Care Home: Ashridge

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What the care home does well People coming into this home receive sensitive, individual and detailed assessments. The staff go out of their way to ensure that they can meet each persons needs. People are encouraged and supported to make choices about what they wish to do and contribute to the running of the home through the monthly "Your Voice" meetings. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. The people like the way the home is run, and enjoy staying at the home. There are plenty of activities for the people to enjoy. Staff communicate well with them, and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. They are in turn lead by an experienced manager who has knowledge about the needs of people with a learning disability. There is a comprehensive programme of education and training provided for staff, which ensures that staff know how to care andsupport the people who live at the home. The staff feel valued by the management and feel part of a team to improve, to help and support the people living in the home. What has improved since the last inspection? Over the last year a programme of refurbishment has taken place to include installation of new double glazing to the dining room, hallway, half landing and door to the new conservatory leading off the lounge in the main building. New flooring has been laid in the lounge and it has been redecorated and new furniture is on order. New flooring has been provided in the shower room on the ground floor as well as new dining room furniture and chairs. In addition, new hallway furniture has been provided and the office refurbished. The range of activities has been reviewed and more activities have been provided in the evening. All these improvements have fully involved the people living in the home and they have decided what they want to do and how they want the home to be run. These initiatives have empowered the people living in the home to have greater control over their lives. This has resulted in the people being involved in interviews for new staff and representing their views at the companies regional quarterly "Your Voice" meetings. What the care home could do better: All the requirements from the last inspection had been addressed. There were no requirements from this inspection. We discussed with the manager our observation that some of the carpets in corridors and on the stairs were very worn and needed replacement. The manager acknowledged this and told us that they would be replaced in the future and there were also plans for the kitchen to be refurbished in the future. We also noticed that some of the information did not have either our new name, address and telephone number and she agreed to amend this where required. Key inspection report Care homes for adults (18-65 years) Name: Address: Ashridge 14 Tower Road Boston Lincs PE21 9AD The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tobias Payne Date: 2 6 0 8 2 0 0 9 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 29 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: Ashridge 14 Tower Road Boston Lincs PE21 9AD 01205366922 01205354957 ashridge@craegmoor.co.uk Craegmore.co.uk Park Care Homes (No 2) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jackalynne Shields Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 19 1 care home 20 learning disability Additional conditions: One bed in the category LD may be used for a service user under the age of 18 until their 18th birthday is reached. This person is named in the Pre Registration Letter dated 9 December 2005. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Learning Disabilities (LD) Learning Disabilitiers over 65 years of age (LD(E)) The maximum number of service users to be accommodated is 20 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home Ashridge is a detached town house situated approximately half a mile from the centre of the market town of Boston. The town has a wide range of amenities including shops, pubs, restaurants and a swimming pool. Accommodation is on two floors in the main building, and there is a single storey annex to the rear of the property known as The Beeches. The home is registered to provide personal care for up to 20 people; 12 in the main building, and 6 in The Beeches. At the time of the inspection each bedroom was being occupied by one person despite there being 2 double bedrooms. The Beeches provides the opportunity for some of the people to develop skills in a semi-independent living environment. The home has extensive and well-maintained gardens. They contain lawned areas, patios, vegetable plots, a summerhouse and a barbecue area. The philosopy is at Craegmoor we listen to and involve each individual in our support and care services, as no one guides and influences us better. Together we create opportunities for every one to achieve their personal goals. The weekly fees on the day of our inspection visit ranged from £421 to £721 Extras were for chiropody £12. Information about the home including the statement of purpose, service users guide and a copy of the last inspection report can be obtained from the manage of the home. Most of this information can be made available in an easy read format in words and pictures to aid understanding Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The previous key inspection was on the 4/7/2007 The inspection which was unannounced took place over 6 hours. The registered manager was present throughout the inspection and was given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting 2 people and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and the people living in the home and related care practices. We looked at a sample of care records, looked at and walked around the home to see the quality of accommodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 5 people living in the home, as well as 4 members of staff. An (AQAA) Annual quality assurance assessment was completed by the manager and sent to us prior to this report being completed. This is a selfassessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. The AQAA was clear and detailed. Care Homes for Adults (18-65 years) Page 7 of 29 Where we or us is used throughout this report it refers to the Care Quality Commission. What the care home does well People coming into this home receive sensitive, individual and detailed assessments. The staff go out of their way to ensure that they can meet each persons needs. People are encouraged and supported to make choices about what they wish to do and contribute to the running of the home through the monthly Your Voice meetings. