaints procedure is not readily accessible. There is no organized system for managing complaints. People are kept safe. Some members of staff are not aware of additional safeguards that have recently been introduced. Evidence: The Assessment says that, we have implemented a more client friendly pictorial complaints procedure. The procedure was not available for us to inspect. No one could give us an account of what it says and how easy it is to use. There is a Requirement about this matter at the end of this Report. The Assessment says, we evaluate any complaints and try to resolve them as soon as possible. In practice there is little evidence to show that there is an organized system for recording, managing and resolving complaints. One support worker says, we dont really need a system because no one complains here. People can just talk to us and well sort anything that needs to be sorted. One person says, Im happy, no complaints really. I can talk and say if theres anything wrong. Who should I talk to then, not sure. Another person smiled when asked about if he had any concerns and shook his head. A support worker says, Ive never heard any one complain about anything major. You have the odd falling out between people but none have complained about the place and the care they get. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Since our last Annual Service Review neither we nor the Registered Provider have received any complaints about the day to day running of the Service. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. One support worker says, all of the people are treated really well here. Sure some people need to be reminded about how to behave so that other people are not affected but this is done in as respectful a way as possible. There is a policy and procedure that describes what should be done to protect someone if there is a concern about their wellbeing. Not all support workers know what steps they can and should take. The people who live in the Service are helped to manage their personal spending money. This involves support workers retaining funds on their behalf and then disbursing them when requested. The records show that this is being done in a reliable and transparent manner. The Assessment says that the Registered Provider is committed to promoting diversity in the Service. By this it means respecting each person who lives there as an individual who is inherently valuable in their own right. New obligations have been placed on all registered providers for managing situations in which it may be necessary to deprive someone of some of their liberties. The Registered Providers responsibility is to make sure that any limitations will only be done in the best interest of the person. There is no written or other evidence to show that the Registered Provider has introduced the necessary development. Care Homes for Adults (18-65 years) Page 20 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the accommodation is presented to a normal domestic standard. There are shortfalls in the fire safety arrangements. There is a suitable kitchen and adequate laundry facilities. Evidence: The exterior of the building is adequately presented. The garden is neat and orderly. On the inside, the accommodation is decorated and furnished to a comfortable domestic standard. In their questionnaire replies most relatives say that the accommodation is presented to a good standard. There is a modern automatic fire detection system. There is no evidence to show that the system is being reliably assessed and checked in accordance with the requirements of the Kent Fire and Rescue Service. There is a Requirement about this matter at the end of this Report. The local Department of Environmental Health has not recently inspected the kitchen. The kitchen is clean and well organised. The records show that the refrigerator and the freezers keep foods cold enough. There is also a system to make sure that foods are used promptly once they are opened. Support workers know about the importance of good food hygiene and they follow the correct procedures. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: There is an automatic washing machine and a tumble dryer. Care Homes for Adults (18-65 years) Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough support workers on duty. Support workers have most of the skills they need to support people in ways that are right for them. There are gaps in the training provided for support workers. Security checks on new members of staff are not being reliably completed. Evidence: The records show that there are usually two support workers on duty in the Service. There is a staff presence at night. Support workers think that there are enough members of staff on duty. One support worker says, there are enough staff around to enable people to get the help they need including be out and about and doing their own thing. When we were in the Service, we kept a look out for things that might give us a clue about how well the place is being staffed in practice. We noticed that people were supported to go out when they wanted to. We also noted that people were supported to do things such as make drinks and organize doing their laundry. The Registered Provider is required to complete and record a number of security checks on new support workers. These include things such as confirming their identity, taking up references and doing a police check. This is done to make sure that they are Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: trustworthy people to work in the Service. There are some gaps in the records relating to the checks completed for Support Worker A. There is a Requirement about this matter at the end of this Report. The Assessment states that it operates, a staff development programme that meets the National Minimum Standards for the Service. The records show that new support workers receive introductory training before they work without direct supervision. One support worker says, I did get some training but I cant remember that much about the subjects. I met the guys and did some in house training. I gradually got to know how the place