Care Home: Badby Park

What the care home does well Records and discussion with staff show that detailed assessments are carried out before anyone moves to Badby Park to ensure that the home can meet people`s needs and expectations. A relative of someone staying at the home commented "Quality of care is fantastic......has received exceptional one to one care since he arrived and this is enabling him to live as happy and comfortably as possible." Individual plans of care seen contained detailed information for staff to ensure peoples needs are fully met and their preferences respected. One person staying at the home told us "I like to get out - I have never been out as much as I have since I moved here, I am going out tomorrow night." and went on to say that "friends can visit anytime" The home has recently been awarded a `Heart Beat Award` which is a nationally recognised award given to caterers who demonstrate a commitment healthier food choices. The day before the inspection the home had won a national award as part of the Health Care design awards for the best restoration and extension. The home has also been awarded five stars from a recent environmental health inspection. This is the highest level. One person staying at Badby Park told us "What I am most impressed with is the friendliness and helpfulness of the carers." Another person commented on the "Very good staff" Observations made during the inspection showed that staff treated people respectfully and had a good relationship with the people staying at the home. One member of staff told us "I love the fact that the care is very individualised and that staff have plenty of time to interact with all the residents." Staff told us that "Badby Park is extremely well run." What has improved since the last inspection? This is the first time that the service has been inspected since it registered with the Care Quality Commission. What the care home could do better: Some potential areas of risk were identified during the inspection and, although the staff had a good knowledge of the risks and the measures to take to keep people safe, this information was not always fully documented. Decisions relating to the withdrawal of active care measures and whether to resuscitate a person need to be clearly documented, including who was involved in the decision, what considerations were made and the basis for the decision. Medication records need show a clear audit trail of medication received into the home and when it is administered. Information relating to Deprivation of Liberty authorisations should be referenced within the appropriate sections of the person`s individual plan of care. Pre recruitment checks should include two written professional, rather than character, references as these give greater accountability and help to ensure that staff employed to work at the home are suitable to do so. Key inspection report Care homes for adults (18-65 years) Name: Address: Badby Park Badby Road West Badby Daventry Northamptonshire NN11 4NH     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: Catherine Perrins     Date: 2 6 0 3 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 30 Information about the care home Name of care home: Address: Badby Park Badby Road West Badby Daventry Northamptonshire NN11 4NH 08008404088 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): info@badbypark.co.uk P J Care Ltd Name of registered manager (if applicable) Ms Mandy Ludlow Type of registration: Number of places registered: care home 68 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accomodated is: 68 The registered person may provide the following category of service only: care home with nursing-code N To service users of the following gender: either Whose primary care needs on admission to the home fall within the following category: physical disability-code PD Date of last inspection Brief description of the care home Badby Park is a large detached property set in several acres of grounds on the outskirts of Daventry. It has been refurbished and extended to a high standard and offers critical and specialist nursing care and rehabilitation within three separate care centres. The Meadows care centre has 24 bedrooms for people with long term progressive neurological disorders; The Arbury Care Centre has 27 bedrooms for Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 68 Brief description of the care home people requiring neuro-rehabilitation and The Lantern Care Centre has 17 bedrooms for people who require intensive and critical care. The home offers long term and respite care. The care team includes nursing and care staff as well as physiotherapists, occupational therapists, speech and language therapists, psychologists and neuro-psychiatrists. The home also employs activity staff and a range of ancillary staff. The home is fully accessible to people with restricted mobility and people who use wheelchairs. The home has a walled garden, roof terrace and large patio area. The home was registered with the Care Quality Commission 7th October, 2009 and started to take admissions in November 2009. Fees are assessed based on individual need and range from approximately GBP1000 to GBP3000 per week. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for people using the service. As part of the preparation for this inspection a period of three hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for since the service registered with the Commission in October, 2009. This included: Care Homes for Adults (18-65 years) Page 6 of 30 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. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Relevant information from other organisations. The inspection visit lasted six and a half hours during the morning and afternoon of a weekday. During the inspection two people were case tracked. This involves looking in detail at all aspects of their care and experiences at Badby Park, including looking as their individual plans of care and other records, talking to them and talking to their care staff. We also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The registered manager was not present for the inspection but one of the company directors was present. The report refers to we because it is written on behalf of the Care Quality Commission. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Some potential areas of risk were identified during the inspection and, although the staff had a good knowledge of the risks and the measures to take to keep people safe, this information was not always fully documented. Decisions relating to the withdrawal of active care measures and whether to resuscitate a person need to be clearly documented, including who was involved in the decision, what considerations were made and the basis for the decision. Care Homes for Adults (18-65 years) Page 8 of 30 Medication records need show a clear audit trail of medication received into the home and when it is administered. Information relating to Deprivation of Liberty authorisations should be referenced within the appropriate sections of the persons individual plan of care. Pre recruitment checks should include two written professional, rather than character, references as these give greater accountability and help to ensure that staff employed to work at the home are suitable to do so. 