Care Home: Ashfield Court Care Home

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What the care home does well People who are accepted for care have a pre-assessment provided for them. This is to ensure that the staff will be able to meet their needs.People are provided with the care support that they need. People who spoke with us felt that their care, privacy and dignity needs were met by the staff from this service.Staff are appropriately trained and new staff start work when the required checks have been carried to ensure that they are safe to work with vulnerable adults.People who spoke with the inspector said that they were encouraged to do whatever they could and were able to make choices for them self and included inany plans about them.Comments on care included:`Staff will listen to me and help me`.`Staff take me out on activities, take me to places that I want to go to and listen to what I say`.`I have a daily programme organised for me to take part in.`Relatives comments included: `Staff will pull everything out to please people here, they even use their own time.``My relative loves living here and we feel that they have been making good progress.`The service has a medication policy that provides guidance for staff tofollow.There is a complaint procedure, which is available for people to use and procedures for staff to follow if they suspect anyone is not being properly treated. It is available in a way that is easy to read.The Registered Manager is an experienced Nurse and is suitably qualified to manage the care service.The monitoring of care is provided through the organisations quality assurance monitoring. What has improved since the last inspection? Medication records are now checked and verified by two staff members to improve the safety of medications.The mental capacity act is included in the care plans for the people who live at Ashfield Court and includes any issues around any areas of consent. What the care home could do better: Parts of the environment are in need of re decoration to ensure the continued well being of the people who live there. Key inspection report Care homes for adults (18-65 years) Name: Address: Ashfield Court Care Home Ashfield Court Care Home Stoneyford Road Sutton in Ashfield Nottinghamshire NG17 2DR 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: Lesley Allison-White Date: 0 7 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 37 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: Ashfield Court Care Home Ashfield Court Care Home Stoneyford Road Sutton in Ashfield Nottinghamshire NG17 2DR 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ashfieldcourt@activecarepartnerships.co.uk Trinity Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 24 Number of places (if applicable): Under 65 Over 65 24 6 0 0 learning disability physical disability Additional conditions: All service users will be within the service user category (LD) Six service users will have additional physical disabilities and will be within the age range 18-30 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Ashfield Court is divided into four bungalows. Twenty four people live are able to live at Ashfield Court. People with learning disability and a physical disability can live here. Ashfield Court has lots of transport for people to use when they want to go out. Fee range form £1138 to £2500 per week. Care Homes for Adults (18-65 years) Page 5 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: three star excellent service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 37 How we did our inspection: This is what the inspector did when they were at the care home This is an over view of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Care Quality Commission (CQC) is on outcomes for people using the service and their views on the service provided. The last key inspection report for this service was on 17th September 2008. However this was inspected as a new service as the Provider details had altered. Care Homes for Adults (18-65 years) Page 7 of 37 Before a visit to the service we gathered different pieces of information. This included information from the Annual Quality Assurance Assessment (AQAA) completed by the provider. Surveys were also sent out and received as part of the evidence gathered. The evidence and judgements that are made, are made on behalf of the Commission and are written as we although there was one inspector at inspection. The site visit lasted eight hours and the main method of inspection used was case tracking which involved looking at the records of two people in detail and tracking the care they received by checking their records and discussing this with them. Care Homes for Adults (18-65 years) Page 8 of 37 We spoke with the Registered Manager, the deputy manager and with other staff. We watched staff providing care and support during the inspection. We visited each of the four bungalows to talk with different people and to see how measures of security were included and to ensure that confidential information is protected. Care Homes for Adults (18-65 years) Page 9 of 37 What the care home does well People who are accepted for care have a pre-assessment provided for them. This is to ensure that the staff will be able to meet their needs. People are provided with the care support that they need. People who spoke with us felt that their care, privacy and dignity needs were met by the staff from this service. Staff are appropriately trained and new staff start work when the required checks have been carried to ensure that they are safe to work with vulnerable adults. People who spoke with the inspector said that they were encouraged to do whatever they could and were able to make choices for them self and included in Care Homes for Adults (18-65 years) Page 10 of 37 any plans about them. Comments on care included: Staff will listen to me and help me. Staff take