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. The people like the way the home is run, and enjoy staying at the home. There are plenty of activities for the people to enjoy. Staff communicate well with them, and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. They are in turn lead by an experienced manager who has knowledge about the needs of people with a learning disability. There is a comprehensive programme of education and training provided for staff, which ensures that staff know how to care and Care Homes for Adults (18-65 years) Page 8 of 29 support the people who live at the home. The staff feel valued by the management and feel part of a team to improve, to help and support the people living in the home. What has got better from the last inspection Over the last year a programme of refurbishment has taken place to include installation of new double glazing to the dining room, hallway, half landing and door to the new conservatory leading off the lounge in the main building. New flooring has been laid in the lounge and it has been redecorated and new furniture is on order. New flooring has been provided in the shower room on the ground floor as well as new dining room furniture and chairs. In addition, new hallway furniture has been provided and the office refurbished. The range of activities has been reviewed and more activities have been provided in the evening. All these improvements have fully involved the people living in the home and they have decided what they want to do and how they want the home to be run. These initiatives have empowered the people living in the home to have greater control over their lives. This has resulted in the people being involved in interviews for new staff and representing their views at the companies regional quarterly Your Voice meetings. Care Homes for Adults (18-65 years) Page 9 of 29 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 If you want to speak to the inspector please contact Tobias Payne CPC1 Capital Park Care Homes for Adults (18-65 years) Page 10 of 29 Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 11 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 12 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 living at this home receive clear and detailed information to suit their needs to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home careful and sensitive assessments take place for each person being admitted to the home to ensure that it meets their needs. Evidence: There was a large information folder in easy read format which included information about the home and had a copy of our last inspection report. The service users guide and brochure were in words and in an easy read format with pictures. Although there was a detailed and up to date statement of purpose it was not yet in this format. The manager told us that the last admission was in November 2008 and there was an established group of people living in the home. The manager told us that where a referral was received she would visit the person to assess their needs and ensure that they could meet their needs. The process could also involve inviting them to visit the home for the day, later on invite them to visit and see or take part in an activity and later stay for an evening meal or overnight stay. The process was to ensure it did not cause distress to Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the person and ensure a smooth transition took place. During this process the manager told us information was obtained from the person their family and other people connected with their care and support. Written confirmation would then be sent to confirm the home could meet their needs based on this assessment. One person we spoke with told us I knew the home as I had been here before. I like being here and everyone is very nice. The manager also told us where requested or required an advocate could be arranged to assist the person. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is detailed care planning which includes risk assessments. People enjoy choices about what activities they want to get involved and have a varied social programme. People are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Evidence: Each person had a care plan which outlined their care and support needs. The records included, personal information, their likes and dislikes, photograph, care plan ,communication record, my health action plan and a detailed initial assessment. From this a care plan had been produced which was clear and detailed. The care plan outlined my need/choice/problems, outcome I would like, the support I need/instructions for staff and review date. Each aspect of care and support was very detailed and specific to each person. There was also an information book for hospital with comprehensive information in case a person was admitted to hospital. There was evidence of review dates and the care plan was reviewed monthly. Care plans were individual and the daily records well written, factual and dated and cross referenced with the care plan. During the inspection Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: visit we saw staff offered and respected choices and were flexible in their approach with good clear communication skills towards the people. The manager told us there where needed care plans would also include a capacity assessment. We saw staff throughout our visit talking and communicating with the people in a kind, calm and sensitive approach respecting their views and opinions. Choice and decision making was clearly shown in the care plans. The people were given choice concerning their interests, activities and lifestyle. Staff received training to assist and support them. This information enabled staff to understand and support each person. All entries were dated with signatures from their key worker and where ever possible the person themselves to show their agreement to what was written about themselves. The manager told us that some of the people arranged where they wished to have their reviews and who they wished to attend as the review concerned them. We looked at the financial records for the people living in the home. They were well maintained with receipts and signatures. Records were kept securely. We also saw assessments of how the people were able to manage their monies. The manager told us that some of the people chose to manage their own finances. The manager checked the financial records every week and they were audited by Craegmoor twice a year. During the visit the people we spoke with told us how they are supported to make decisions and choices about things like meals and activities. People told us I choose how I spend my time, I am going out shopping today and later I will go bowling and I tell my key worker what I want to do and we do it together. Staff we spoke with told us of the support they gave to enable the people make choices about the decisions they made each day concerning what clothes to wear, what they want to eat and where they want to go. They also talked about how they help the people to maintain and develop their independence. There is a large kitchen available for the people to be able to do this with the support and guidance from staff but the manager told us that it was no longer suitable and was to be refurbished and made more accessible for the people to cook with the support and supervision of staff. Care Homes for Adults (18-65 years) Page 16 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 involved in meaningful and appropriate