Care Home: Ashbury

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What the care home does well Ashbury provides people with a very comfortable, well maintained and homely environment. Each person has their own bedroom which they are encouraged to personalise. The home has a good range of aids and adaptations to assist people with mobility difficulties. Staff morale was noted to be very good and staff told us that the home was a very `happy place to work`. People benefit from a stable staff team who have been appropriately trained. During this inspection we noted the atmosphere within the home to be very calm and relaxed. Staff were observed interacting with people in a very kind and professional manner. People responded positively to staff interactions. Care planning procedures are good and clearly set out peoples` assessed needs, abilities and preferences. Care plans promote a person centred approach to care. The home`s arrangements for ensuring peoples health care needs are met are very good. Detailed documentation is maintained and we were able to see that people have access to a range of health care professionals. Peoples` rights are protected and people are supported to make choices about their lives. Risk assessments are in place and we were able to see that people have access to independent advocates where appropriate. Routines within the home are flexible and people can choose how and where to spend their day. The home ensure that people have the opportunity to access a range of activities. The home has a wheelchair accessible mini bus. Staffing levels are flexible so that peoples` social needs can be met. Procedures are in place which reduce the risk of harm or abuse to the people living there. Staff spoken with demonstrated a good knowledge of these procedures. The standard of cleanliness was noted to be very good and the home has appropriate procedures in place to reduce the risk of the spread of infection. Up to date procedures ensure the health and safety of persons at the home. In completed comment cards, staff and people using the service made the following comments under the heading, `What does the home do well?` `Respect and support each individual and we have a good staff team`, `Ashbury has a dedicated and hardworking team`, `Provide a good activity and social life`, `They care`. What has improved since the last inspection? No requirements were raised at the last inspection. What the care home could do better: This was a positive inspection and no statutory requirements were raised. People who completed comment cards for the Commission indicated that there was nothing the home could do better. Key inspection report Care homes for adults (18-65 years) Name: Address: Ashbury Ashbury Six Acres Close Roman Road Taunton Somerset TA1 2BD     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: kathy McCluskey     Date: 2 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Ashbury Ashbury Six Acres Close Roman Road Taunton Somerset TA1 2BD 01823327713 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset County Council (LD Services) care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service Users who have a concurrent physical disability may be admitted to the home Date of last inspection Brief description of the care home Ashbury is a single storey building situated close to Taunton town centre. There is a large lounge, dining room and two assisted bathrooms at the home. The home is set in pleasant gardens that are accessible to service users. A range of aids and adaptations are in place to assist people who have mobility difficulties. All bedrooms are for single occupancy. Ashbury is registered with the Care Quality Commission to provide care for up to nine people with learning disabilities including physical disabilities. The home is run by Somerset Social Services. The responsible Individual is Mr David Dick. The Commission is currently processing an application for the acting manager to be the registered manager. We were informed at this inspection that current fee levels are between £65.20 & Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Brief description of the care home £108.10 per week with daily rates ranging from £11.24 to £17.37. People pay a mobilty rate of £13.50 per week for transport. We were informed that people meet the cost of their own personal items, toiletries etc. Further details on fees should be obtained from the home. 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: 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 unannounced key inspection was conducted over one day by regulation inspector Kathy McCluskey. The acting manager was not available for this inspection. We were given unrestricted access to all parts of the home and records required for this inspection were made available to us. At the time of this inspection 9 people were residing at the home. During this inspection we were able to talk to five members of staff and met with all people using the service. The home completed its Annual Quality Assurance Assessment and returned this to the Commission within agreed timescales. The AQAA is a self-assessment which focuses on how well outcomes are being met for people using the service. It also provides us with some numerical information. Care Homes for Adults (18-65 years) Page 6 of 29 As part of this inspection we sent comment cards to a selection of people using the service, staff and health care professionals to seek their views on the quality of the service delivered. We received completed comment cards from 2 people using the service and 2 members of staff. Comments have been included in this report as appropriate. The term we used throughout this report refers to we the Commission. We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the 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: This was a positive inspection and no statutory requirements were raised. People who completed comment cards for the Commission indicated that there was nothing the home could do better. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information to enable them to make an informed decision about moving to the home. The homes admission procedures ensure that people are appropriately assessed before a placement is offered. People are provided with a contract which sets out peoples rights and terms and conditionals of occupancy. Evidence: The home has produced a Statement of Purpose and Service User Guide which provides people with information about the home and services offered. The homes completed AQAA stated that in the next twelve months the home plan to review these documents to ensure that they are; providing a person centred quality of service. The homes admission procedures ensure that people are appropriately assessed before a placement is offered. We were able to see evidence that assessments are Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: obtained from other health care professionals as appropriate. People thinking about using the service and/or their representatives would be provided with opportunities to visit the home prior to making a decision to move there. We received completed comment cards from two people using the service. Comment cards indicated that these were completed with the assistance of their family members. Both confirmed that they had received enough information about the home to enable them to make an informed decision about moving there. People currently using the service have been there for many years. Staff told us that they did not experiencing any concerns in meeting peoples current needs. The home is equipped with a good supply of aids and adaptations to assist peoples with mobility difficulties. All staff spoken with confirmed that they had received appropriate training to allow them to meet the needs of people currently using the service. People are provided with a contract which clearly states the terms and conditions of occupancy, fees to be charged, room number to be occupied and details on their rights and responsibilties. 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. The homes care planning procedures ensure that people receive appropriate support in line with their assessed needs, abilities and preferences. People are supported to make decisions about their lives and the home ensures that any risks have been identified along with action to reduce risks. People can feel confident that information about them is handled appropriately. Evidence: Each person has a plan of care which is developed from a range of assessments. We examined three care plans at this inspection. Care plans contained clear information about peoples assessed needs, abilities and preferences which helps to ensure that staff are able to support people in a consistent manner whilst promoting a person centred approach to care. We were able to see that people are supported to make decisions about their lives. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Any restrictions had been clearly identified through the homes risk assessment process. We were also able to see evidence that the home had obtained an advocate for individuals where required. Care records were found to be up to date and there was evidence that formal reviews had been held for people involving health care professionals and the individuals representatives. The home currently use a tick box form to indicate whether the individual and/or their representative have been involved in, and agree, the care plan. It has been recommended that, where ever possible, the home obtain signatures to confirm peoples agreement. We also found that care plans contained a large amount of documentation going back many years which made easily identifying current information more difficult. It has been recommended that the home reviews this and archives documents as appropriate. We were informed that people currently using the service were unable to manage their personal finances. This had been clearly documented in the individuals plan of care. Information on the homes procedures for the management of peoples finances can be found later in this report under the outcome group complaints and protection. Staff are made aware of and have access to policies and procedures on confidentiality. During this inspection we found all records pertaining to people using the service to be securely stored. We observed that discussions about people using the service were held in private. 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. People are given the opportunity for personal development. The home ensure that people have the opportunity to access a range of social, leisure and vocational activities in line with their assessed needs and preferences. People are supported to make choices about their lives. The home ensure that people received a well balanced diet which takes into account peoples needs and preferences. Evidence: The home ensures that people are provided with opportunities to maintain and develop independent living skills. The majority of people currently using the service experience difficulties around communication. Staff at the home have received Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: appropriate communication training and information around the home has been included in symbol format for people. Photographs have been used so that people always know which staff are going to be on duty to support them. The days menu has also been produced using photographs to assist people. On examination of care records and through discussion with staff, we were able to see that people are supported to attend a range of social, leisure and vocational activities. Some care records examined contained certificates of achievement on completing vocational studies at a local college. Staff support people to attend a local day centre, meals out, shopping, walks and bowling. In-house activities also take place. Activities are not limited to those identified and are based on peoples assessed needs and preferences. Staff told us that staffing levels were good and that they were always able to spend quality time with people using the service. The home has its own wheelchair accessible minibus. We were informed that daily routines are based on the needs and preferences of the people using the service. People are supported to make choices about how they spend their day. We observed those who were able, moving freely around the home. People are able to access their bedrooms as they choose. We were informed that people make choices about what time they go to bed and get up in the morning. With the assistance of their relative, two people completed comment cards for the Commission. Both confirmed that they were always able to make decisions about what they do each day. All meals are prepared in the homes kitchen. The home have recently been awarded a 5 star excellent rating by Environmental Health for their food hygiene standards. The home employs a cook for four days a week. Care plans contained clear information on peoples dietary requirements, ability, likes and dislikes. We were able to see lunch being served in the dining room. There was a relaxed atmosphere and we observed people being assisted in a dignified manner. Protective clothing and specialised cutlery/crockery was seen to be available for those with an assessed need. A lighter meal is served at lunch time with the main meal served in the evening. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to meet their personal care needs in line with their assessed needs and preferences. The homes procedures ensure that peoples health care needs are met. The home follows appropriate procedures for the management and administration of peoples medication. Evidence: We found care plans to contain clear information for staff on the level of support each person required to meet their personal care needs. It was positive to note that peoples preferences had been included i.e; whether a bath or shower was preferred, their preferred toiletries and the time and frequency of their bath/shower. The home has two assisted bathrooms. Both are fitted with hi-low baths and overhead tracking. One bathroom also has the provision of a shower. The homes procedures ensure that peoples health care needs are met. We were informed that the home have excellent support from local GPs and health care Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: professionals. Care records contained documented evidence that people have access to a range of health care professionals. Detailed records are maintained. Many people at the home have epilepsy and have been prescribed Midazolam, a drug used to manage multiple epileptic fits. Care records contained very clear and detailed protocols and guidance for staff on the use of this medication. We were also able to see evidence that staff had received training on the administration of this medication. We were also able to see that staff made good records for the monitoring of peoples epilepsy. We were also able to see that people were regularly reviewed at an epilepsy clinic. We examined the homes procedures for the management of peoples medication. We were informed that there was nobody currently able to self medicate. The home uses the monitored dosage system (MDS) with pre-printed medication administration records (MAR). We examined all available MAR charts and found these to be well maintained. Medicines are administered, checked and signed for by two staff. This is good practice and reduces the risk of any errors. Appropriate records are made for medicines received into the home and those returned to the pharmacy. This practice allows for a clear audit trail. Medicines are only administered by staff who have received appropriate training. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints procedures ensure that people feel confident in raising concerns. Procedures are in place to reduce the risk of harm and abuse to people using the service. Evidence: The home has a complaints procedure in place which is also in an appropriate format for people using the service. Photographs are displayed so that people know who to raise their concerns with. People also have access to a DVD called I want to complain. This has been produced by people using the local authority services. A copy of the local authoritys document Our promise to you and details of advocacy services are also displayed within the home. Two people using the service completed comment cards for the Commission and both confirmed that they knew how to make a complaint and who to speak to if they had any concerns. We spoke with five members of staff during this inspection and all confirmed that they would not hesitate in raising concerns if they had any. They also stated that they felt confident that any concerns would be acted upon. Staff demonstrated a good understanding of the whistle blowing policy and of policies for the protection of vulnerable adults. Training records confirmed that staff had received appropriate training. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We examined the homes procedures for the management of peoples finances. The home support people to manage small amounts of money. Individual records are maintained for each person and two staff sign to confirm all transactions. Receipts are obtained and balances are audited twice weekly by a member of the local authority administration team. Monies were found to be stored securely. 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. People live in a comfortable, homely and well maintained environment. The home is fitted with a range of aids and adaptations to assist people with mobility difficulties. People have their own bedrooms which they can personalise. The standard of cleanliness in the home is good and the home has procedures in place which reduce the risk of the spread of infection. Evidence: Ashbury provides a comfortable, homely and well maintained environment for people. The home has pleasant gardens and all areas are wheelchair accessible. Accommodation is provided over one level and the home is fitted with a range of aids and adaptations to assist people with mobility difficulties. All bedrooms are for single occupancy and are comfortably furnished. Keys are provided and people are encouraged to personalise their own rooms. All bedrooms are fitted with a wash hand basin and one bedroom has the provision of a toilet and shower. Three bedrooms are fitted with overhead tracking. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home has adequate numbers of toilets and two assisted bathrooms. Both bathrooms are fitted with overhead tracking to assist those who require the use of a hoist. One bathroom has the provision of a shower and both bathrooms are fitted with hi-low baths. Corridors and reception areas are spacious. The home has a good size lounge which is very comfortably furnished. The patio area and gardens are accessed through patio doors from the lounge. The dining room is spacious and provides plenty of seating and tables for people. The laundry room was found to be well equipped, organised and clean. Staff hand washing facilities were seen to be appropriately located throughout the home and staff confirmed that they had a very good supply of protective equipment. The standard of cleanliness throughout the home was noted to be of a good standard and the home was free from malodours. A cleaner is employed covering four days a week. 