Care Home: Applewood

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What the care home does well The assessment process for residents before admission is extensive ensuring Applewood is an appropriate placement, and one that would benefit the individual admitted. Applewood already provides a very individualised service to the people that live there with the emphasis firmly on skills development, and increasing independence for individuals, who may move on to more independent living. Feedback from all sources was positive `I could not be happier with the home and care` `the home is professionally run and I feel confident about the care`. The home is managed in an open and inclusive way promoting a relaxed atmosphere where residents are encouraged to feel part of the home and wider community. The staff are well trained with the skills to provide a high quality service. Effective communication and consultation systems enable residents to be directly involved in developing and reviewing their individual care plans, as well as many decision-making processes within the home. The environment is bright and provides a home that looks and feels like any family home. It has been well adapted and equipped to meet the needs of the current residents. The manager and staff are clearly committed to maintaining high standards of care and support, and are continuing to develop the service in response to the residents who are central to any function of the home, and to meet it`s Stated Purpose. What has improved since the last inspection? Applewood is a new service and has only been operational since August 2009. It was clear from the AQAA and discussion with the manager that the environment is still being developed in a flexible way to respond individually to the resident`s needs. The AQAA also recorded that the staff have worked to build trusting relationships with residents to be able to work with them to identify their development needs whilst recognising their individuality. This with the development of a supportive staff team, able to recognise its own strengths and needs and working together to ensure that the residents are happy, challenged and fulfilled, are recognised as key areas to a good service, and take time to establish. What the care home could do better: The AQAA identifies that the manager has recognised the need now `to consolidate and develop our own and the resident`s skills whilst maintaining performance by continuing to communicate effectively in all areas of our work, and use lessons learned in training and in life and work experience to improve our working practice`. This consolidation needs to address an understanding and adherence to the organisations polices and procedures, along with robust environmental risk assessments. Key inspection report Care homes for adults (18-65 years) Name: Address: Applewood 37 Headland Avenue Seaford E Sussex BN25 4PZ     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: Melanie Freeman     Date: 1 2 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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: Applewood 37 Headland Avenue Seaford E Sussex BN25 4PZ 01323873270 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): enquiries@seeability.org Seeability Name of registered manager (if applicable) Mrs Fiona Grafton Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 5 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: Sensory Impairment - SI Date of last inspection Brief description of the care home Applewood is registered to provide residential care and support for up to five adults who are blind or partially sighted and may have additional disabilities, supporting them to explore their potential, develop their level of independence and enhance the quality of their lives. Applewood is a converted premises that was formely a family home and is located in a residential area. The property provides ground and first floor accommodation and the main building comprises of four single bedrooms, (two of which have en suite Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home shower/WC facilities), one bathroom, one sleep-in room, laundry room, separate WC, communal lounge and adjoining dining area, kitchen, office and conservatory. To the rear there is access to a patio and gardens. The property includes a self-contained annexe with its own dedicated entrance, hallway, bedroom, bathroom, kitchen, lounge and conservatory. It is intended that the occupant of the annexe can have full access to all services, facilities and support offered in the main part of the house, but with the additional opportunity to experience greater independence and autonomy. The accommodation is designed to enable easy access for people who have a visual impairment; good use has been made of colour and texture contrasts in decor and furnishings, tactile information and lighting. Seaford town centre with its shops and access to bus and rail routes is approximately half a mile away. Information about the service, including the homes statement of purpose, service users guide is available to prospective residents or their relatives, on request, as part of the admission process. The annual base fee, as of January 2010, is £69,230 this price includes 15 hours at the nearby Activity and Resource service, run by the same Organisation. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Applewood will be referred to as residents. This was a key inspection that included an unannounced visit to the home, and follow up contact with residents relatives. At the time of this visit there were 4 residents living in the home and feedback from those spoken with was very positive. The inspection involved a tour of the premises, observation of working practices, examination of the homes records and discussion with the registered manager. The main focus of the inspection was to focus on the quality of live that residents experience. Care Homes for Adults (18-65 years) Page 6 of 29 The required Annual Quality Assurance Assessment (AQAA) was completed and returned prior to the inspection visit and information from this has been used to inform this report. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 29 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. Prospective residents have all the required information available to enable them to make an informed choice about the home, and if they want to live there. The admission procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents have the opportunity to visit the home, and know that it is able to meet their individual care and support needs. Evidence: Applewood is a new service, and has a comprehensive combined statement of purpose and service users guide. A copy of this is available to any prospective resident and given again to anyone admitted to the home. These documents are available in braille and audio formats and promote a good understanding of the homes facilities, services and how it is run. A charter of rights and responsibilities for residents of the home is included in the service users guide along with information on raising concerns or complaints. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: All residents living at Applewood have been admitted to the home over the last 5 months. The home has four permanent residents at the moment, and a fifth resident was having an assessment visit at the time of this inspection visit. Records and practice observed during the inspection process, confirmed that the admission procedure followed was very thorough, taking into account not only the prospective residents and familys own assessment, but a wide range of external and internal professional assessment as well. An assessment visit to the home is always completed, which may take place over a number of separate visits, including a night stay. This enables the prospective resident to experience the home fully, and for the existing residents and staff to share their views on how any prospective admission may impact on the communal living. The assessment process was seen to be comprehensive, only being progressed when thought to be in the best interest for the prospective resident. 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. Each resident has a plan of care that enables staff to meet the assessed support needs of residents in a structured and consistent manner. Systems for consultation and participation are effective. Residents are treated with respect and are encouraged and enabled to make decisions about their day-to-day living. Evidence: The care documentation includes a support plan which sits alongside the person centred plan and a health action plan. A review of the care documentation confirmed that all the individual plans are developed in conjunction with the resident. The focus of the home is to work with residents encouraging them to maximise their potential, and work towards as much independence as possible. The individual plans reflected this with objectives being set using a person centred approach. The documentation was extensive however, it was Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: was noted that some information needed to be updated and ways of using the plans as working documents was discussed with the manager. There was evidence that the care and support provided is being reviewed with input from outside agencies as necessary. Each resident is allocated a key-worker by the manager who takes into account individual personalities. Key-working sessions are incorporated into everyday working of the service on a formal and informal basis and recorded within a diary, to highlight future goals and current issues. The AQAA recorded that generic risk assessments are in place for all activities, both indoor and outdoors, and that these are explained to the residents, and identify procedures in place for particular tasks or activities where a need has been identified. There was evidence that identified risks are assessed and recorded in the care documentation. The ethos of the home is based very much on promoting independence and the risk assessments sampled support this. From observation it was clear that residents are central to any decision making and involved in making choices about how the day is organised for example shopping trips and meals. The manager confirmed that although residents are given advice they make the final decisions as to their purchases. The AQAA also recorded that during the assessment period prior to moving in to the house, the future residents were consulted as to their choice of colour schemes, bedding, carpeting and window dressing, for the home. Self advocacy meetings, which residents are encouraged to attend, are held on a monthly basis at a local venue, and are used to encourage residents to discuss the home and their lives in the home. There was evidence that the evening meals that are eaten communally are discussed along with the possible changes to the menus. Group discussion on this matter allowed for the use of skills used in negotiation and compromise. 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. Residents have the opportunity for personal development, and to take part in appropriate leisure and community activities. Individual rights are respected and dietary needs are met. Evidence: An ethos of the home is to encourage residents as individuals to participate in all aspects of daily living, and develop their level of practical,social and emotional independence. It was clear from observation and discussion with staff that residents are encouraged and facilitated to participate in the home fully, mixing with staff and other residents, to form meaningful relationships. Residents at Applewood lead a very active life that includes social and life style activity. They are supported and enabled by staff as necessary, and have opportunities for social and educational development, including attending local Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: colleges and visiting the nearby leisure centre, banks, pubs and restaurants. The AQAA confirmed that one resident had been supported to visit a number of local churches to enable him to make an informed choice as to which he would like to attend. Staff work alongside the residents who use the service to explore local community resources, which are of interest to the them. Opportunities for social, educational, cultural and recreational interests are explored with flexible staffing arrangements allowing for residents to be supported