Care Home: Autumn Cottage

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What the care home does well The manager and her staff are highly knowledgeable, experienced and well trained. The staff are supported well and in turn this gives all residents a good quality of support and care given. The team are very good at including people within the decision making of the home and actively try different ways in which to engage individuals who have difficulty in making their needs clear. Documentation and recording in general is to an excellent standard. Medication is well maintained and accounted for. All people have good access to other health professionals and the home keeps good partnerships with these professionals. Families are encouraged to be part of their relatives lives and advocates are used if need be. A lot of information is available to the residents, staff and visitors that comes in various forms of symbols, picture sand photographs to enable as much understanding and involvement of people as possible. The home is clean, fresh, homely and comfortable for all of the residents. The manager sent us the home`s Annual Quality Assurance Assessment (AQAA) when we asked for it and it was clear and gave us all of the information that we asked for. Relatives of people living in the home said in their surveys that `Autumn Cottage provides individual care according to need in an homely environment and they do everything so well`. A health and social care professionals survey state, `staff works well with a variety of health care professionals and they are skilled and experienced and make the care of their clients their highest priority`. What has improved since the last inspection? The home has recently been completely refurbished. The manager and team have achieved all the requirements and recommendations made from the last key inspection. What the care home could do better: The manager needs to continue and pursue two new staff for the vacancies they presently hold, this will give the residents greater consistency of care and security. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Autumn Cottage 160 Ness Road Shoeburyness Essex SS3 9DL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Hannington     Date: 3 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Autumn Cottage 160 Ness Road Shoeburyness Essex SS3 9DL 01702292005 01702292005 christinec@outlookcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Christine Chaplin Type of registration: Number of places registered: Outlook Care care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Autumn Cottage is a purpose built care home that was built in 1993 by the National Health Service. The property is registered for seven people with learning disabilities two of which may be over sixty-five years of age. The home has seven single bedrooms all of which are fitted with overhead tracking. There are two large bathrooms fitted with assisted baths and there are additional toilet facilities. The garden runs along one side of the property and is laid to lawn with a small shed on the patio area. The garden is enclosed with no access from outside the home. In summer months a large marquee is set up in the garden with tables and chairs to enable residents and their visitors to relax outdoors. Autumn Cottage is within walking distance of the seafront and Gunners park; it is close to the local health centre and the West Road shopping centre. There is easy access to all forms of public transport. 5 Over 65 2 Care Homes for Adults (18-65 years) Page 4 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The site visit took six hours to complete and was carried out as part of the annual inspection programme for this home. This visit was conducted with assistance from the manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. The site visit also focused on any requirements and recommendations from the last key inspection. The last key inspection for this service was on the 17/03/2007. Prior to this site visit CSCI (Commission for Social Care Inspection) sent out surveys to all interested parties, these comments will form part of this report. A number of residents and four staff were spoken with during the site inspection and a tour of the building was undertaken. Care Homes for Adults (18-65 years) Page 5 of 31 We looked at all the information that we have received, or asked for, since the last key inspection or what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way.This included; The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. In addition to the day spent at the home, the inspector reviewed written material submitted to the Commission since the last inspection in order to reach the conclusions identified in this report. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Adults (18-65 years) Page 7 of 31 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 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 9 of 31 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: We were informed by the manager and by looking through records that once a person is referred and has shown an interest in the home, a service user guide will be provided to them. (Additionally a statement of purpose can also be provided) The service user guide is a document that gives a quick snap shot of what the home and staff provides. The service user guide can also be provided in picture form, braille, large print and upon request different languages. Both these documents are annually reviewed and updated. By providing these documents it allows people to make a decision to see if the home can provide for their individual needs before any visits or admission are arranged. The statement of purpose is a more in-depth document produced by the