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. People benefit from a stable staff team who are motivated and appropriately trained. Robust staff recruitment procedures are in place which reduce the risk of harm or abuse to people using the service. Procedures could be further improved if staff and people using the service could be involved in the selection of staff. Evidence: We were able to speak with five members of staff during this inspection and all were clear about their roles, responsibilities and lines of accountability. We were informed that staff turnover at the home is low thus meaning that people using the service benefit from a stable staff team. Staff morale was noted to be very good and staff told us that the home was a very happy place to work. At the time of this inspection there were no vacancies and nine people were using the service. We were informed that minimum staffing levels were three during the day with one waking and one sleep-in night staff. In addition to these care staff, two agency carers provide twelve hours a day support to two people using the service who have been awarded continuing health care. We were informed that staffing levels were flexible to meet the assessed needs, including social needs of people using the service. Two staff members completed comment cards for the Commission and both responded Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: usually to the question are there enough staff to meet the needs of people using the service. No concerns were raised with us during this inspection regarding the current staffing levels. Staff were positive about the training opportunities available to them and all confirmed they had received appropriate mandatory and specialist training to enable them to meet the needs of people living at the home. Staff told us that they were encouraged to request additional training to meet their needs/preferences. The homes completed AQAA told us that of the 21 permanent care staff employed, 10 have achieved a minimum of an NVQ level 2 in care. This equates to 48 which is just short of the recommended 50 of the National Minimum Standards. The AQAA also told us that 2 staff are currently working towards this award. Staff told us that they felt well supported and that they received regular formal supervision. We were able to see documented evidence of this in the staff files examined. This was also confirmed by the two members of staff who completed comment cards for the Commission. We examined the homes procedures for staff recruitment. We were informed that recruitment procedures are carried out by the Somerset County Council and this being the case, applicants do not visit the home prior to their appointment. It has been recommended that this is reviewed so that existing staff at the home and people using the service, as appropriate, are provided with the opportunity to meet applicants and provide their own feedback. As appropriate, people using the service should also be given the opportunity to be involved in the selection of staff. We examined two staff recruitment files at this inspection and these were found to contain all required information. We were able to see evidence that staff had not commenced employment until receipt of two satisfactory references and an enhanced criminal record check (CRB) and checks against the protection of vulnerable adults register (POVA). Staff follow an in depth induction programme on commencement of employment. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently managed by the acting manager though the Commission are currently processing an application for registered manager. Systems are in place to monitor the quality of the service delivered. Up to date procedures are in place which ensure the health and safety of persons at the home. Evidence: An acting manager is in post and the Commission are currently processing an application for registered manager. This being the case, not all standards in this outcome group could be fully assessed. The acting manager was not available for this inspection. The home has a quality assurance programme in place which seeks the views of peoples representatives and other stakeholders. We were informed that questionnaires are sent out on an annual basis. Returned questionnaires are then Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: analysed by the registered provider. We were informed that surveys have recently been sent out but not yet returned. Regular meetings are held for all staff with minutes maintained. We were informed that formal meetings for people using the service was not currently appropriate. Staff told us that they encourage people, on a one to one basis to express their views on a daily basis. Under the heading, What we could do better, the homes completed AQAA identified this as consultation with service users to ascertain their views. Progress will be followed up at the next inspection. As part of the homes quality assurance procedures and in accordance with the Care Homes Regulations 2001, a provider representative makes monthly unannounced visits to the home to review the quality of the service provided. This was confirmed by staff spoken with and was also confirmed in the homes completed AQAA. Reports could not be accessed at this inspection as they were stored on the homes computer. We examined the homes procedures for ensuring the health and safety of persons at the home and found them to be up to date. We also toured the premises and no concerns were raised. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The home should consider obtaining signatures from individuals using the service and/or their representative to confirm their agreement of individuals care plans. The home should consider reviewing the documentation held in working care plans and archive more historical information as appropriate. The registered provider should give consideration to enabling staff and people living at the home, to meet with and provide feedback on applicants applying for employment at the home. 2 7 3 34 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. 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