me out on activities, take me to places that I want to go to and listen to what I say. I have a daily programme organised for me to take part in. Relatives comments included: Staff will pull everything out to please people here, they even use their own time. My relative loves living here and we feel that they have been making good progress. The service has a medication policy that provides guidance for staff to Care Homes for Adults (18-65 years) Page 11 of 37 follow. There is a complaint procedure, which is available for people to use and procedures for staff to follow if they suspect anyone is not being properly treated. It is available in a way that is easy to read. The Registered Manager is an experienced Nurse and is suitably qualified to manage the care service. The monitoring of care is provided through the organisations quality assurance monitoring. Care Homes for Adults (18-65 years) Page 12 of 37 What has got better from the last inspection Medication records are now checked and verified by two staff members to improve the safety of medications. The mental capacity act is included in the care plans for the people who live at Ashfield Court and includes any issues around any areas of consent. Care Homes for Adults (18-65 years) Page 13 of 37 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 14 of 37 If you want to speak to the inspector please contact Lesley Allison-White Government Office East Midlands The Belgrave Centre Stanley Place Talbot Street Nottingham NG1 5GG Tel: 0115 971 9971 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 set out 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 15 of 37 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 16 of 37 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. Peoples needs are appropriately assessed prior to being admitted to Ashfield Court. This is to ensure that staff will be able to meet their needs. They are invited to visit the home before they accept a place there. Evidence: The Annual Quality Assurance (AQAA) states: We arrange a home visit prior to admission and a full assessment of needs prior to admission. This is done by the manager or another senior member of staff as an this information is integrated into their individual plan of care. This will include all relevant information about the individual. We also adhere to our policy including the admissions of a new service user, policy on transition which includes information about relocation syndrome and transitional shock. This is information that identifies how an individual may feel and react when new within a care home. The AQAA continues by stating: We are able to show that we do this well by the pre admissions documentation, and subsequent incorporation into individual records. This is shown by policies such as the transitional policy, Statement of Purpose and Service User Care Homes for Adults (18-65 years) Page 17 of 37 Evidence: Guide which uses symbols to make the information easier to understand. The AQAA explains: We have addressed the implications of the Mental Capacity Act 2005 and addressed the issues of Deprivation of Liberty Act 2009. During the inspection we saw assessments that included the preferred methods of communication and style that the person uses or finds beneficial. This can include the use of communication charts, different communication styles such as Makaton sign language, relationship circles, objects for reference, photographs, visual time tables, drawing and signing or symbols. There were records of care plans, daily and weekly activities, accident sheets, incident sheets, hospital visits, medical visits, clear evidence of person centred planning, peoples wishes and desires current and future individual ambitions within all the plans seen. Care Homes for Adults (18-65 years) Page 18 of 37 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. People are involved in making decisions about them self and are supported by the staff to do so. They are supported to take risks and are enabled to stay independent. Evidence: We looked at the care and support plans of the two people. We saw that they both lead an active and varied life style. One person went out for lunch four days of the week, took part in aromatherapy on a weekday, had free time included most days for relaxation where they would watch television and select their favourite programmes. On another weekday they went out to the pub or some other activity if they wanted to. At the weekend they had a pre planned activity of football, going to the pub, going to the cinema or a visit to the park. Recently there had been a change of activity and the person had changed their mind about a regular shop that they visited and elected to visit another shop. Although the carers had not written it into their support plan at inspection this person was able to tell the inspector that they had started to do this as one of their recent choices. Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: Another person was seen to have made many improvements since being at Ashfield Court. They went out shopping for food and clothing and took advice from staff as part of their desire to control their own weight. They told us that they had lost weight and found it easier to move around and felt proud of this. The care plans identified people with communication difficulties and explained how the staff helps the person and noted the positive ways of providing help with the abilities that the person has. One plan stated X must be given time to answer a question and responds better in a relaxed and quiet environment. When we spoke with X they explained that they like healthy foods and drinks, and enjoy having a balanced diet which they are given at the home. Another person told us that they are able to communicate their needs to other people and are able to express their likes and dislikes. They told us: Staff will listen to me and