Care Home: April Court

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What the care home does well April Court has achieved a consistently good standard in many aspects of the care provided to service users. Service users are well supported during the admissions process and there was evidence that the home liaises well with placement teams to ensure that they can meet their needs. Staff are aware of service users individual needs and choices and these are clearly detailed in Essential Lifestyle Plans. This helps ensure that service users preferences are taken into account in care delivery, that risks to their safety are managed and their independence is promoted. Regular meetings are held which give service users the opportunity to be involved in decision-making about their lives in the home. There was evidence that service users take part in group and individual leisure activities and they are supported in accessing their community on a regular basis to promote their right to an ordinary life. Friends and families of service users are welcomed in the home which means that they benefit from a wider circle of support. Service users are enabled to make choices about what they do each day, their holidays and what they want to eat with appropriate support from staff to ensure that their needs are met. The personal and health care support offered to service users was seen to be of a high standard. Support plans contain enough detail to ensure that staff are aware of the assistance that is required by each individual. The home also works in close partnership with health care professionals to ensure that service users receive enough support to maintain good health. The home has a complaints procedure and systems in place to ensure service users are listened to. There are policies, procedures and training for staff on abuse awareness to ensure that staff are aware of how to respond in the event of a service user being at risk of harm. The home is clean and health and safety procedures in place at the home mean that service users are protected from infection. All staff are given a comprehensive induction programme at the start of their employment at the home. They are supported to do nationally recognised qualifications which give them the knowledge they need to work effectively with service users. A range of other courses are offered to staff that are relevant to their role and promote their confidence in specific areas of service users care. The Registered Manager has a sustained track record of managing the home with competence and demonstrates a commitment to continuous improvement. This is reflected in the support available to staff in their work with service users. The home has a robust quality assurance process and regular audits take place to ensure that the service meets its objectives and provides a consistent service for its users. Health and safety policies and procedures are in place and promote service users welfare in their home. What has improved since the last inspection? The medication policy has been improved and implemented. Staff that administer medication are all suitably trained to do so. Robust employment procedures are followed and can be evidenced by the records kept in the home. The premises present well as improvements have been made to the environment. The management of April Court Continue to maintain an excellent service What the care home could do better: No specific recommendations are made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: April Court 186 Poole Lane Kinson Bournemouth Dorset BH11 9DS     The quality rating for this care home is:   three star excellent 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: Michael Dennis     Date: 1 3 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 30 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 30 Information about the care home Name of care home: Address: April Court 186 Poole Lane Kinson Bournemouth Dorset BH11 9DS 01202576110 01202570093 april.court@bournemouth.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Bournemouth Borough Council care home 18 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 18. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home April Court is a Local Authority retained residential home for eighteen adults with learning disabilities. The home is managed on behalf of Bournemouth Borough Council by Ms Lindsay Divall. April Court is a purpose built home located in the Kinson area of Bournemouth. It is situated a residential area with shops, churches and other amenities nearby. The main bus route between Poole and Bournemouth is easily accessible. Residents accommodation is provided in twelve single and three twin bedrooms on two floors. A phased plan to achieve all single resident bedrooms is being implemented. A Care Homes for Adults (18-65 years) Page 4 of 30 18 Over 65 0 Brief description of the care home shaft lift is being added to facilitate easy access between floors. The communal areas consist of a lounge, smaller lounge and dining room, all of which can be used for various activities. There is a training kitchen that is available to residents with support from staff. There is a pleasant patio area at the rear of the building which is accessible to all service users. The Registered Manager is experienced and well qualified to NVQ Level 4 standard and the home is staffed by a team comprising a Deputy Manager, four Assistant Duty Managers, Residential Support Assistants and Night Care Staff. There is a part-time cook and domestic and clerical support. Since the last inspection an increase to care staff hours of 48 per week has been implemented. There are currently 12 residential Support Assistants for days plus 5 for waking night duty. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection. The purpose was to assess the homes compliance with key national minimum standards and the progress made in relation to one requirement and two recommendations made at the last inspection. The inspection was conducted over six hours on two days in January 2010. April Court currently provides accommodation for fifteen service users. The current group of service users are aged between 31 and 67. The inspection included discussion with the Registered Manager, Lindsay Divall, and other staff members. Time was also spent observing service users in their daily life in the home. A sample of staff and service user records including medication records were inspected. A tour of the home was also taken. Prior to the inspection, a completed Annual Quality Assurance Assessment was Care Homes for Adults (18-65 years) Page 6 of 30 received from the Registered Manager of the home. A total of nine completed service user surveys were received in addition to nine surveys from relatives, five surveys from Social and Health care professionals, and nine surveys from relatives and advocates and eight surveys from staff members. All were extremely positive and complimentary. All of the residents said that they liked living at April Court and were well supported by the staff. Relatives consider the care provided is exemplary and commend the staff for their love and dedication. The comments from interested professionals are best summed up by one which said, April Court continues to provide an excellent service for all the residents and respite service users. The staff indicated that they worked in a positive environment and were given good support and training. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: April Court has achieved a consistently good standard in many aspects of the care provided to service users. Service users are well supported during the admissions process and there was evidence that the home liaises well with placement teams to ensure that they can meet their needs. Staff are aware of service users individual needs and choices and these are clearly detailed in Essential Lifestyle Plans. This helps ensure that service users preferences are taken into account in care delivery, that risks to their safety are managed and their independence is promoted. Regular meetings are held which give service users the opportunity to be involved in decision-making about their lives in the home. There was evidence that service users take part in group and individual leisure activities and they are supported in accessing their community on a regular basis to promote their right to an ordinary life. Friends and families of service users are welcomed in the home which means that they benefit from a wider circle of support. Service users are enabled to make choices about what they do each day, their holidays and what they want to eat with appropriate support from staff to ensure that their needs are met. The personal and health care support offered to service users was seen to be of a high standard. Support plans contain enough detail to ensure that staff are aware of the assistance that is required by each individual. The home also works in close partnership with health care professionals to ensure that service users receive enough support to maintain good health. The home has a complaints procedure and systems in place to ensure service users are listened to. There are policies, procedures and training for staff on abuse awareness to ensure that staff are aware of how to respond in the event of a service user being at risk of harm. The home is clean and health and safety procedures in place at the home mean that service users are protected from infection. All staff are given a comprehensive induction programme at the start of their employment at the home. They are supported to do nationally recognised qualifications which give them the knowledge they need to work effectively with service users. A range of other courses are offered to staff that are relevant to their role and promote their confidence in specific areas of service users care. The Registered Manager has a sustained track record of managing the home with competence and demonstrates a commitment to continuous improvement. This is reflected in the support available to staff in their work with service users. The home has a robust quality assurance process and regular audits take place to ensure that the service meets its objectives and provides a consistent service for its users. Health and safety policies and procedures are in place and promote service users welfare in their home. Care Homes for Adults (18-65 years) Page 8 of 30 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 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home works closely with care management teams to ensure that only individuals whose needs can be met by the service are admitted. Evidence: Three service user files were selected at random and case tracked. It is evident that Assessment packs are sent to all prospective service users and relatives to collate initial background information. Reports are also obtained from other agencies such as social services. If the prospective service user has been involved in respite care, reports from those sources are also obtained. One or more visits are then undertaken to the current place of residence for further information gathering and to give the individual and their family the opportunity to meet and question staff from the home. There then follows a planned introduction to the home, prior to full admission. The planned introduction periods will vary according to individual circumstances. On completion of this process the home will have gathered substantial information as Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: to the persons care needs. This information then forms the initial care plan. Contracts and or Statements of Terms and Conditions with the home were evident. This process was explained by the staff on duty and verified from the written records. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual plans contain sufficient detail to identify how service users needs will be met by the service. The home has systems in place to ensure service users have opportunities to make decisions in their daily lives. Risk assessments are in place to promote the welfare and independence of service users. Evidence: The individual plans of three service users were examined. They gave an overview of the service users personal history and offered the reader essential information about what is important to them and the arrangements in place to make that happen. The Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: plans identified details of personal care needs and preferences, communication skills and preferred activities. There was evidence of a goal setting process in place and monthly reviews had been undertaken to monitor the progress being made to support service users in meeting their objectives. Essential life style plans, personal life histories, personal health records and hospital grab sheets were available and well documented. It was noted that staff had the skills to communicate with service users and understand what they wanted. In addition, minutes of the monthly service user meetings show evidence that they are given opportunities to contribute ideas about individual and group activities. A sample of risk assessments was seen. These clearly identified the nature of the risk, the degree of hazard, the probability of it occurring and an overall risk rating. Precautions already in place had been listed with further information about any additional control measures required. All risk assessments were dated and signed and there was evidence to indicate that reviews take place on a regular basis to ensure that information remains valid and up-to-date. A specific risk assessment had been put in place for one service user with some challenging behaviour. It was clear from the documentation that staff received training in a technique to support the service user in managing this, that strategies were in place to ensure that incident records were completed each time the technique was used and that these had been monitored by the Registered Manager. In addition, appropriate intervention from the Community Learning Disability Healthcare team had been sought. Discussion and review of the individual plans for service users indicated that where needs differed from other residents, staff were undertaking specific pieces of work to meet these needs and support individuals with greater risk-taking. This promotes independence in the home and community. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to activities that meet their needs for appropriate occupation and leisure. Service users are supported to be part of their local community which promotes their right to lead ordinary lives. Service users families and friends are welcomed into the home which enables them to maintain and enjoy positive relationships with those people who are important to him. The home is responsive to the individual needs of service users and promotes their rights to make choices about their everyday lives. Care Homes for Adults (18-65 years) Page 15 of 30 Judgement: Systems are in place to ensure that there is a balance between promoting choice and giving service users the support they need to eat a healthy diet that meets their individual requirements. Evidence: The majority of service users living at April Court attend day services either on a parttime or full-time basis which provide them with opportunities for occupation. Many service users commented in surveys that they enjoyed attending their respective day centres. Minutes of a recent service user meeting indicated that service users are consulted on activities they wish to do in the future. Surveys returned indicated that requests are followed up and that the home facilitates activities both on a group and individual basis. The home keeps records of service users participation in activities which show they have a regular and varied lifestyle based on choice within a risk management framework as necessary. The home has access to their own transport as well as local public transport. This facilitates opportunities for trips to places of interest, activity venues, day centres etc. Many service users at the home are reported to have regular contact with their families. The nature of this contact is clearly documented in Essential Lifestyle Plans and discussion with staff demonstrated that this is clearly considered an important part of service users welfare. This was also highlighted in surveys received from relatives, all of whom indicated that they feel welcomed in the home at any time and were able to see their relative in private. Service users were observed to have free access to their bedrooms at any time and also access the dining room and two lounges as they wish. Staff were seen to knock on service users doors and wait for a response before entering so as to respect their privacy. The Registered Manager also ensures that service users are supported to complete surveys about the home by a person who is not employed at April Court so that their confidentiality is protected. Service users are able to personalise their bedrooms as they wish and are encouraged to participate in tasks such as tidying their bedrooms and clearing away their crockery after dinner. The menu at the home is drawn up with consideration to the likes and dislikes of service users and a cook is employed to prepare main meals so that this does not detract from the personal support of service users. Service users are given choices Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: about what they want to eat on a daily basis and are enabled to do this by the use of pictures and objects of reference. There is always a vegetarian option and salad option available to service users who prefer this. We understand that where a service user wishes to have an alternative to what is on the menu, this is accommodated. There was evidence in Essential Lifestyle Plans and on notices in the kitchen area of service users individual dietary needs being considered. Yoghurts and fruits are available at every meal. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal care that meets their individual needs and preferences. The home promotes service users access to a range of community services to ensure their physical and emotional health needs are met. Medication is competently administered according to the homes medication policies and procedures. Evidence: There is a strong ethos of personal support and preservation of privacy. The inspector observed staff interacting with service users in a caring and positive way. Details concerning service users were not discussed in front of other service users and when discussing a particular service user, that person was present and permissions sought. The policies concerning the administration of medication were inspected and deemed Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: comprehensive and satisfactory. Staff involved in the administration process have been suitably trained Essential Lifestyle Plans contain information about ways in which service users need and wish to be supported with their personal care. All surveys received from relatives at this inspection indicated that they are satisfied with the overall care provided by the home. In surveys received from health and social care professionals, including GPs, who have had contact with service users at the home indicated that staff demonstrate a clear understanding of the care needs of service users. All professionals also indicated that the home communicates clearly with them, works in partnership with them and notifies them of changes to service users well-being. Service user records seen demonstrated that service users access generic and specialist health care services to meet their individual needs. Surveys received from service users relatives indicated that they have been kept informed of important matters affecting their relative and they have been consulted, as appropriate, about their care. During the inspection a sample of medication administration record (MAR) charts were seen. These specified the allergies of individual service users and photographs of service users to aid identification. MAR charts seen had been signed appropriately to indicate that medication had been given as prescribed and a sample of medication was checked to ensure that there were no gaps. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to ensure that service users and their representatives have opportunities to express their views about the service they receive. Procedures and training with regards to the protection of vulnerable adults are in place to inform care workers of the action they must take to keep service users safe. Evidence: The home has a complaints procedure which enables service users or their relatives and representatives to air their views and know that their complaints will be responded to formally and within a given timescale. The complaints procedure is available in symbols format. Information is given on how to contact the Care Quality Commission so that the complainant is aware of the options available to him or her when raising concerns about the service. Review of the homes compliments and complaints record showed that there have been no complaints received by the home since the last inspection. The majority of service users responding to the survey indicated that they always felt that their carers listened to them and acted on what they say. Most service users also Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: indicated that if they were unhappy about something they would speak to staff. Minutes of service user meetings showed that staff asked service users for feedback on the staff, food and home environment. The home follows the local multi-agency adult protection procedure. The home also has a whistleblowing policy. The Manager confirmed that there have been no adult protection issues arising at the home since the last inspection of the service. All staff attend compulsory abuse awareness training during their induction programme. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes premises are suitable for the stated purpose, accessible, safe, clean and hygienic and well maintained. Evidence: Discussion with the Registered Manager indicated that there is an ongoing plan for refurbishment of the home. Plans to install CCTV outside the home to improve security have been implemented. A tour of the home indicated that some refurbishment has taken place, resulting in improvements being made. The environment now presents as being clean, tidy and suitable for use A part-time cleaner is employed by the home to ensure that standards of cleanliness are maintained. The majority of service users responding to the survey indicated that the home was always fresh and clean. The home has an infection control policy and there is provision of aprons, gloves and hand-cleaning gel for staff who are supporting service users with their personal care. Bedrooms are comfortable and display the personality of the occupant. Communal areas are well presented and any repairs needed are quickly undertaken. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The laundry facilities in the home have been improved to meet the requirements of service users. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are actively encouraged to achieve qualifications that give them underpinning knowledge about working with people with learning disabilities. Recruitment procedures within the home are robust to ensure that only suitable people are employed to work with the service user group. Staff have access to appropriate training to be able to meet the needs of service users with knowledge and skill. Evidence: Staff training records showed that the home is committed to enabling staff to undertake National Vocational Qualifications in Care or Management, as relevant to their role. Of the four Assistant Managers, two have an NVQ qualification at Level 3. The deputy is working towards NVQ level 4. The majority of Support Workers are either working towards an NVQ Level 2 or have already achieved this. The home benefits from having staff who are trained NVQ Assessors. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Discussion with the Registered Manager demonstrated that recruitment of staff is undertaken by the management of the home with the support of Bournemouth Borough Councils Human Resources Department. The Manager confirmed that it is the Councils policy that care workers do not commence in post until satisfactory checks have been received. These include two written references and an enhanced disclosure from the Criminal Records Bureau. Records for three members of staff employed by the home since the last inspection of the service were seen. These showed evidence of proof of identity, a declaration that the care worker is fit to work from Occupational Health, two appropriate written references and a probationary report. The Registered Manager reported that disclosures from the Criminal Records Bureau are received by the Councils Human Resources Department who then e-mail her with confirmation that they are satisfactory. All applicants are expected to complete an application form and attend for interview at the home, in the staff records inspected there was evidence of these processes taking place. All staff attend a comprehensive six-day induction programme at the commencement of their employment at the home which comprises all mandatory health and safety training and training in abuse awareness. Ongoing training that is relevant to care workers roles is also made available to staff, for example Diversity and Supervision training for senior staff and training in Essential Lifestyle Planning and Person Centred Planning Awareness. Examples of training provided to staff include, Safeguarding and adult protection, Safe handling of medication, Fire safety at work, Social care transformation, Equality and diversity, Moving and handling, Recruitment and selection, Mental capacity, First Aide, Person centred awareness, Understanding dementia Communication. Evidence was seen to indicate that staff are appropriately supervised at regular intervals. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Consistent and effective management of the home has achieved a sustained track record of positive outcomes for service users. Systems are in place to ensure that the home is monitored internally in relation to objectives set in the Business Plan and their progress in meeting National Minimum Standards. The home operates safe systems of working which promotes the welfare of service users in their living environment. Evidence: Previous inspections of the service have evidenced that the home has achieved consistently good outcomes for service users over a sustained period of time. Requirements and recommendations made at inspection have been responded to Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: promptly and effectively by the Registered Manager demonstrating that the home is committed to improvement. The Registered Manager has also been conscientious in keeping the Commission informed of any issues affecting service users welfare. Members of staff reported how much they enjoy working at April Court and spoke positively about the support they receive from the Manager and the good working atmosphere and sense of team work in the home. There was evidence to show that where there have been concerns over the performance of individual staff this has been responded to promptly and effectively. Records showed that the Manager has achieved a National Vocational Qualification (NVQ) in Care to Level 4 standard and the Registered Managers Award. She continues to attend internal training courses, for example, in management development, continuous improvement and service transformation to equip herself with the up to date knowledge needed to undertake the responsibilities of her role. The home has a comprehensive quality assurance strategy which includes seeking the views of service users, their families, day centres, purchasers of the service and social and health care professionals on a regular basis. There was evidence that where issues had been highlighted in responses, plans had been put in place to address them. Senior managers at Bournemouth Borough Council undertake monthly visits to the home to monitor that procedures are being followed consistently and to check on the general safety and welfare of service users. The Registered Manager reported that procedures within the home are subject to regular audits, for example, audits on the supervision of staff and their Personal Achievement and Development Reviews. April Court has an annual development plan in place which links with the business plan of Bournemouth Borough Council. Records indicated that systems are in place to ensure staff receive regular training in fire safety. This comprises formal training with the Boroughs fire Officer, scenarios, videos and questionnaires throughout the course of a year. Staff receive mandatory training in health and safety including moving and handling, emergency aid, basic food hygiene and infection control at induction and through regular updates. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 29 of 30 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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