Care Home: Astor Hall

What the care home does well The new owners and new manager of Astor Hall encourages and supports staff training and development ensuring that people who live at the home receive the best possible service. The new owners have a commitment to continue to update and upgrade the home to ensure the environment is comfortable and suitable for the people who live at the home taken into consideration. The home provides a good range of activities to meet individual`s choice. The expert by experience wrote in their report, "All of those spoken with were quite vocal about the social life they enjoyed and one resident said he had come in for respite care, enjoyed living in the home and asked to stay ("I refused to go home") and he said he enjoys living at Astor Hall, "it`s a very sociable place, it`s comfortable and I`m treated with respect". What has improved since the last inspection? Several of the bedrooms have been redecorated to include new carpets and new furniture. The main entrance hall has been decorated and the lounge has the benefit of a large screen TV. What the care home could do better: The new manager must register with the Commission. The medications records must be completed accurately to ensure that the omitted medication procedure is followed. All medication used must be in date. Key inspection report Care homes for adults (18-65 years) Name: Address: Astor Hall 157 Devonport Road Stoke Plymouth Devon PL1 5RB     The quality rating for this care home is:   one star adequate 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: Kim Fowler     Date: 1 6 0 3 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Astor Hall 157 Devonport Road Stoke Plymouth Devon PL1 5RB 01752562729 01752565390 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Astor Hall Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service who can be accommodated is 26. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Physical disability (Code PD) Date of last inspection Brief description of the care home Mr James Sutherland now owns Astor Hall. This large home is situated in the Stoke area of Plymouth and can accommodate 26 people with a physical disability over the three floors. The dinning room, lounge and kitchen are on the ground floor with a quite lounge on the second floor. The home has a shaft lift and is fully wheelchair accessible. All bedrooms are single with adapted bathrooms available. There is parking to the front of the building and a large patio garden for people to enjoy. The minimum fees start at 500 pounds however this may change depending on needs. 26 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place over 1 day and started at 9:40am and finished at 4:40pm on the 16th March 2009. The homes manager was available throughout the inspection. An Expert by Experience was also available for part of the inspection. An Expert by Experience is a person who, because of shared experience of using services and/or ways of communicating, visits the service with an inspector to help them get a picture of what it is like to live in the service. The inspector made a tour of the building and spoke to most of the people living in the home. Documentation relating to the care planning process and the management of the home were examined. Any comments are in the relevant section of the report. Care Homes for Adults (18-65 years) Page 5 of 30 Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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 7 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective new admissions referred to the home can be assured that they will be provided with sufficient information for them to make an informed choice about living at this care home. Evidence: All files examined contained a pre-admission assessment. Also in place were the placing authoritys detailed care plans. The Manager will visit any prospective new admission to gather information to completed the pre-admission assessments. From discussion with the manger she was aware of the admission process. These documents are important for prospective new admissions to assure them that not only can their health care needs be met but also their emotional, social, cultural or religious needs. Other people spoken with stated that they had known the home for many years. Many had attended the day centre or come in for respite care before choosing to live at the home. Care Homes for Adults (18-65 years) Page 9 of 30 Evidence: Some people living at the home were spoken with about their admission. One person was able to confirm that they had received information prior to moving in and another said, I came for a short stay before I moved in. The homes AQAA states, All Residents are pre-assessed in detail prior to them coming to Astor Hall. Care Homes for Adults (18-65 years) Page 10 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to make daily decisions as much as possible about their own lives to maintain their independence. Evidence: Five files were examined and each held individual care plans in place and the details held on these files are needed by staff to met individual needs. These care plans show a breakdown of the services and facilities provided by the home as well as current needs, specialist input and guidelines for staff to manage people who can have restriction on their communication. Each individual plan provide staff with the information on how to care for each person and ensure continuity in care and have been completed to enable staff to carry out their duties. All plans ensure that all aspects of health, personal and social needs will be met. Each persons file held information on all aspects of individual care including, a list of professional involved with individuals, money and how and who manages this and information on medication currently being taken. Both files showed that regular Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: reviews and update were undertaken and that each person was involved in these reviews with family members in attendance at times. Some people spoken with confirmed that they had been involved in updating their care plans and also that they asked about specialist equipment they required to meet their individual needs. This ensures that everyone has the required equipment to maintain their independence. Observation showed that staff encourages each person to be as independent as possible and included