manager that describes what people can expect the staff and home to provide. It includes information such as, aims and objectives, policies and procedures, Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: services that are provided, care that can be provided, the number of staff they have and their qualifications, specialist services that may be provided, costs, contracts, complaints assessment process, hours of operation and general information about the organisation and Autumn Cottage care home. Once this information is given, then a date will be set for the manager or another qualified member of staff to carry out an assessment of need, with the individual and their representatives. As part of this process a number of visits will be arranged to the home so that the person can meet the other residents and the staff. They will also have the chance to see what the home is like, how many communal rooms are available, bathing, kitchen and laundry facilities, look at the garden and general things they would like to know before making a decision. It also gives the person a chance to sample the food provided and ask about any issues that are important to them. Just as important is that the person can see if the room they would be offered if accommodation were to be provided. By having the different types of visits as suggested by the manager, a person can get to explore the local area and sample what is provided within the local and wider community. The assessment process is recorded onto the managers assessment document which is then kept and forms part of a persons care plan. Additionally if a person is to be funded through the local authority or health or primary care trust, then these agencies will also supply their own assessment to the manager upon referral. The manager told us on the Annual Quality Assurance Assessment, that, A full assessment is provided to every service user prior to being admitted to Autumn Cottage, multi discipline teams are involved , Social Services, Trust, Consultant, Social Worker, OT, Parents /family Home, other residents that presently live in the home. The purpose of this assessment is not only to identify the persons needs, but to also allow the manager to consider if they can provide a service for the person who has made a referral. If they can do so, then a letter is written to the individual confirming this. These letters were evidenced within peoples care information looked at. The manager told us on the Annual Quality Assurance Assessment, that, We assess the needs of Service user on referral we carry out a needs assessment to ensure the person has been placed to the right environment, or to see if the environment can be adapted to meet there needs. We looked at the information of a new resident who has recently moved into the home. This information showed us that, good assessments and information about this individual were secured. The family and resident have been well informed and involved Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: at each stage. Overall all documentation looked at, showed us that detailed and sufficient information is provided in both the statement of purpose and service users guide and described well all information that would be of benefit to all interested parties. We were told by a resident that, I had lots of visits to my home before I moved in. Care Homes for Adults (18-65 years) Page 12 of 31 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 using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. Evidence: The care plans described individual needs clearly. All six care plans looked at, included a thorough health assessment and regular health monitoring by the staff and outside agency appointments. The manager told us on the Annual Quality Assurance Assessment, that, We have a record of risk assessments, reviews, care plans and a record of policy and procedures in place. Risk assessments reflected well the identified needs and the current care plans in place. All documentation is regularly reviewed. Also included in part of the care plan is a persons skill level and a plan to further develop the individuals skills. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: In one of the care files looked at it showed us that where the individual can express choices well, it was recorded in detail how they would like to be supported by staff. This is recorded in a style that would allow the individual to understand what had been written. Further to this, dailt notes were detailed and reflected that care was given as described in the care plans. A resident informed us that they felt the staff included them in their care plan to their satisfaction and that they knew what is written and contained within their personal folder as they have regular access to this. Information was signed by the individual that they had been consulted. It is apparent through observation that a resident who liked to carry out duties in the office for the manager, knew their rights and how they expected staff to treat them. Relatives told us and documentation looked at showed us, that they are actively involved in their relatives care. In another care plan looked at, we found that lots of reference tools were being used, such as, pictures, photographs and symbols to make the care plan accessible to the individual it was about. Again within this persons daily notes, it showed us how staff supported this individual and how well the staff knew this individual, by the information written by them. Care Homes for Adults (18-65 years) Page 14 of 31 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 using the service can be assured that they will have the opportunities for personal development and build upon their daily living skills so that they are able to lead a lifestyle that they choose. Evidence: Throughout the home, pictures and photographs are on the walls, giving information to the people of the home. This is to enable them to understand better, information about the service and to be part of the running of their home as much as possible. Speaking with staff showed us that the team are well experienced and know individuals well. Conversations showed us that they have lots of compassion and care for individual people who live at Autumn Cottage. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The manager told us on the Annual Quality Assurance Assessment, that, Autumn Cottage recognises the need for service users to be seen as individuals regardless of their diagnoses, by the development of individuals daily routines and social activities. The home provides a sensory room where people receive 1-1 support and can have time out from other people in the home, to relax and receive quality of care. When speaking with the manager it is clear that she is a good advocate of the people that live there, that she is pro-active in purchasing the best equipment, services and lifestyle as much as possible for the residents of Autumn Cottage. The manager told us on the Annual Quality Assurance Assessment, that, we have a record of daily activities record of likes and dislikes, record of support plan for each person in place. We saw that residents have an activity plan and this is based on their interests and abilities. For example, one person attends church every Sunday, others attend social clubs in the evening and one person is involved with the local boroughs recycling scheme. Because of their involvement in this scheme, they got to meet with the mayor. Evidence was also seen that in general people are encouraged to access local community activities, educational and leisure pursuits. A letter received from a professional (Drama therapist) told us, I would like to thank all staff when they participated in the drama sessions with the residents. They were all marvellous and gave lots of support and encouragement to all of the residents. Autumn Cottage generates such a friendly environment and it feels like one big family. The manager told us on the Annual Quality Assurance Assessment, that, Service users use the local community supported by staff, they purchase toiletries from the local shop on a regular basis, and they have a valued role as a consumer in the local community. The manager and her team foster good relationships with the local community, peoples relatives and other professionals, this gives individuals a wide range of support networks and access to a lifestyle of their choosing, this was seen through lots of documentation looked at and with speaking with residents and the staff. In care plans looked at people according to their skills are involved within the house of maintaining their rooms, laundry, using the local shops and various other tasks. During the lunch time period, foods were prepared to the individual need. For instance foods that had to be liquidised preserved the original different smells and tastes of that Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: meal. Foods used are fresh vegetables, fresh meats and menus looked at showed good nutrition value. Residents spoken with told us that the meals reflected their tastes and choices. The manager told us on the Annual Quality Assurance Assessment, that, Staff encourage service users to help prepare there meals or snacks to the best of their ability. All service users can be involved in some way if they wish in the kitchen area and this is encouraged. Looking through the menu books photographs of individual foods and meals were in place so that all residents can make an active choice of the meals and foods bought. Residents told us that they go out shopping with staff for food and help the best they can when meals and snacks are prepared. During the inspection, staff interactions were observed. No rushing and lots of verbal interaction was observed, whilst staff were seen supporting individuals to eat their meals. The lunchtime period, was a relaxed and pleasant environment as a result. The manager told us on the Annual Quality Assurance Assessment, that, Nutritional needs are priority for the residents, all people have there own GP, Medical files, with weekly weights recorded flow chart to Identify weight Gain and Loss. We saw that the meals consumed by all individual residents, weight monitoring and general monitoring of individuals health in this area were recorded well. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their personal care and health needs will be met. Evidence: The manager is very vigilant in purchasing equipment that will give the individual a good quality of life and retain a good level of safety within the home. A number of specialised equipment is in place. Overhead tracking is supplied in every bedroom and above baths and hoisting equipment is up-to-date and appropriate for the needs of individuals who live at Autumn Cottage. Alongside this, regular occupational health (a qualified person) assessments are carried out and all equipment is regularly serviced and maintained to a good standard. As a result the residents safety and dignity is well managed. Relatives of people living in the home said in their surveys that very good information is sent to me and I feel that the home offers excellent care. The manager told us on the Annual Quality Assurance Assessment, that, daily Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: evaluation plans, record of menus, bathing temperatures, record of service users weights, records of menus, record of choices, record of bowel movement chart, records of GP appointments, records