Care Home: Avondale House

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What the care home does well Avondale is a small, family run home, with a stable staff team. Staff have a good knowledge of the individual needs of the people who live in the home and how to respond to them. People who live in the home are at the centre of home life. The staff team offer support in a calm and relaxed manner that promotes people`s self-esteem and improves their mental health. The three people who live in the home spoke very positively about their experience of life in the home. "I know how to relax here" said one person. People who live in the home have developed good relationships with the staff team and supportive relationships with each other. "We have known each other a long time, haven`t we" said one person who lives in the home, about another person who lives at Avondale. The home promotes and encourages independence, providing support to people to enable them to take on more responsibilities for themselves. For example people manage their own healthcare appointments and take responsibility for taking their own medication. The home is constantly looking at ways to improve the home. At the last inspection the home was researching information into `solution-focused therapy` as a way to improve the lives of the people who live in the home. Training has now been booked in this area. People who live in the home go on regular holidays, which they say how much they enjoy and are stimulated by regular events, which tap into their interests, such as trips to the races, placing small bets and fantasy football league. What has improved since the last inspection? The home now has written strategies in place for staff to follow, to make sure that the needs of the people who live in the home are met. This ensures that all staff work the same way to meet people`s needs. Staff have now received training in how to minimise infection and how to move and handle people safely. More robust practices are in place in relation to the storage, recording and selfassessment of people taking their own medication. This minimises the risk of people being put at risk of harm. Staff files are now held on the premises so that the registered manager can use them to plan staff training and supervisions. Staff now participate in regular fire drills so that they know what to do to make themselves and people safe if there is a fire at the home. What the care home could do better: Although there has been an increase in staff training since the last inspection, not all staff have had training in protecting adults, administering medication safely and health and safety. This means that staff are not fully trained to meet the needs of the people who live in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Avondale House 25 Roxburgh Road Westgate-On-Sea Kent CT8 8RX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nicki Dawson     Date: 0 9 1 0 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 29 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 29 Information about the care home Name of care home: Address: Avondale House 25 Roxburgh Road Westgate-On-Sea Kent CT8 8RX 01843833973 01843833973 lesjeffs@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Avondalecare (Kent) Ltd Name of registered manager (if applicable) Mr Leslie Michael Jeffs Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Avondale House provides care and accomodation for up to four people suffering, or recovering from mental illness. The home is a four storey semi-detached house, which is within close proximity to local shops and public transport. People who live in the home have their accomodation on the first and second floor. There are four single rooms, including one which is ensuite. The people who live in the home have use of a communal lounge/diner and a small quiet room. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home Avondale Care (Kent) Ltd operates another home for people recovering from mental illness in the local area. We were told that the weekly fees at the time of the inspection are between £439 and £547.67 depending on individual need. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was unannounced, which means that the people that live in the home, the staff and the registered home manager did not know that the inspector was calling at the home. Key unannounced inspections are aimed at making sure that the individual service is meeting the National Minimum Standards and that the outcomes for people using the service promote their best interests. This is the first key unannounced inspection to Avondale House as part of the company Avondale Care (Kent) Ltd. Avondale House was previously inspected by us when it was owned by a partnership. Therefore, any mention in this report of the last time the home was inspected, refers to the care home when it was owned as a partnership. The inspection started at 9.45 am and took just over four hours. All three people who live in the home, the registered manager and a company owner, who also works at the home, were involved in the inspection to gain their views and knowledge of the level of Care Homes for Adults (18-65 years) Page 6 of 29 care, provided by the service. The main communal areas of the home and the newly registered bedroom were entered. A number of records to do with peoples care and safety were looked at. It is now a legal requirement for services to complete and return an annual quality assurance assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The service returned their AQAA to us within the timescale requested and it contains all the information that we asked for. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? The home now has written strategies in place for staff to follow, to make sure that the needs of the people who live in the home are met. This ensures that all staff work the same way to meet peoples needs. Staff have now received training in how to minimise infection and how to move and handle people safely. More robust practices are in place in relation to the storage, recording and selfassessment of people taking their own medication. This minimises the risk of people being put at risk of harm. Staff files are now held on the premises so that the registered manager can use them to plan staff training and supervisions. Staff now participate in regular fire drills so that they know what to do to make themselves and people safe if there is a fire at the home. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Avondale are given all the information they need to help them decide whether or not to it is the right place for them to live. Peoples needs are fully assessed before they move into the home so that people can be sure that they will receive the right type of care. Evidence: All care homes are required to provide information about the service that they provide. This is to help people decide if a particular care home is somewhere that they would like to live. The aims and objectives of the home are clearly set out in the homes Statement of Purpose. The services and facilities that are available to the people living in the home are detailed in the Service User Guide. These documents provide useful information such as which areas of the home are available for use by people who come to live at Avondale and about meal arrangements. Before new people move into the home, a representative of the home should carry out Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: a full assessment of their needs, so that it can be decided if Avondale is a suitable place for them to live. The assessment of one person who is considering moving to the home was looked at. We found that the assessment is in sufficient detail so that the home can make a judgment as to whether they can meet this persons care needs. Evidence was seen that this person has had the opportunity to visit the home and that family members have been consulted. The home has also obtained an assessment from the local health authority which contains lots of important information about this persons care needs. The main aim of the home as set out in the Statement of Purpose is, to provide a comfortable, safe and caring environment for men and women who are suffering from or recovering from a mental illness. At the last inspection the registered manager said that he intends to introduce solution-focused therapy. Evidence was seen that the home is currently undertaking this therapeutic approach with the people who live in the home and formal training for the staff team has been booked. The aim of this as described by the registered manager, is, to encourage free expression of thoughts and feelings about issues which arise amongst people who live in the home and to help them to work towards finding their own solutions to these issues. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a plan of care that gives clear guidance to staff as to how to meet their assessed needs. People are supported to make decisions and choices and to take responsible risks. Evidence: Each person that lives in the home should have an individual plan of care that clearly sets out their health, personal and social care needs, together with the staff support that is required to meet these assessed needs. These care plans are important because they are one of the ways that people can say what assistance they want to have and how they want it to be done. One such plan was looked at and was found to give a clear account of the persons needs and what needs to be done to meet them. Evidence was seen that the care plan is regularly reviewed and updated so that the information that it contains is correct. During the inspection the people that live in the home spoke about some of the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: choices and decisions that they make about their lives on a daily basis. They said that they are free to come and go as they please and structure their own day, with support from staff as needed. Everyone is responsible for looking after their own money, but assistance is given as necessary. For example, written daily notes show that one person wanted to buy a magazine and discussion then took place to help the person decide if they had enough money to buy what they wanted. People who live in the home said that they are consulted on all aspects of their life in the home. The registered manager said that he seeks peoples views an informal basis and also through formal systems such as regular quality assurance questionnaires. The severity and likelihood of a people engaging in risky behaviour or activities are assessed. Written guidance and direction to keep these risks to a minimum are contained in each persons plan of care. For example, plans are in place to support people to eat a balanced diet and maintain a healthy body weight. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take responsibility for their own healthcare needs and to be responsible for controlling their own medication where appropriate. Evidence: Avondale gives people opportunities for personal development. For example, evidence was seen in written daily notes that discussions take place around how people may conduct themselves in the community so that they gain respect from other people and about how to keep themselves safe. The home gave us good information in the AQAA (annual quality assurance assessment) about how they encourage people to develop any interests that they have. They have told us that people who live in the home are very interested in sport. The home have sought to satisfy these needs by escorting people to horse racing meetings at Folkestone and Royal Ascot in the summer or Cheltenham in the spring, Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: including staying away in shared accommodation for several days at a time. They also organise a Grand National sweepstake in the spring for everyone with prizes. The home have told us that they continue to offer people college and employment opportunities on a regular basis, even though people do not always take them up. Evidence of this was seen in peoples care notes. They have also told us that with assistance one person has succeeded in securing an updated driving licence although they have chosen, as yet, not to drive. Other opportunities include providing internal informal education one to one time with staff, to cover such topics as coping mechanisms, dietary balance, hazards of alcohol overuse, psychotropic medication and maintaining general fitness. Evidence was seen that people are given opportunities to try out new things. Some people have tried out a martial art and others have been to a singing group. People spoke about their daily activities which include going out to the local shops, cafes, cinema, social clubs and visiting friends. People also said that they had enjoyed a caravanning holiday this summer. People are supported to maintain relationships with friends, family and the community. On the day of the inspection, one person was meeting up with a family member and another was going to visit some