staff assisting people to make everyday choices. Some people living in the home are more independent and go out on their own. One person confirmed that they visited the local shops on his or her own. Other people use a local taxi firm for transport. The expert by experience received the following comment from someone living in the home, I came back, I have a good care plan, I left for a while, I wouldnt leave now Im settled. The homes AQAA states, All Residents who have the capacity to make decisions regarding their lives are encouraged to do so wherever possible. Each file held individual risk assessments for both outside and in-house activities and how each activity could be managed safely for both the staff member and the person concerned. This information is important to minimise risk for all and is updated if a new activity is undertaken. How the home manages any money held for individuals was discussed. This showed that the home had a clear audit trail for any income expenditure and receipts held were needed. All people have their own bank account and only a small number of people have their money managed and held by the home and people are encouraged to have family involved or a receivership officer assists with this role. Care Homes for Adults (18-65 years) Page 12 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in Astor Hall can be confident that the home will promote and provide support for them to access the local community and leisure activities as much as possible. Evidence: Most of the people living at the home were spoken with and some were able to that confirm that they go out to different places and include local shops, the local city centre and visits to the theater. The staff spoken with were able to confirm that the home arranges day trips as well as in house activities. A Dog Show is arranged for the Easter weekend. Observations during the inspection were several people discussing with staff the plans for future activities and included a planned BBQ. The home employs two staff designated to organise and arrange all day care activities and several people come Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: into the home for day care only. The manager confirmed that people living in the home attend a variety of outside day courses including one person hoping to attend college in the new term and another who has a work placement. Several other people had information recorded into their files of the work they undertake. The home arranged different activities within the home and in the community to ensure each person has a wide range of activities. One person living at the home reported to the expert by experience, I am happy here there is a good social life we go to a social club on Saturday and weve been skating. The homes AQAA records under what they do well,Offer our Residents who vary considerably in age and disability, more appropriate in house activities that would help to promote their interests and independence. Information was recorded into individual files of the input from relatives and friends. The staff confirmed that several people have regular visits from family members and some people visit the families at home. One person said, My family visit me. The expert by experience wrote in their report that one person had stated the following, if they went out and were likely to be late back for a meal, one would usually be put aside for them on their return, as long as they told the staff they might be late back. Observation throughout the day was people living in the home participating in daily routines including collecting their laundry and several people were able to confirm that the staff knocks on their bedroom doors to gain entry. Information held on files is used to promote the respect, privacy and dignity of each person living in the home and the home and the grounds are assessable for wheelchair access. As Astor Hall runs a separate day care service on site many of the people living in the home are encouraged to join in. Theses designated staff employed to run the day care encourage individuals to participate and pursue their own interests. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: The home is within easy reach of local shops and amenities where people can go independently if able or with staff support. Observed during the inspection was person ordering a taxi to go to visit a friend independently. Other people were able to say that they go to the pubs and city centre shops and participate with local events and in particular the theater. The home has one mini bus to access for any trips arranged and hire a second bus if needed. Everyone has a key or are offered a key and those who do not wish to have a key have this information recorded into individual files. Observation during the inspection showed staff and people living in the home interacting with each other and some people remaining in their own rooms. One person confirmed that it was their choice to stay in their own room, however staff would pop in regularly to check on them. Everyone spoken with about the food and who were able made positive comments. One person said, The food is fine and another person stated, There is a choice for me. The management confirmed that there is a menu available but it is discussed with the people living in the home regularly to change and update it as needed. The lunchtime meal observed being served consisted of Sweet and Sour chicken or chicken and leek pie. Both served with fresh vegetables and potatoes and a choice of desserts. Including blancmange and apple crumble and cream providing evidence that individual choices of food were offered. And that fresh product were used with the home employing cooks to organise the ordering and menu planning. The meal was well presented and freshly prepared and the menu showed a varied choice was offered. Further observation during this meal served provided evidence that everyone has staff support and specialist equipment if required and this promotes independence at meal times. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People could be placed at risk by poor medication administration and recording practices. Access to health care is maintained to promote the wellbeing of all who live in the home. Evidence: All personal support is recorded into individual care plans and these are easily accessible for staff and all rooms are single. Individuals who require assistance with moving has a moving and handling risk assessment to assist staff on how each person prefers to be supported. The manager confirmed that an Occupational Therapist assisted drawing up plans when needed. This ensures consistency in the care provided. These care plans are based on assessed needs and evidence was recorded that these are regularly reviewed and then signed. Guidance on personal care is clearly recorded into individual files and this ensures that staff are aware of peoples needs and will promote consistency in care. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: The effective and friendly staff team meets peoples health and personal care needs and many of the people spoken with confirmed that the staff provides good personal support. During a tour of the home it was observed that peoples privacy and dignity was respected by staff knocking on doors before entering rooms, personal care being carried out behind closed doors and conversations being held that were appropriate to the individual. The expert by experience spoke to many of the people living in the home and reported the following in his report, There were no negative comments made by any of the people spoken with and the expert by experience perceived that users felt they were having generally good experiences and being treated with dignity, respect and understanding of there needs. The completed AQAA states that all everyone living in the home has control of the times they prefer to go to bed. All visits by GPs and other health care professionals are recorded into individual files and any one seeing the District Nurse has a separate file held in their individual bedroom. All healthcare needs are recorded into each care plan. District Nurses were in attendance during the inspection and confirmed that the home provides health care support and that all health care need are recorded and maintained. The District Nurses confirmed that the home has a designated file for each person and that the home and the staff support them with any treatments that need to be carried out and all treatment was carried out in private to promote privacy. This provides access to any health care professional at any time ensuring that all service users health needs are consistent. The files examined provided information on the specialist involved with individuals and this included an Occupational Therapist either at the home or via out patients appointments. This ensures that individuals physical needs are met and that specialist equipment is provided. Other files contained letters for hospital appointments and confirming future dates arranged. These appointments ensure that all individuals have their health care needs are met. The medication system was checked during this inspection. The home uses the blister pack system to dispense medication. The local pharmacist carries out staff training in medication. Some of the staff spoken with confirmed they had completed medication Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: training. However the Controlled Drugs currently being administered were checked and found to be out of date. The Medication Record sheet showed that several people had not received their medication as prescribed; this was mainly due to individuals being out at the time of administration. The manager was advised that the GP should be contacted if people miss medication and this information should be recorded into individuals files. The system for dispensing and recording of medication and in particular the Controlled drug requires updating and regular checks would ensure people receive the required medication. Poor medication systems, administration, recording could place people at risk. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in Astor Hall can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: The present owners have owned Astor Hall for 6 months. During this time no formal complaints to either the home or the Commission have been made. The homes complaint procedure is displayed in the main entrance and is available in large print and other formats if required and the completed AQAA states that the procedure is available in individuals bedroom. This information included how to contact the Commission and the process of how a complaint is dealt with including timescales. This information assists people on how complaints are managed. Some of the people spoken with confirmed that they knew they could make a complaint and some people were aware the home has a complaints procedure. One person said, I would speak to the staff, and another said, I would talk to the manager. No issues of adult protection had been raised by the home and the manager stated that most staff had completed the adult protection training. One member of staff interviewed confirmed that they had attended the Safeguarding training and they Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: understood the process. However during the inspection the manager was observed making a safeguarding alert, this alert involved an outside agency. This observation showed that the manager was aware of the process and the procedure in place and dealt with this alert professionally. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Astor Hall benefits from the ongoing upgrading and decoration work currently being carried out and will provide the people living in the home with a homely, comfortable, clean and well maintained building that has been appropriately adapted to meet their needs. Evidence: The new owners of Astor Hall are aware that many parts of the home require updating. The tour of the premises showed that this updating has already commenced. This included the refitting of several of the bedroom to include new carpets and furniture. The entrance hall has been redecorated and the lounge has benefited from a new larger screen TV for the comfort of people living in the home. The owners have devised a rolling maintenance programmer to ensure that all parts of the home that require updating will have this work carried out. All areas of the home are assessable for people with a physical disability and this included the use of a lift and the annexe area and the first floor can be accessed by a shaft lift. The home is very spacious with wide corridors and large sitting rooms and an activities hall making the home easily assessable for people who have a physical Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: disability. The laundry is well managed and the home was clean and odour free. The home has 2 sluices available on both the accommodation floors. A staff member was observed wearing protective clothing and this staff member confirmed that gloves and aprons are available when needed. Individual bedroom are fitted individual key locks, although this is only of a type that allows the door to be locked from the outside and not to provide secure privacy from the inside. All the bathroom and toilet doors are fitted with a lock that can be overridden from the outside maintaining both the privacy and safety of people living in the home. The homes AQAA states, In the future the new owners of Astor Hall are intending to improve the home with some structural changes and extensive redecoration. They are planning to improve the whole environment and facilities for the Residents, present and future. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training is carried out regularly for all staff to ensure that all assessed needs of the people living at the home are met. Evidence: The staff on duty were observed throughout the inspection responding sensitively and respectfully to each person living in the home and thus were able to use their knowledge of individuals to encourage choice and independence were possible. All staff were observed to be friendly, good-natured, courteous and respectful at all times. They interacted well with the people living in the home and some of the activities sessions observed showed that the staff and the people living in the home having fun in a relaxed friendly atmosphere. Several staff members spoken with felt that the home has sufficient staff on duty to meet the needs of people living in the home. On the day of the inspection there was the manager, deputy manager, one senior care assistance and 2 care staff. Administration staff supported these staff and auxiliary staff including a cook, laundry and Kitchen assistant, one domestic and a handyman were also in attendance. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Observation showed that the staff members on duty were aware of individuals needs and how best to support them. Examination of staff files showed that most staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. One file for a member of staff who was employed at the home before the present owners purchased the home only had one reference on their file and another staff member file showed their were gaps in employments dates that had not been discussed and recorded on why these gaps were their. The manager stated that this would be rectified to ensure two references were obtained and any gaps in employed discussed with individuals. Discussions with manager and the staff showed that all staff participate in and update training course when needed. The training recorded in individuals files show that induction, adult protection, first aid, health and safety, fire safety, medication, food hygiene and National Vocational Qualifications (NVQs) is regularly undertaken. The homes AQAA records that in the next 12 months they will, fully implement and complete all mandatory training for all relevant Staff. Several staff members were spoken with during this inspection and all confirmed regular training was offered. These staff members also confirmed that the home carried out regular supervision and yearly appraisals. One file examined held a recently completed appraisal form. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. One staff member said, I enjoy working here and another said, They provide training. Staff files, staff spoken with and the manager confirmed that staff required updated training including Infection control and medication training. Regular updated training benefits the people living in the home with a well-trained staff team. One new staff member stated that they had completed an Induction programme and shadowed other staff on duty until the completion of their Induction training to ensure the staff had confidence in the care delivered. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The Expert by Experience who spoke to several people living in the home wrote in their report,we have a good team of carers. Comments received from the people living in the home also included, The staff are 200 , cannot fault any of them and another said, The staff are always happy and always look after everyone. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The new owners, new manager and the staff team strive to provide a homely, stimulating environment that respects and protects people who live at the home. Evidence: The previous manager left the home 6 months ago and the new owners have employed a replacement. This manager is not yet registered with the Commission but has plans to do so. This manager is currently working towards their Registered Managers award but has already gained a NVQ 4 in Care. The new manager has worked at the home for a number of years and has many years experience in the care profession. The homes quality assurance forms were held on individual files and the results published and displayed in the main entrance hall for all visitors to see. And the AQAA states that Quality Assurance questionnaires are offered to all. These surveys were completed in 2008 and many held positive comments including, I am happy at Astor Hall and another wrote, I could recommend Astor Hall to care for Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: everyone. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Gas and electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out. The manager confirmed that staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Previous inspections showed that all windows had restrictors fitted and had safety catches fitted. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 All medication, in particular controlled drugs should be audited, recorded and any changes reported to the GP and recorded onto individuals files. This would ensure that all people living in the home receive the correct medication. 26/06/2009 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 2 34 37 All employments checks should be in place to ensure people living in the home are protected. The new manager must Register with the Commission. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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