of Dentist appointment, record of optician. Records of podiatry, record of consultant input, record of epilepsy appointments, food menus chart, record of pressure relief charts, record of personal hygiene are all in place. Looking within care plans, they recorded that people had regular access to dentists, speech therapy, chiropody, health care staff, district nurses, occupational health and consultants. The information looked as such as visits, daily notes, and summaries were to a good standard and were in a style that if read to a person could be easily understood. Again evidence of inclusion of people was evident. All staff had the appropriate accredited medication training and the management of the home are trained nurses. The manager and her deputy were very vigilant in checking in medication and checking out returns. The medication was kept secure in locked cabinets. Medication looked at was well accounted for, with no omissions. The whole medication system was excellent and staff had excellent knowledge around this when they were spoken with. The management strategies, information and training given to staff secured and protected the well being of the residents who live at Autumn Cottage. The manager told us on the Annual Quality Assurance Assessment, that, We follow Outlook Care policy procedures and protocols at all times, we also follow boots policy and procedures, we have an up to date BNF to which we refer to if needed. Each service user is registered with their own GP, Consultant, Neurologist, District Nurse, (reviews) EP Nurse. We saw by records looked that, all people who live at the home have a GP of their choice and good access to a number of specialised medical professionals if needed. Throughout documentation looked at, showed us that, professionals thought highly of the care given at Autumn Cottage. Here is a sample of quotes from them; A consultant (Epilepsy Specialist) from Southend Hospital told us, I can say that I am extremely impressed with the professionalism and knowledge and the way staff are managed at Autumn Cottage. It is evident that the manager and deputy have gained excellent management and care skills, which show in the efficient running of the home. It is extremely effective and shows in the attitude and behaviour of the other staff and residents. Another professional (Consultant Psychiatrist) from South Essex Partnership told us, I Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: regard Autumn Cottage as a centre of excellence as I notice that residents that came in with pressure sores have completely healed and that residents have not developed any whilst being at the home. Staff at Autumn Cottage treat residents with respect and dignity, with excellent motivation of giving the best quality of life. Care Homes for Adults (18-65 years) Page 20 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Autumn Cottage are protected by staffs knowledge, training and understanding of safe guarding procedures and by the organisations policy and procedures in dealing with complaints. Evidence: The manager through discussion and paperwork showed us, that she works transparently and welcomes any chance to learn about her practices and the overall quality of care given to people in her care by the staff of the home. Recently a safeguarding issue was raised with the manager by an outside agency. Showed us the way it was dealt with, that the manager worked well with the safe guarding unit. Staff spoken with had good knowledge, training around safeguarding issues and knew who to contract regarding any safeguarding issues that may arise. In the front entrance to the home was good clear information given to all residents, staff and visitors of contact names of the safeguarding unit and how to make a complaint. Advocacy services are used if the residents wish or if the management think that a situation requires their input. This allows people who live at Autumn Cottage to have an independent person to secure their rights and voice their opinions. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: The manager told us on the Annual Quality Assurance Assessment, that, The complaints procedures are made available to all, such as, we have an easy read procedure. When staff are in the community they carry a complaints card with them. Care Homes for Adults (18-65 years) Page 22 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an environment that is homely, safe and comfortable. Evidence: The manager told us on the Annual Quality Assurance Assessment, that, Autumn Cottage is maintained to a very high standard of cleanliness and odour free. Although most people living within the home have some issues around incontinence (some double) it is odour free. This gives residents a nice pleasant home to live in and preserves their dignity, self esteem and shows us that excellent practice in terms of infection control and hygiene is in place amongst the staff. The manager told us on the Annual Quality Assurance Assessment, that, Infection control is of high priority, all staff follow policies and procedures, Covering essential steps to safe, clean care Peoples individual rooms are well maintained decorated to their liking and personalised. Communal areas are clean and comfortable with plenty of light and areas for people Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: and their visitors to use. The overall health and safety practices by staff are well monitored documented and training is regular. The organisation provides an infection control link nurse for the home to use and get guidance from. Staff spoken with have good knowledge and experience around these issues and were able to evidence that residents are well protected by them. Care Homes for Adults (18-65 years) Page 24 of 31 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 who live at Autumn Cottage benefit from the care and support they receive from a competent and qualified staff team and are protected by recruitment policy and practices. Evidence: Residents and relative informed us that they have confidence in the staff that support them. The manager told us on the Annual Quality Assurance Assessment, that, Recruitment procedures are based on equal opportunities at all times,CRB checks are always obtained prior to employment, two written reference checks are obtained, observation to any gaps in employment are investigated. At present the home has two full time vacancies. The manager is currently interviewing for these, however, she has stated to us that she has not found the calibre of staff that she would expect working within the home. Agency staff are used to cover these gaps. The agency workers used are regular and known to the residents. The manager carries out recruitment checks on all agency workers. This practice ensures not only the safety of all of the residents but ensures that consistency of care Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: is maintained. Staff members regularly undertake training, have regular staff meetings, supervisions and yearly appraisals. Training consists of safeguarding, fist aid, infection control, fire safety, medication, data protection, food safety, manual handling, equality and diversity, epilepsy, mental capacity act and various other courses. The manager told us on the Annual Quality Assurance Assessment, that, 50 of the Staff hold either the NVQ2 and NVQ 3 and half have Nursing qualifications. Training documentation seen at the inspection showed us that, half of the staffing team hold the NVQ training level 2 and 3 qualification. The manager told us on the Annual Quality Assurance Assessment, that, All staff receive an induction training package. New staff have a good induction package that follows the care for skills criteria. Staff recruitment is thorough and all six staff records looked at by us held these. Speaking with permanent members of staff and observation of an agency member of staff, showed us, that they are skilled, well trained and that attention is given to ensuring that people who live at Autumn Cottage receive a good quality of support and care. Staff said in their surveys, the manager is very supportive both to staff and to people that live in the home and communication is very good, there are weekly residents meetings and regular reviews. Care Homes for Adults (18-65 years) Page 26 of 31 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. People live in a well run home that ensures that their best interests are met. Evidence: The manager has been in post for fifteen years, as has her deputy and they are both registered general nurses. Additionally the manager has a great philosophy of care and ethos in practice, she is an excellent role model for the staff. Good practice is also seen through out documentation looked at and through observation of staff practice seen at this site inspection and by the discussion we had with the staff on duty. It is apparent to us that the manager actively encourages the staffing team to practice in terms of residents rights, to respect people, include them, to secure their dignity and treat people as individuals. The office and documentation held within it is consistent well organised and to a high standard. Monitoring of risks, staff practices, health and safety issues are regular, well recorded and maintained. All certificates, safety checks needed to ensure the Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: protection against abuse of individuals was current and in place. The manager told us on the Annual Quality Assurance Assessment, that, Accountability is taken in a professional manner, both with in the home and outside agencies, providing high standards of the running of the day-to-day of the unit, the staff team work well together under my management. Quality assurance that the home carries out annually, underpins that good practices are maintained and that people have a chance to view their opinions on the service that is provided to them. Information given to us on the Annual Quality Assurance Assessment was well written and informative. It gave us a good pre-inspection idea and evidence of how the home practices and how the manager secures the rights of residents. The organisation supports the manager well by holding regular supervisions and manager meetings. Senior management carry out regular regulation 26 checks. (These are monthly audit checks of the home required by regulation). The manager keeps us regularly informed of any issues arising and works well with us. The manager told us on the Annual Quality Assurance Assessment, that, There are good financial management and accountability from financial abuse. Regular checking of service users paper work against monies held and the petty cash float is in place. Residents records regarding finances and the processes in place protect them against financial abuse, was well recorded and accounted for. Documentation monitoring the health and Safety of the home were excellent. Staff training was up-to-date and a member of the staff team is trained to the level to be the official health and safety officer for the home. This member of staff checks and monitors all health and safety aspects of the home. As a result a high standard of records and information is available for the staff. This practice ensures that the residents are best protected. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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. 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