help me. They told us that they enjoy having one to one time with staff and does different activities such as ironing their own clothes or using the washing machine. Within this is a risk assessment that explains the limited understanding that this person has of potential dangers such as not always being aware that touching the face of the iron would result in an injury to them self. This person can display challenging behaviour. An iron could be dangerous to them self and others. However appropriate measures were put in place by staff to protect the person and others. This included: Q should be supervised at all times when using an iron or near a hot iron. Q must use the iron in a place with few distractions and not in crowded places. Safest places recommended included their own bedroom or the laundry room. In the support plan staff are advised to ensure that when the person is using the iron they must be seated to avoid them losing their balance and injuring them self when ironing. If they display challenging behaviour whilst using the iron and board they should be redirected to another area and non verbal communication intervention techniques used. Physical intervention would only be used as a last resort. For another person their risk taking was assessed as being in need of all assistance accompanied by two staff most of the time; to ensure correct administration of medications and to avoid situations where self injury could result. Issues such as sexuality is also included and fully explored to allow people to receive the assistance they may need with special mention of the need for privacy and to be treated with dignity to meet those needs. Each of the care plans goes through a list of things that the person can or cannot Care Homes for Adults (18-65 years) Page 20 of 37 Evidence: understand (capacity issues) and their ability to be able to have an input into their own care planning, as an example. Other people told us that they knew who their key worker was and that they found staff at the home: helpful for arranging holidays and events at Christmas time. They also said that they found staff: helpful when they wanted to visit the shops and to go shopping. In this way people are supported to carry out the choices that they make. Care Homes for Adults (18-65 years) Page 21 of 37 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are actively encouraged to be independent and to be involved in all areas of the home wherever possible. People are encouraged to enjoy a full and stimulating lifestyle with a variety of options to chose from and routines are made flexible to suit their needs and desires. Evidence: We spoke with staff who said that they regularly took people out in the vehicles provided for individuals at Ashfield Court using transport provided for specific individuals as a result of their mobility vehicle allowances. There are seven vehicles for taking individuals out, this includes using the four community vehicles provided by Ashfield Court for each of the bungalows. This encourages independence as people go out as part of their one to one or two to one activity. We saw that there were people who went out to work and college. Others went out to places of interest to them such as shopping, the cinema or the swimming baths. Care Homes for Adults (18-65 years) Page 22 of 37 Evidence: Comments from surveys included: Staff take me out on activities, take me to places that I want to go to and listen to what I say. Other comments included: The home supports me so that my needs can be met. I like the facilities provided. I am helped with education and placements. I have a daily programme organised for me to take part in. I would like to go out on more week end trips. I feel the home does everything well and after a night out I am always itching to get back to Ashfield Court. We saw activity pictures in each bungalow of each person’s activities throughout the day and photographs of the staff that accompanied them. In the care and support plans we saw there was consideration given to sexual aspects and desires. It was carefully and sensitively documented including the role of the staff for providing assistance and privacy to allow sexual feelings to take place. We spoke with one of the parents of someone that we observed. They explained that their relative went out to bowling 2 to 3 times a week and regularly went into the community. Comments about care from relatives included: My relative has come on tremendously since being here. Staff will pull everything out to please people here, they even use their own time. Im always in contact with other parents and we find that staff are always doing some activity with the people who live here. Peoples care and support plan reflected how they were to be supported and what choices they were able to make. We saw care plans that included aspects of the Mental Capacity Act 2005 and Deprivation Of Liberty Act with each point covered carefully. This was also evidenced through discussion with individuals at the home who spoke about access to community activities as well as activities within the home. Menus are available that reflects peoples individual choices and a balanced diet and there is evidence of independent food buying and preparation. The AQAA tell us that: There is a policy on service users’ rights and equal opportunities as part of the support for peoples individual life style choices. The AQAA continues: All care plans have been updated in the last 12 months and provide more information on the needs and wishes of the individual. The level of community activity and community Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: access within the home has improved. Programmes are evaluated on a daily basis. We saw care and support plans and spoke with people who live in each bungalow who were also able to verify this. Comments from a relative included: My relative loves living here