works and I was given a gradual introduction. The Assessment says that there is, regular staff training to meet the needs of the current client group. The subjects include first aid, food hygiene and how to respond to people who are expressing themselves in difficult ways. The records show that some but not all of this training is being delivered in a reliable way. There is no clear plan to correct omissions. There is a Requirement about this matter at the end of this Report. The Assessment says that half of the support workers have completed a relevant National Vocational Qualification (NVQ). This Award is designed to further develop their ability to provide people with the support they need. Care Homes for Adults (18-65 years) Page 24 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Provider is not in day to day charge of the Service. There are shortfalls in parts of the quality assurance system. There are shortfalls in the health and safety arrangements. Evidence: The Registered Provider is also the Manager of the Service. This means that she is responsible for directly supervising its day to day operation. We understand that she only calls to the Service about twice a week. She was not present in the Service when we were there. There is a deputy manager who runs the Service in the absence of the Registered Provider. He was not on duty when we called. Support workers say that there is good team work between them. There are handover meetings at the beginning and end of each shift. One support worker says, Its a very supportive place. You can talk to (the Registered Provider) and (the deputy manager) and they will listen and help if they can. Its a friendly place to work like a big family really. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: The Assessment says that there is, good leadership and ethos within the home. Service users are happy with the way home is run. Friends and family are happy with the management of the home. People who live in the Service are regularly asked what they think about their home as part of everyday life. There are also house meetings every few months when people get together to talk about their home. The records of the last meeting show that people suggested various improvements. There is evidence to show that some but not all of these ideas have been implemented. There are also the questionnaires completed by relatives from which we have already quoted. The Assessment says that, we have a specialist company who oversees our health and safety policies and assists with our employment law. This has proved very beneficial to the general and efficient running of the home. There is no recorded programme of fire drills. Some support workers do not have a comprehensive knowledge of the Services fire safety procedure. There is no certificate to show that the electrical wiring installation has been checked to ensure its continued serviceability. There are Requirements about these matters at the end of this Report. Other health and safety certificates are correct. There is a detailed record kept of all accidents and other untoward events. These records show that suitable steps are being taken to help prevent and to manage accidents. There is no evidence of a regular health and safety audit of the building being completed. The Senior Support Worker says that there are no particular hazards that need to be addressed at the moment. Care Homes for Adults (18-65 years) Page 26 of 31 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 31 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 1 17 The Registered Provider must ensure that there is a suitably detailed Statement of Purpose and Service Users Guide. To ensure that there is sufficient written information about the facilities and services provided. 26/04/2010 2 6 15 The Registered Provider must ensure that all support workers are competent to implement the agreed plans of support for Person A and Person B. To ensure that Person A and Person B are supported in a consistent and effective manner. 26/04/2010 3 7 17 The Registered Provider must ensure that there are appropriate arrangements for funding the use of the people carrier vehicle. 03/05/2010 Care Homes for Adults (18-65 years) Page 28 of 31 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 To ensure that people are consulted about and agreed to any financial contributions they make. 4 22 17 The Registered Provider 03/05/2010 must ensure that there is a suitable system for receiving and resolving complaints. To ensure that stakeholders can be confident that any concerns they have will be addressed. 5 24 23 The Registered Provider 26/04/2010 must consult with the Kent Fire and Rescue Service about the steps that need to be taken to ensure that a suitable fire safety regime is operated in the Service. To ensure that people who live in the Service and members of staff enjoy an adequate level of fire safety protection. 6 34 19 The Registered Provider 03/05/2010 must ensure that sufficient references and a current police check have been obtained for Support Worker A. To ensure that Support Worker A is an appropriate person to have unsupervised Care Homes for Adults (18-65 years) Page 29 of 31 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 contact with people who live in the Service. 7 35 18 The Registered Provider 01/06/2010 must ensure that there is an organised system for making sure that all support workers have the skills and knowledge they need. To ensure that people reliably receive support in ways that are right for them. 8 37 8 The Registered Provider must be in day to day charge of the Service. To ensure that the Service is appropriately managed. 9 42 5 The Registered Provider must ensure that the electrical wiring installation is inspected in line with the requirements of the local Department of Environmental Health. To ensure that the installation is in a safeworthy condition. 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 19/04/2010 03/05/2010 Care Homes for Adults (18-65 years) Page 30 of 31 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 31 of 31 - 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!