Care Home: Avenues (The) (Neave Crescent)

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What the care home does well The service supports service users in a very person centred manner ensuring their choices, preferences are met. This support is given in a manner which respects their dignity, human rights and diversity. All service users are actively supported in all aspects of their lives and are encouraged to participate in community activities. The service creates opportunities and encourages the service users to experience aspects of life that they may not have experienced prior to moving into the home. The home has a diverse, flexible and committed staff team who work towards high standards and goals which are set for the home to achieve. Recruitment procedures are robust and training is seen as very important to ensure that the staff team delivers the service in a person centred way for the benefit of the vulnerable people living at the home. The manager ensures that the home is operated in an open and transparent manner and has ensured that this service remains an excellent home. What has improved since the last inspection? The staff team has expanded and the LDQ process is compulsory as part of the induction. Training records have been reviewed and updated. Service users have been supported in achieving their goals for their first holiday abroad and this was very successful. What the care home could do better: No requirements nor recommendations have been identified at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Avenues (The) (Neave Crescent) The Avenues 73a - 74b Neave Crescent Havering Romford Essex RM3 8HN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Legg     Date: 1 9 0 4 2 0 1 0 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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Avenues (The) (Neave Crescent) The Avenues 73a - 74b Neave Crescent Havering Romford Essex RM3 8HN 01708370048 01708370048 neave.crescent@theavenuestrust.co.uk glebe.house@theavenuestrust.co.uk Avenues Support Services Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Joanne Clifford Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability sensory impairment Additional conditions: Date of last inspection Brief description of the care home 73a-74b Neave Crescent is a purpose built ten- bedded unit comprising of two connecting bungalows set on a housing development. The home is registered to provide care for residents with learning disabilities, physical disabilities and/or sensory impairment. The home is on a bus route and is within a short distance of shops, Romford market and other local community resources. The home also has its own custom built vehicle, which is used to take service users out. All of the 10 large bedrooms are en-suite with toilet and shower facilities. There are Care Homes for Adults (18-65 years) Page 4 of 28 10 10 10 Over 65 0 0 0 Brief description of the care home two large dining/sitting areas; two kitchens, two laundries, two assisted baths and two garden areas, and all areas are wheelchair accessible. The home?s Statement of Purpose is made available to service users on request and a copy is kept in the staff office. Every service user/relative has been given a copy of the home?s Service User Guide. The fees for the home are #1449.80 a week, this does not include hairdressing, toiletries, private chiropody or holiday spending money. This information was given by Joanne Clifford (the manager) on 24th April 2007 Care Homes for Adults (18-65 years) Page 5 of 28 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: We undertook a key inspection on the 19th April 2010 over a period of 5 hours. This included gathering information from records and other documents, the returned annual quality assurance assessment, talking to staff and relatives and also discussions with the manager. It was not possible to have a meaningful discussions with any of the service users due to their profound and complex communication needs. Care Homes for Adults (18-65 years) Page 6 of 28 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 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home have the information they need to make an informed decision as to whether the service can meet their needs. The preadmission assessment is detailed and comprehensive and this will assist the service in deciding as to whether they can meet the needs of the service user. Evidence: Since the last inspection the home has had one new admission. The pre-admission assessment was closely looked at. The assessment was conducted professionally and sensitively and involved the service user, their family as well as social and health care professionals. The assessment focused on achieving positive outcomes for the service users and this included ensuring that the facilities, staffing and other specialist services was able to meet their ethnicity and diversity needs. Before agreeing admission the service carefully considered the service users needs and the capacity of the home to meet their needs. Part of the transition process was that the service user spent time at the home, which enabled them to test drive the service and to ensure that the service could meet their Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: needs. This transition was over a period of time ranging from a pop in visit, to lunch and eventually an overnight stay. The service user was allocated a key worker to help them to feel comfortable in their new surroundings.This service user is currently in another care setting and considerable time is being spent on his transition back to Neave Crescent. The service has produced his transition plan in a pictorial format that also states how many days are remaining to his eventual return. Because the assessments shows that the needs of the service user have changed additional staffing hours have been identified and agreed. It was evident that significant time and effort had been spent planning to make the transition to the home personal and well managed. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are involved in decision about their lives and they play an active role in planning the care and support they require. Evidence: The service is very clear that service users are in control of their lives and that they direct the service. Staff are fully committed in supporting service users to lead purposeful and fulfilling lives. We spoke to staff and relatives who told us that service users are encouraged and supported to make their own informed decisions and that they also have the right to take risks in their daily lives within a risk management framework. The interaction we observed between the service users and the staff confirmed the philosophy and approach of the service. There is a care planning system in place that is very person centred and comrehensive, which is also produced in a pictorial format. The care plans are completed with the involvement of the service user and their families and they cover all relevant areas including health, personal and social care needs as well as Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: identifying service users religious and cultural needs. The documentation also includes other areas such as likes and dislikes, things that are important to me, what I need help with and how I communicate. The information provided in these care plans is very detailed and individualised and they included evidence that the service values improving outcomes for the service users. Staff were seen referring to the care plans and there was written evidence that these are being used as working documents. The service operates a key worker system and they ensure that the care plans are being kept up to date through regular evaluation and review. The manager has developed very good working relationships with other agencies and this ensures that there are effective and well co-ordinated health services, including alternative therapies for service users. Care plans include comprehensive risk assessments which are regularly reviewed. It was very apparent from observations made during the inspection, from talking to staff and looking at documentation that the service has a can do attitude and risks are managed positively to assist the service users to lead the life they want. The attitude and practice of the service and the staff team ensure that service users Independence is not only maintained but improved where possible, that they are able to exercise choice and they are given the opportunities and avenues to express their wishes and needs. We were able to speak to a therapist who offers alternative treatments and they felt that the service had an open and positive approach to the service users at Neave Crescent. As stated earlier care plans are seen as working documents and are reviewed on a six monthly basis or as and when required. Evidence was seen of reviews taking place which also involved the service user, relatives and other professionals. Written feedback is requested if they are unable to attend, this assists the service in gaining a full picture of peoples views. Reviews focus on asking what has worked for the individual, where progress is being made, achievements, any concerns and then action points are identified. relatives that were spoken to as part of the inspection all confirmed that they were invited to attend reviews and felt very much part of the decision making process. I am extremely happy with the care and I dont have to wait for a meeting to discuss X with Jo (manager) or the staff. We are very happy, Y is very well looked after, it is the best home he has been in. Each service user has their own daily log sheet, which is in written and pictorial format. These daily records reflect the support that has been given on a daily basis and how service users are involved in the life of the home, such as menu planning, shopping trips, cooking gardening and the redecoration and refurbishment of the home. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: From viewing documentation and in discussions with staff it was evident that they were aware of the need to respect confidentiality of the service users and to handle information about service users in accordance with the homes written policies and procedures, the data Protection Act 1998, Freedom of Information Act and in the best interest of the service users. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to develop their life skills in all areas. Evidence: The service has a very strong commitment to enabling service users to develop and maintain their skills, including social, emotional, communication and independent living skills. Goals are identified and service users are supported to achieve them. All of the service users require a high level of support due to their physical needs and their non verbal communication but as stated earlier in the report the service has a can do attitude. This has meant that service users at Neave Crescent have been able to lead full and valued lives. All of the service users are involved in activities within the home and in the wider community, trips that have taken place include Disneyland Paris, Legoland, Calvert Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Trust in Scotland where service users where able to experience abseiling, kayaking, canoing and trampolining. The service seeks the views of the service users and considers their varied interests when planning the routines of daily living. Routines are very flexible and service users can make choices in all areas of their lives. Service users are supported on a daily basis to go out in the homes mini bus either to the shops or local attractions and the service provides activities within the home and alternative therapies such as reflexology, aromatherapy, Reiki and massage. On the day of the inspection one service user had chosen to stay in bed, some of the service users had gone