and we feel that they have been making good progress. Care Homes for Adults (18-65 years) Page 24 of 37 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. Peoples health care needs are delivered in a way that is supportive, responsive and consistent. Evidence: There is a photograph of each person in their care and support plan and a detailed description of their physical build. This is to help newer staff identify a person and can be used to assist someone should an individual from one of the bungalows become lost in the community. We saw care plans that were effective by detailing individuals needs stating how the staff should support someone who they provide care for. If a person needed support with moving and handling this was included. If they were taking part in an activity the risk within the activity was clearly stated and ways of handling the risks. People who we spoke with were able to say how they were provided with the help or support that they needed to lead a full and active life. We spoke with staff that were able to describe their role when helping people to become independent. People are encouraged to make decisions regarding the way they live. The care and support plans show how people are supported and assisted in a way that they prefer. Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: The diversity of the staff includes male and female workers to ensure that individual preferences can be met. Records show that peoples health and emotional needs are being appropriately met. At inspection people we spoke with told us this and relatives also confirmed this. Surveys from the Commission, completed by people living at Ashfield Court were completed with the assistance of key workers (in many cases). Comments included: The home supports me, to meet my needs. When I have a nightmare the staff are there and help me to feel better. Staff look after me. Parents comments included: Staff are always polite and communication is good. My relatives needs are all met and they appear happy. Another relative wrote: We continue to be satisfied with Ss care and we feel the home communicates well with us as parents and ensures that S is well cared for at all times. Another parent wrote: We feel that the environment provided is homely and we are happy with the service. When we spoke with one of the relatives by telephone they said: The Psychiatrist makes out of hours visits and recently saw our relative. Staff and management are very supportive with anything concerning the care of my relative and this includes follow up appointments. We looked at the medication records of two people they were satisfactory. We were told that there were no controlled medications on the premises. None of the people using the service at the time of inspection had been assessed as safe to administer their own medication. Care Homes for Adults (18-65 years) Page 26 of 37 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. People at the home have access to a complaints procedure that is made easier for them to understand. Staff are trained to be able to identify when help is needed to protect the needs of the people they help and support. Evidence: People are provided with information that contains a copy of the complaints procedure. This information is also found in the main reception area of the home and in each individual bungalow. The homes complaints records show that there have been no formal complaints since the last inspection although any issues or concerns are recorded and resolved. We have not received any information about any recent complaints or unresolved issues within the home. We spoke with two relatives who explained that when they had any problems or concerns they were dealt with promptly and appropriately and they were satisfied with the outcomes. There are policies for Safeguarding Adults. We spoke with staff who were able to explain their role in alerting their senior managers if they had a concern and understood their roles and responsibilities in ensuring that peoples needs were being met. Care plans show that staff have been given guidance on how to deal with people who are physically or verbally aggressive. Staff receives training which is accredited in physical and non physical interventions. We spoke with staff at inspection who said that they felt Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: supported by other staff and would feel confident to deal with behaviour challenges that they may face during the course of a shift. We checked the records of two people and found that there were measures to keep peoples money safe although sometimes staff did not always check that there were two signatures on the records. However, people at the service felt that they were provided with access to their money and had independence. Care Homes for Adults (18-65 years) Page 28 of 37 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 bungalows are well presented and offers a clean, comfortable and homely environment for the people who live there. However, there may be areas that should be included in the re decoration programme. Evidence: Comments from people who live at the bungalows included: The home is kept clean and I am able to have regular baths and showers. Further comments included: I am happy with where I live and with the facilities provided and that my bungalow is kept clean and tidy. Parents comments included: We are generally happy with the arrangements. Occasionally, depending on which staff are on duty the cleanliness of the toilets could be improved by staff checking when someone has used the toilet area. We sometimes find that repairs are not done quickly examples of this are broken toilet seats. Sometimes repairs seem to take a long while. We saw a copy of the rota. There were two domestic staff for cleaning of the bungalows and one maintenance person who worked a thirty seven hour week. Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: The AQAA tell us: The internal decoration including choice of colours for people who live in the bungalows is on ongoing process. Some people have had new bedroom furniture. A new orchard of fruit tress have now been planted. When we visited the bungalows we noticed that the premises are mainly kept well decorated although in parts there are signs of wear and tear. (Bathroom areas). The bungalows are well presented and offers a clean, comfortable and homely environment for the people who live there. A friendly environment is provided for the people at Ashfield Court. People are encouraged to keep their environment clean, tidy, safe and odour free. We saw that people are encouraged to make their bedrooms individual to them. The grounds were paved for ease of access to anyone who needed to move from one area to another and were kept pleasant, clean and tidy. Care Homes for Adults (18-65 years) Page 30 of 37 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 at the home and their relatives are confident that staff knows how to care for them. Training provided for staff is targeted at meeting peoples care needs. The recruitment policy is effective and ensures that the service is delivered in an effective way. Evidence: There is a manager for each bungalow and a team of dedicated staff to provide care for people in the bungalows. Photographs of staff members on each shift is displayed on the walls of each bungalow. Regular staff visitors are also seen on the wall so that people within the bungalow can identify people who are visiting their home. Staff training includes an induction to Ashfield Court, Fire safety, Food Hygiene, Health and safety, Moving and Handling, Medication and First aid. A large percentage of the staff have a National Vocational Qualification in care at level two or above. There are in house trainers for moving and handling, infection control, autism, adult protection, person planning and behaviour management training. Staff receives regular supervision and have regular staff meetings to discuss aspects of care and to find out about changes that affects the way they work. External students also do placements at the care home. These include Social Workers and Students nurses. Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: A key worker system is in place and people told us that they liked their key workers as they: looked after them and talked with them when they had any concerns. We looked at two staff records and they had all the correct procedures in place to show that safe recruitment practises are followed. A parents comment from the Commissions survey: Zs likes and interests are always considered with Z. Zs key worker is very good with this role ensuring that Zs needs are met and communication between staff and family is very good. Z has settled very nicely into the bungalow where they live and appears happy whenever we visit. Another parent wrote: My daughter is very well cared for. We are extremely satisfied with all aspects of Qs care and know that if major problems occurred we would be kept informed. Recently we were helped through a difficult time and the staff were able to tell Q for us. Care Homes for Adults (18-65 years) Page 32 of 37 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. There is a strong ethos at the home of being friendly and transparent. The views of the people who live there and their relatives is listened to and valued. Evidence: The Registered Manager for this service has been on long term sick leave however we have received regular updates through the Regulation 26 site visits by senior managers of Ashfield Court that have indicated that the service continues to run well. On the day of inspection we were assisted by the Registered Manager, deputy manager, other staff and relatives. The Registered Manager attends regular meetings and acts as an employer champion by encouraging the use of apprenticeship schemes. There is an array of company information leaflets promoting staff at the service. This is made available for staff and visitors to see and read. We saw minutes from meetings for the people who live at Ashfield Court and minutes of staff meetings. Care Homes for Adults (18-65 years) Page 33 of 37 Evidence: We saw copies of quality assurance surveys and actions taken as a result of them. The manager at this home has ensured that there is a regular investment in the training provided to all staff who work at this care home. Staff were sent a memo as a reminder about the use of modern technology websites such as face book they were reminded not to comment about work issues or to use their mobile telephones when at work and reminded about the circulation of fake money where staff were asked to be extra vigilant to avoid such situations. However, a warning about the risks of disclosing confidential information and action that may result could have been included in this memo to staff. Comments from relatives included: We were very pleased that when a small problem arose we were able to meet with the consultant that visits people at the home at very short notice. In other parts of the care industry this would have taken months. Another relative commented: We find the staff to be supportive, respectful and friendly. We are satisfied with the care that our son receives from all staff members at Ashfield Court and know that any issues that arise are promptly addressed Care Homes for Adults (18-65 years) Page 34 of 37 Are there any outstanding requirements from the last inspection? Yes  No  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 35 of 37 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 Description 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 Description 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 36 of 37 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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