individually to access these. This was evidenced during the inspection visit. The AQAA recorded that prior to Applewood opening the future residents were informed of the choice of courses at the local community college. They were also advised of the weekly programme at the Bradbury Centre (activity and resource centre) which is on the site of SeeAbilitys other home in Seaford. They were then able to apply for their chosen course as soon as they became residents. Trial sessions were organised at the college so informed choice could be made by the individuals as to their suitability. The evening meal is cooked by residents who have a rota, purchasing the required food during shopping trips. The weekly menu is set and did not vary a great deal, but the AQAA and the manager explained that this had been discussed at the residents meetings, and as one residents has a problem with changes the adjustments to the menu are kept to a minimum at the moment. Other meals are prepared individually by the resident with support as necessary. 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. Appropriate arrangements are in place to meet the individual assessed emotional, and physical health care needs of residents. Evidence: Residents are given privacy, respect and shown dignity and choice when meeting their personal health care needs. All staff have visual impairment training, and are aware of the particular needs and preferences for support and guidance of the people in the home, and were sensitive to residents dignity when providing support and prompting. Residents confirmed that they had showers and baths as they wished and felt that they had privacy when they needed it. Independence is promoted and one of the showers has been adapted to allow one of the residents to use this more independently. Appointments relating to physical and mental health and welfare are recorded, and residents are accompanied to these and reminded of them as necessary, but are encouraged to take responsibility for them. The AQAA identified that for some residents the transition to a new health care area has been traumatic. The manager and key-workers have worked with The Community Learning Disability Team, parents Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: and carers to ensure all areas of health care are being addressed in the best possible way. The manager confirmed that all staff have medication awareness training and are verbally and visually assessed as competent by her, or her deputy before administering medicines. Detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. It was however noted that these are not adhered to fully, as one resident who self administers did not have a risk assessment, and individual guidelines were not in place for those residents prescribed as required medicines. This was raised with the manager who confirmed that these shortfalls would be addressed. Medicine administration records were clear and accurate and the storage facilities were good, with a secure storage facility in residents own accommodation, allowing for privacy. Residents are encouraged to take responsibility for their own medicines with self medication being a goal whenever possible. The AQAA confirmed the home works closely with the pharmacists and GPs to ensure medication is in a format suited to the needs of the individual. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a formal complaints system with evidence that residents views are listened to and acted upon. Residents are safeguarded from abuse through relevant staff training, and robust policies and procedures. Evidence: All residents are provided with a copy of the service users guide on admission and this contains a complaints procedure, to facilitate people in raising any issue of concern and also records residents rights. This document is available in braille or on audiotape. A full complaints procedure is also held in the home and is available if needed. Regular residents meetings are held where concerns can be discussed if appropriate, keyworkers also work with residents to promote their own views. The home maintains a log of complaints that demonstrated that when made are dealt with thoroughly, with a resolution achieved. The AQAA documented regular contact and good relationships with families who are able to voice any concerns. Telephone contact with relatives as part of the inspection process confirmed this. Records seen and discussion with the manager confirmed that staff have received training on safeguarding vulnerable adults, and that an appropriate policy and procedure was in place. Recruitment practice ensures that staff have an enhanced criminal records check (CRB) to ensure only staff suitable to work with vulnerable people are employed. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Each resident has their own bank account and they can access money with support from staff as they wish. secure storage is available in each residents individual accommodation and checks on the amounts of money held and spent by the residents are made according to individual risk assessments, to ensure resident money is safe. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is accessible, safe and clean and is suitable for its stated purpose. Residents benefit from all necessary specialist equipment and pleasant accommodation that is comfortable, well maintained and decorated to a good standard. Evidence: Applewood is a detached property with an integral self-contained annexe that has been adapted to its current use in 2009. SeeAbility purpose-converted the premise from a private house, and fitted it to a high standard for the provision of a quality living environment for the benefit of up to five adults with visual impairment and disabilities, receiving personal care and rehabilitation. Situated in a residential area of Seaford, the property provides ground and first floor accommodation and the main building comprises four single bedrooms, two of which have en suite shower/WC facilities. There is a communal lounge and adjoining dining area, kitchen, office and conservatory. The self-contained annexe can have full access to all services, facilities and support offered in the main part of the house, but with the additional opportunity to experience greater independence and autonomy. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The accommodation is designed to enable easy access for people who have a visual impairment; good use has been made of colour and texture contrasts in decor and furnishings, tactile information and lighting. There is good ramping to the front and rear of the property. The garden is well established and allows for sitting outside, and some gardening if wanted. The home has a very pleasant modern feel with light and airy spaces throughout, and reflects an attractive modern home, with residents private accommodation being individual and personalised. Residents spoken with were very pleased with their private space that was clearly respected as such. The home has good communal space that promotes communal life but allows for residents to have there own space and privacy. Although each room does not have an emergency call facility the home does have call bell facilities in bathroom areas and the annex. The manager advised that further mobile call bells are available and can be used strategically around the home if needed. The resident in the annex calls each day via the intercom to say that all is well. During the visit it was noted that the radiators were not guarded, and could get hot and pose a risk to residents .These had not been guarded before registration and had not been risk assessed as part of the homes or individual risk assessment process. This was discussed with the manager who said as residents were mobile the radiators did not pose a high risk. She confirmed that appropriate risk assessments with control measures, would be completed by the end of the month. The home was found to be clean with good hand washing facilities at hand basins. The laundry room is separate from the kitchen and the manager confirmed that this machine is suitable for soiled laundry. Each resident is responsible for the completion of their own laundry with support as necessary. 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. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. Robust recruitment procedures and appropriate staff training ensure the safety and protection of residents. Evidence: At the time of this assessment visit four residents were living in Applwood, and an assessment visit for a prospective resident was taking place. The staffing arrangements were found to be flexible to meet the activity of each resident, and promoted one to one working throughout the day. During the night there is one member of staff on the premises who can sleep from 10.30. The manager said that there is a lone working policy and on-call arrangements that include her, being able to get to the home within a few minutes, if extra staff are required. A selection of staff recruitment files were viewed and demonstrated that there is a thorough recruitment process in place, although it was noted that some of the required documentation is not retained within the home. This was discussed with the manager for her to address, who advised that all these records are held at the head office where the recruitment process is co-ordinated. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Recruitment practice also includes the involvement of residents in the informal interview process. The manager also confirmed that new staff are not employed until the Criminal Records Bureau check is returned, although they may start their induction training. Records confirmed that new staff receive comprehensive induction and foundation training, the Common Induction Standard, which is compatible with Skills for Care. Staff routinely commence on their National Vocational Qualification (NVQ) as soon as possible after completion of their six monthly probationary period. Many of the staff have worked for SeeAbility before and completed relevant training at Barclay House, a nearby care home within the same organisation. There was evidence that staff training is given a high priority and is used to benefit residents ensuring they are safe and well cared for. 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. Residents benefit from a qualified and competent manager who is approachable and promotes the health, safety and welfare of residents. Systems will need to be fully established to take into account residents views on the service and its development. Evidence: The registered manager has had a wide ranging career, with managerial experience in a variety of settings. She has worked with people with a wide range of disabilities and learning disabilities for over 25 years and has had extensive training, and is working to complete the Leadership and Management for Care Services Award/NVQ 4 in Social Care. Observation indicated that the manager was well respected and works well with the staff, and has good relationship with residents promoting a relaxed atmosphere in the home. The AQAA was well completed and used to audit the service provision. Further systems for quality monitoring and improvement that take into account residents and other stakeholder views will need to be established in the future, to developed the service. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The AQAA recorded that the necessary safety checks have been completed on equipment and services to the home. There are systems within the home to ensure the health and safety of staff and residents are promoted and protected. Environmental risk assessments are completed and there was evidence to confirm that risks identified are responded to. However there was no evidence to confirm that the radiators had been risk assessed. This matter has been recorded within this report under the section relating to the environment. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 The registered person shall make arrangements in consultation with the Environmental Health Department, to ensure that all parts of the home are as far as possible free from hazards to safety. This should include the risk assessment with appropriate control measures to ensure the safety of radiators in the home. This will ensure residents and staff are as safe as possible. 01/02/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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!