friends in another care home owned by the company. Information in the AQAA states that a neighbour has recently spoken to one of the people that live in the home about their shared passion for sea fishing and has offered to spend a day with them. People who live in the home have limited opportunities to develop independent living skills in all areas since they do not have access to a kitchen or washing machine. People make their own breakfast, lunch and hot drinks throughout the day. A stock of ready made meals is kept in the freezer in the communal room, so that people may prepare themselves a meal at any time. Staff cook the evening meal or people are given an allowance to buy their meals out at a local cafe. Evidence was seen that a variety of different foods are cooked for the people that live in the home. People are responsible for doing their own washing up and some cleaning. The registered manager is aware of the limitations of the current environment and this is clearly stated in the Service User Guide. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take responsibility for their own healthcare needs and to be responsible for controlling their own medication where appropriate. Evidence: The main role of staff in the home is to provide encouragement to the people who live there to attend to their own personal care needs and evidence that this aim is carried out can be seen from care plans and daily notes. The aim of the home is that the people who live there should be enabled to control their own healthcare needs. Therefore, people generally make their own appointments. The home discretely monitors this and will intervene in as minimal way as possible. For example, if a person shows specific symptoms, these are observed and monitored and the person will be encouraged to consult a GP if it is deemed necessary. Evidence was seen that the mental health needs of people are monitored through daily contact and conversation. The home has developed some good practices in relation to peoples medication in that everyone is responsible for taking their own medication. Each person who lives in Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the home now has an assessment of the risks around them self-medicating. This is regularly reviewed so that it can be certain that each person is able to manage their medications safely. There is an agreement between the home and the people who live in it, that medication, which is prescribed as prn (to be taken as needed), is only taken after a consultation between them. The registered manager explains that, residents seem to appreciate that talking out their feelings might be better than taking a drug which in the end creates some dependency. The registered manager, who is the main person responsible for medicines in the home, has undertaken formal training in the safe administration and storage of medicines. The other person who is responsible needs to update their training in this area. The medication administration sheet, which records all medicines which enter the home, was viewed. It was seen that the home now make sure that when peoples medications have been written by hand on this document, that the record is checked and signed by another member of staff. This ensures that there is a lower probability of staff incorrectly recording the dosage of any medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that any complaint they make will be listened to and resolved to their satisfaction. People who live at the home feel safe and protected. Evidence: Neither the home nor the commission have received any complaints about the level of service provided by the home, since the last inspection, which was eighteen months ago. The registered manager said that staff aim to deal with any issues or concerns as they arise. Should it be required, there is a formal process stating timelines for responding to and dealing with any complaint. This complaints process is posted on the notice board. People at the home said that they can talk to staff and it was observed that communication was relaxed between the registered manager and people who use the service. Its very important that people who live in the home are confident that they are safe from being taken advantage of. People said that they did not feel safe in the places that they lived before, but that at Avondale House, they do feel safe. Information received about the service before the inspection confirms that that home has a policy in place about safeguarding adults and the prevention of abuse. The staff meeting minutes evidence that discussion about how to protect people is discussed at these meetings. The registered manager said that he keeps his knowledge up to date in this Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: area and has achieved this by recently attending an information day on this topic, held by the local authority. Evidence was seen that all but one member of staff have received external training on safeguarding vulnerable adults. This omission was pointed out at the last inspection. It is required that the home ensure that they meet this breach in the Care Homes Regulations 2001, which require that, the registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Avondale feel that they benefit from living in a home that offers them a good standard of comfort. Evidence: There have been some changes since the last inspection, to the accommodation provided for people who live at the home. The home is now registered to provide accommodation for up to four people, and this new fourth bedroom provides ensuite bathing facilities. People who live in the home have also been newly provided with access to a small quiet room, in addition to the main communal room, which is a kitchen/diner. As mentioned previously, people who live in the home do not have access to the main kitchen or laundry room which limits their ability to undertake a range of independent living skills. The home was tidy, comfortable, clean and well maintained on the day of the inspection. The people who live in the home said that they are able to have their personal belongings in their bedroom and that they are comfortable. Information received about the service before the inspection confirmed that that home has a policy on infection control. Soap dispensers and paper towels are available in the bathroom and toilet to minimise the risk of the spread of infection. Evidence was seen Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: that all staff have received training in how to minimise the spread of infection in the home. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure that peoples needs are met in a satisfactory way, the home needs to continue to train all staff in all necessary areas. Recruitment practices within the home are good ensuring that people are protected from potential harm. Evidence: The staff rota shows that there is a minimum of one member of staff on duty at all times. People who live at the home are supported by a small, stable, staff team, which is mainly made up of family members. Information given by the home in the AQAA (annual quality assurance assessment) is that the home has met the National Minimum Standards that over 50 of staff are currently trained to National Vocational Qualification (NVQ) level 2 or above. The NVQ award is useful because it helps staff develop good care practices and their skills in working with people who live in a residential care home. Before new members of staff are employed at the home a number of checks need to be carried out to make sure that all members of staff working at the home are suitable to care for vulnerable service users. At this last inspection it was found that information about staff was not kept at the home. The registered manager confirmed that this information is now kept Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: on the premises. No new members of staff have been employed at the home since the last inspection. The last time records were looked at it was found that all the relevant checks and documentation were in place showing that the homes recruitment process followed protects the people who live in the home. The registered manager is responsible for making sure that staff undertake a number of training courses that develop their skills in caring for the people that live in the home. There is a staff training matrix for recording all staff training and alerting the registered manager when mandatory training is due. There are few gaps in the staff training matrix evidencing that staff are generally up to date with this mandatory training, which includes how to safely support people move about, basic first aid, food hygiene, what to do if there is a fire and keeping people safe. In the AQAA the registered manager states that, we are attempting for the first time this summer to have all staff trained in all mandatory areas during the summer. However, there is one member of staff for whom the majority of gaps in training apply and it is required that the training for this person is given more priority. The home believes that staff supervision is important so that staff have the opportunity to discuss care practice, the philosophy of the home and their own development needs. Staff files viewed show that a formal supervision programme is in place both individually and as a staff group. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home where they are valued and their interests are at the centre of what the home aims to achieve. To make sure that peoples safety and welfare continue to be met in a satisfactory way, the home needs to continue with its staff training programme which includes all staff. Evidence: The registered manager has managed the home for over twenty years. He is a qualified as a Social Worker to Masters Level and has completed the Registered Managers Award. These awards are recognised by the commission to be useful because they help to make sure that people who manage residential care services have the competencies that are necessary to do so. The registered manager is clear about the homes aim and purpose. He states in the AQAA (annual quality assurance assessment) that the home, promotes confidence, social skills, life skills, a positive mental outlook and a sense that they are self Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: determining people whose views matter. We listen to every client. Evidence that the staff are constantly working towards these aims can be found throughout the content of this report. For example, the care notes for one person state that each time a person achieves a particular goal, they should be lavished with praise to help reinforce the desired behaviour and good outcome for the person concerned. The home has shown that an effective quality assurance is central to the development of life in the home. Quality assurance questionnaires are completed with people who live in the home every six months and evidence from these surveys are contained in the AQAA (annual quality assurance assessment). The overall satisfaction of people who live in the home, according to the quality assurance survey is 91 . Other examples given in the AQAA are that, satisfaction levels with staff are 92 ; service users feelings related to safety are 94 and anti-discriminatory practice is a 100 approval level. The registered manager told us that there are no people living at the home subject to a deprivation of liberty authorisation under the Mental Capacity Act 2005. Some staff have attended training in this area and the registered manager has told us that the deprivation of liberty is one of the topics that have been discussed as a staff group in staff meetings. The registered manager has provided information in the AQAA that all items of equipment in use in the home remain in good working order. No evidence could be found at the last inspection that regular checks were undertaken on the fire system and equipment in the home. Evidence was seen at this visit that these visual checks are now regularly undertaken to make sure that the equipment remains in good working order to be effective if there is a fire. At the last inspection the home was required to ensure that all staff participate in regular fire drills so that they know what to do to make themselves and people who live in the home, safe if there is a fire at the home. Evidence was seen that this is now done, but it is not always clearly recorded. As mentioned previously, the homes staff training matrix identifies that most staff are up to date with essential training for their role, with the exception of one member of staff who has not undertaken training in how to look after medicines safely, understanding health and safety in the home and how to protect people. This omission has not been identified on the six monthly training programme and it is required that these deficits are action so that it can be certain that all care staff working in the home are up to date in current care practices. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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