to Barleyland, others went on a canal trip and two of the service users had a reflexology session with a visiting therapist. Both the therapist and the staff felt that service users enjoy and benefit from the reflexology sessions, one of the service users sleep pattern has improved. Central to the care and support that is provide is the importance of respect for the human rights of people in the areas of fairness, equality, dignity, respect and autonomy. The service supports and encourages service users to develop and maintain important personal and family relationships. Most of the service users have lived together for a number of years and all have good relationships. All of the service users have families that visit, some more regularly than others, the service actively encourages relatives to visit and operate an open door policy. One relative stated we visit twice a week, we just turn up and are always made to feel very welcome. The home provides meals, which are varied and nutritious and meet the dietary needs of the service users. Menus are provided in a pictorial format as well as written and any dietary requirements are clearly stated in service users care plans and on the menu board which is placed in the kitchen. One of the service users is offered finger food, this assists him in mountain his Independence and improves his co-ordination. On the day of the inspection service users that had gone out on trips had taken various packed lunches which some included homemade carrot and coriander soup and the evening meal consisted of fish in a homemade sauce and fresh vegetables. Service users can have an alternative meal if they so wish. Some of the service users require support with eating their food and drinking. Staff were calm and relaxed with service users going at their pace. Care Homes for Adults (18-65 years) Page 15 of 28 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 who use this service receive support with their health and personal care based on their indiviudal needs and on the principles of respect, dignity and privacy. Evidence: The support around personal and health care is very person centred with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Each service user has a detailed health plan which identifies their individual health care needs including, specialist health, nursing and dietary requirements. The plan also identifies service users daily routines including the type of support they require in relation to their personal hygiene. Staff support is flexible, consistent and able to meet the changing needs of the service users. the use of a key worker system ensures that staff have in depth about the service users personal and health care needs. Staff were observed to respond appropriately and sensitively to various situations. All of the service users are registered with a local GP and are supported by staff to access other health specialists such as physiotherapists, community nurses, dentists, Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: chiropodists and any other health professionals as required. Where necessary, the service arranges for health care professionals to visit the service user at home. The service has developed an efficient medication policy, procedure and practice guidance. None of the service users are able to self medicate and this is clearly identified in their care plans. Staff involved in the administration of medication have undertaken training which is regularly reviewed and updated. Medication administration records (MAR) were examined and all medication was being appropriately stored. Medication records were fully completed, contained required entries and were signed by members of staff. All medication practices were found to be in good order. The service has taken steps to find out the wishes of service user in the event of their death, relatives have also been contacted where service users have been unable to express their views. There are policies and procedures for staff to follow in the event of a death, this will ensure that the death of a service user is handled with respect and as the individual would wish. All of this information is included in each service users care plan documentation. Care Homes for Adults (18-65 years) Page 17 of 28 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure and are protected from abuse and have their rights protected. Evidence: The ethos of the home is that it welcomes complaints and deals with these in a very positive manner. We looked at the complaints log and there had not been any complaints since the last inspection. Each service user has very special needs with regards to communication and formats around complaints have been individualised to meet these needs. We spoke to relatives during this visit and they all spoke very highly of the service and were very sure that if they had any complaints they would address these wits the manager who they told us would deal promptly with any concerns. We spoke to staff around safeguarding and they were all very aware of the procedure to follow and had all undertaken the relevant training. According to information contained in the annual quality assurance assessment all of the current service users are under the Court of Protection for their finances. The home keeps clear records of any expenditure made on behalf of the service users. As part of the services quality assurance procedures regular audits are undertaken. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: All staff spoke to were aware of what restraint is and alternatives to its use in any form would always be looked for. People using the service are fully involved in decisions about any limitations to their choice and the staff fully respects the human rights of people using the service. Individual assessments are always completed which involve the individual where possible, their representatives and any other professionals such as the care manager or GP. Care Homes for Adults (18-65 years) Page 19 of 28 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. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. Evidence: We toured the home and found that the physical environment provides individual requirements for each of the service users. All of the bedrooms are single and have recently been redecorated and each one has been fitted to suit the requirements of the occupant, for example some have overhead tracking. All bedrooms have en suite facilities which includes a shower. In addition there are two specially fitted bathrooms. The open plan kitchen/dining area and lounge are well furnished and decorated to high standard. These areas are spacious to meet the needs of the service users, some of whom are wheelchair dependent. The sensory room is well equipped and used by the service users with support from staff. The rear garden is well maintained with raised flower beds and there is car parking facilities to the front of the building. Overall the home has been designed to provide small group living where the residents can enjoy maximum independence in a discrete non-institutional environment. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Infection control procedures within the home were found to be of a high standard and staff spoken to demonstrated an understanding of the need to ensure that these high standards were always worked to. Care Homes for Adults (18-65 years) Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service and also support the smooth running of the service. Evidence: The service has a highly developed recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important than the filling of a vacancy. Due to the very high complex needs of the service users they would be unable to effectively be involved in the recruitment of staff. However, the manager ensures that all prospective staff meet service users during the interview process. The service has plentiful staff available at all times to support the needs, activities and aspirations of the residents in a person centred way. On the day of the inspection some of the service users were out on a canal trip and some were visiting a local farm and craft centre. The service ensures continuity of care in that it does not use agency staff, but any vacancies are covered by the homes permanent staff. The home has a key worker system and key workers are allocated specific time to spend with individuals. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: We looked at training records and spoke to staff who told us that management prioritise training and facilitate staff members to undertake external qualifications beyond basic requirements. The majority of the staff have been trained to NVQ level 2 or 3 and newly recruited staff are on the list for this qualification pending a successful probation period. The service sees induction and any probation as vital to the success of staff recruitment and retention. Staff are also expected to achieve the LDQ, and the deputy manager has achieved her diploma in management. Both the senior team leaders have commenced the diploma in management. It was evident during the inspection that the staff team support each other and share skills and knowledge with colleagues. The roles and responsibilities of staff are clearly defined and understood and all staff demonstrated the need to ensure that care was delivered in a person centred manner. All staff have supervision on a regular basis and this includes 1:1 supervision sessions, group meetings and on the job supervision. It was evident from talking to staff that they enjoyed working at the home, were very person centred in their thinking and actions and some told us that this was the best job that they had ever had. Care Homes for Adults (18-65 years) Page 23 of 28 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. The management and administration of the home is based on openness and respect, has effective quality assurance systems which are operated by a qualified, competent manager. Evidence: The registered manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. The manager was able to demonstrate sound knowledge of both strategic and financial planning and had a sound knowledge of the organisations strategic and financial planning systems and how the business plan for the home fits with these. During the inspection the manager was able to communicate a clear sense of direction, was able to evidence a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction and quality assurance. Equality and diversity, human rights and person centred thinking are given priority by the manager who was able to demonstrate a high level of understanding and best practice in these areas. The way the home is run Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: shows an understanding of peoples needs in respect of diversity, gender, age, sexual orientation, race, religion and disability. Staff told us that at all times the manager provided an excellent role model and that she was always supportive. The manager ensures that staff follow the homes policies and procedures and that they have easy access to training materials and courses. There was strong evidence that the home is open and transparent and this was supported by staff and relatives. The annual quality assurance assessment contained excellent information and this was appropriately supported by evidence seen during the inspection process. Health and safety are given a high profile within this service and all staff have undertaken training in this very important area. Risk assessments are completed and reviewed on a regular basis or when the needs of the service users indicate a change. Currently there are no deprivation of liberty safeguards in place and also there are no safeguarding issues at this home. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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. 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