activities, which include educational and recreational activities. They enjoy varied and nutritious meals which within their capabilities they are involved in. Evidence: The manager told us that they had reviewed the range of activities available as a result of discussions with the people who lived in the home. They had wanted more activities in the evening and the staffing rotas had been changed to enable this to take place. We saw on the notice board details of activities throughout the seven days and a large board produced by the people with photographs of the activities which had taken place . There were also a wide range of home and community based activities. On the day of our inspection visit several people were going into Boston for a shopping trip. We could see that these arrangements could be flexible reflecting the persons wishes on the day. There were also a range of other activities, which included trips to Skegness which we were told was very popular, golf, theatre nights, walking along Frieston shore, country walks, cinema, visits to parrot world, monster trucks as well as local pubs. Other Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: activities included local churches, Gateway club and morris dancing. The manager told us that some of the people had been on an annual Holiday in Great Yarmouth. There was a people carrier available. The manager told us that they were exploring opportunities for education in horticulture and horse riding. In addition 3 people had work experiences in local shops. The manager also told us that a newsletter Ashridge News is to be provided in the very near future and thereafter every 2 months. Photographs of all staff were displayed at the entrance to the home and at the request of the people a notice board with the photographs of staff on duty for each shift. There was a monthly Your Voicemeeting. The agenda was drawn up by the people and at this meeting people were involved in choosing food, deciding on activities as well as other issues. As a result of the last inspection by Boston Borough Council on the 21/4/2009 they were awarded a bronze award in recognition of the catering standards. The manager told us that this rating had gone down from silver to bronze on account of the unsuitable facilities in the kitchen. All issues had been addressed and this situation would be improved further by the refurbishment in the future of the kitchen which will improve standards and facilities. People within their risk assessments were supported and guided in cooking or preparing food or helping in the kitchen. All staff were required to prepare meals and all had food hygiene training provided. Food records on the day of our inspection were detailed and up to date. We were told that the people had requested occasional themed food nights and these had proved to be very successful and enjoyable. People we spoke with told us they liked the food and it met their needs. People living in the adjacent semi-independent bungalow are responsible for their own individual shopping, menu planning and cooking with the support and guidance of staff. Care Homes for Adults (18-65 years) Page 18 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that peoples health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. Evidence: We saw staff throughout our inspection visit show a person focused approach to care, using a flexible, sensitive and relaxed approach. Each person was registered with a local doctors surgery and other services such as psychology were available by referral. Each person had a detailed Health Action Plan, a nationally recognised health check assessment and a health profile. In addition each person had an information book for hospital with comprehensive information in case a person was admitted to hospital. There were also clear plans and risk management strategies in place for supporting people with behavioural needs. Where required we were told staff would accompany people to hospital visits. Care staff were responsible for medication and did this after they had been assessed as competent to do this. Craegmoor had assessment criteria and additional training was provided by distance learning. Records were well maintained with receipt and disposal records. The manager told us there were 3 people who wished to give their own Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: medication and had been assessed as safe to do so. Other people needed assistance with medication to ensure it was given safely. We also saw that Craegmoor as part of their quality assurance carry out medication audits throughout the year. The last was in July 2009 at which they scored 89 . We saw staff giving out medication to the people which was done in a calm, friendly and professional manner. We saw that care records gave information to staff about the individual care needs and preferences for each person and they were involved in the devising and updating of their own plans where this is possible. Their emotional, health and medical needs and input were identified within the care plans seen. Care Homes for Adults (18-65 years) Page 20 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. Complaints received were treated properly. Staff are recruited correctly to ensure that the people were protected from abuse. Staff have a good knowledge of the adult protection procedures Evidence: Each person had a pictorial complaints procedure in their care records. The home had a complaints book and information provided by the manager told us thay had received one which had been investigated by the service using their complaints procedure but the particular complaint had not yet been concluded. We could see a good audit trail with letters to the complainant keeping them informed of progress over their complaint. We had received no complaints. We had been aware of 33 safeguarding adults issues over the year all of which had been refered to and investigated by Lincolnshire County Council in line with the correct procedures. We had been told by Lincolnshire County Council that they had received full co-operation and assistance from the manager of the home throughout their investigations. There was an adult protection policy and all staff as part of their induction received abuse training. The home also had a copy of Lincolnshire County Councils adult protection procedures. We spoke with 2 members of staff who knew about abuse and what they should do if they suspected abuse. During our visit no person living in the home or staff had any concerns about the home. Care Homes for Adults (18-65 years) Page 21 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 clean, safe, and comfortable accommodation suited to their needs. Evidence: Over the last year there has been an extensive programme of refurbishment which has included new windows, new conservatory, new furniture and renovation of the summer house. The manager told us that there is to be further refurbishment in the future to include a new more accessible kitchen and new carpets in the corridors and stairway as they were worn. The home is in extensive gardens which had vegetable gardens where people were involved in producing their own vegetables for the house. There were various sitting areas in the garden. Each person had their own bedroom. Communal spaces included lounges for each part of the home as well as other sitting areas and a newly decorated and refurbished dining room in the main building. Their bedrooms were individual and the people were involved in choosing colours and decorating their bedroom if they chose to do so supported by their key worker. They also told us they were able to keep their room the way they awished and that they were responsible for the tidiness of their room with the support and guidance from their individual key workers. The people told us I like my bedroom, it is how I like it and I have chosen the colours for my room and I like to spend time in my room. On the day of our visit people were either in their bedrooms or in the lounge, conservatory or in the garden. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well-trained, established, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: Each person living in the home had a key worker. Staff were responsible for care and there were other staff employed for catering, cleaning and gardening/maintenance. People with the support and guidance from staff washed their own laundry and cleaned their rooms. The manager told us she ensured that staff had the skills to support the particular needs of the the people. We saw recruitment records for 2 members of staff. These records showed they had been safely recruited with a check by the Criminal Records Bureau, application form, 2 references and proof of identity. Craegmoor requires each person during the recruitment process to undertake a basic skills literacy assessment. The company also ensures that representatives of the people living in the home are involved in the interview process for staff and managers. Once recruited each new member of staff had an initial supported 1 week induction, after that they received a nationally recognised common induction programme over 3 months. Thereafter they would be offered the opportunity of studying for a National Vocational Qualification in care. Records we saw confirmed this and the manager told us that 75 of staff had obtained an NVQ and 3 staff were working for this. In addtion, 4 staff had obtained NVQ level 3 and 3 were working towards this. Training over the last year had included, basic Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: food hygiene, equality and diversity, fire safety, first aid, health and safety, infection control, moving and handling and safeguarding adults. The manager also told us that staff had received training about manageing challenging behaviour and this would be developed further. Other training had included medication dementia awareness, record keeping, person centred thinking and British Sign Language (BSL) and Makaton to improve the communication skills of the staff. We spoke with 2 members of staff who told us there is alot of training provided as it is very important, I receive regular supervision every 2 months and an appraisal every year and the training and support is very good. There was an equality and diversity policy and a number of staff from outside the UK were working in the home. There were no equality and diversity or communication issues. The staff felt they could meet the needs of the people living in the home and felt they had sufficient time. During our inspection visit we saw staff taking particular time to communicate to the the people in a calm, kind, friendly and sensitive manner. 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. People and staff benefit from the positive leadership of the management team. Management record systems show that peoples health, welfare, safety and choices are promoted. The management team ensures that the people living in the home with the support of the staff, relatives and staff have the opportunity to voice their views and opinions. Evidence: Since the last inspection we registered in February 2009 a new manager for the home. This person had worked in the home since 2005 as the deputy manager and had many years experience in care and support and was studying to obtain a management qualification. Staff we spoke with told us they had confidence in her and spoke of the supervision and support received. Throughout our visit we saw a very relaxed and happy atmosphere in the home and staff showed knowledge about the needs of the people lving in the home. The people told us Jacky is the best manager we have had and she is always there if I need to talk to her, she and the staff are very good to us and I like living here and the staff are my friends. Staff we spoke with also echoed these views. Comments included all the people are treated with respect, I have noticed a lot of change for the better, there is more space now with the new conservatory and the home Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: looks better and Jacky consults everyone about aspects of the home. Craegmoor had an established quality assurance system which included internal quality clinical governance audits in the form of a comprehensive service review and internal audits by the manager the last being in July 2009. Other audits had included infection control, health and safety and medication. There were monthly staff meetings with minutes and the home had comprehensive policies and procedures. During our visit we found records easy to find up to date and the office well organised. The company made monthly unannounced monitoring visits and detailed reports were available with action plans where there were issues found during the visit. Where money was kept on behalf of the people living in the home the records were well maintained. The company also had an employee of the month award which was open to everyone in the home to nominate by secret ballot the member of staff they felt was the best. The views of the people living in the home were very important at the monthly Your Voice meetings. The agenda was drawn up by the people with the support from staff. The manager told us about a representative going to a quarterly regional meeting representing the home. The manager told us that a representative of the home was also going to meet the Chief Executive Officer for Craegmoor representing the home and this group. Minutes of all meetings were in pictorial and easy read symbols. Craegmoor carried out a survey of peoples views in July 2009 and the results were not available as they had just been returned to company head office for analysis. The home had a comprehensive and detailed health and safety policy together with detailed risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were no concerns. There were regular tests of the fire system as well as regular fire drills. Care Homes for Adults (18-65 years) Page 26 of 29 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 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 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 28 of 29 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!