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information about the home and their needs are thoroughly assessed before they move in to ensure that the home is right for them. Evidence: The home has a brochure which includes a statement of purpose and information about each of the three units within Badby Park. This provides clear information about the home and the services it offers. Records and discussion with staff show that detailed assessments are carried out before anyone moves to Badby Park to ensure that the home is can meet peoples needs and expectations. People living at the home told us that either they, or their relatives had been able to visit prior to them moving in. At the time of inspection there were twelve people staying at the home. One of the directors told us that people were being admitted gradually to ensure that the home Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: could fully assess and meet peoples needs. An emergency admission was agreed during the inspection for the following day. Observation showed that this was being carefully planned to ensure that the persons needs could be fully met. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated as individuals, their preferences respected and encouragement given to exercise choice in their daily lives. Evidence: A relative of someone staying at the home commented Quality of care is fantastic......has received exceptional one to one care since he has arrived and this is enabling him to live as happy and comfortably as possible. Each person staying at the home has an individual plan of care which contains their health action plans, risk assessments, daily notes and other information that the staff need to care for people in the right way. Individual plans of care seen contained detailed information for staff to ensure peoples needs are fully met and their preferences respected. For example the health action plan for one persons personal care gives very detailed and specific instruction to staff taking account of the persons health and hygiene needs whilst respecting their preferences and upholding their dignity. Staff told us that they always talk to the people they are caring for and Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: explain what they are doing even if the persons condition means that they may not be able to show that they are aware of what is being said to them. One of the directors explained that the home has identified dignity champions to ensure that peoples dignity is respected. Some of the dignity champions are staff members and some are relatives of people staying at the home. Discussions with staff showed that they had a very good understanding of peoples needs and how to care for them. One person staying at Badby Park told us There is always two staff to help me, they know what to do and how to use the hoist and how to care for me. Another person told us that staff know whats gone on and what to do People staying at the home told us that they were able to make choices about how they spend their time and when they get up and go to bed. Individual plans of care contained some assessments of the risks to people and to the staff supporting them for example from moving and handling. Further potential areas of risk were identified during the inspection and, although the staff had a good knowledge of the risks and the measures to take to keep people safe, this information was not always fully documented. Advice was given to one of the directors about the need to clearly document all decisions relating to the withdrawal of active care measures and whether to resuscitate a person including who was involved in the decision, what considerations were made and the basis for the decision. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples quality of life is promoted in accordance with their known lifestyle and interests. Evidence: The home employs activity staff as well as care staff. A visitor explained that one of the activity staff had spent time with her discussing her relatives interests and hobbies so that they could offer activities which reflect these. She also told us that the staff do individual activities and have brought in music and books that are appropriate for the age and interests of her relative. One person staying at the home told us I like to get out - I have never been out as much as I have since I moved here, I am going out tomorrow night. and went on to say that friends can visit anytime Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Staff told us that one person is helped to use Skype (a service that allows people to make video calls via the internet) to keep in touch with relatives who do not live in the local area. One of the directors told us that all of the bedrooms have internet access, a telephone point and Sky television. The home has a large activity room which can be used be people on any of the units. There is also a walled garden with a large greenhouse. On the day of inspection one person staying at the home spent time doing some gardening in the greenhouse. There is a seated communal area over looking the walled garden, one of the directors told us that when families with children visit the children can play in the garden. People told us that the food is good. One person said that if you dont like what is on the menu they will do you something else. The menu was viewed and appeared varied and nutritious. The home has recently been awarded a Heart Beat Award which is a nationally recognised award given to caterers who demonstrate a commitment healthier food choices. The chef showed us a pictorial menu that he has developed which contained photographs of all of the foods on the menu to help people indicate their preferences and choices. The chef told us that he talks to the people staying in the home to make sure that they are happy with the meals that have been served. Staff explained that people can eat in their bedrooms, in the communal areas on each unit or, if they prefer to eat somewhere quieter, they can go to the activity room. Staff told us that this can be useful for people who may become distracted eating in a busier environment or people who are at risk of choking. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health care needs are being met by staff who understand their needs and deliver care in a respectful manner. Evidence: Information about peoples health and personal care needs is clearly documented in their Health Action Plans and associated paperwork. This ensures that staff have the information that they need to ensure that peoples health and personal care needs are being met. For example the pain assessment for one person who is not able to verbally indicate that they are in pain states the facial expressions, body language and physiological indicators which suggest that the person is in pain. In one persons health action plan it noted that they should change position ever three hours to help ensure that they do not develop pressure sores. At the time of inspection there was no monitoring sheet in place to check whether the person is being helped to change position as required. Staff explained that they were aware of the fact that the person needed to change position and that with only twelve people in the home they were able to monitor this and ensure that it did happen. Staff told us that a sheet had been developed to monitor this information but that it was in the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: process of being approved by the company before it could be used. The administration of medication is generally well managed with appropriate storage and recording systems in place to ensure that people are receiving their medication as prescribed. There were some signatures missing on the medication record for one person who has some prescription cream. Staff explained that the usual procedure if someone had not been given there medication would be to note this in their daily notes. There was no entry in the daily notes for the days where to cream had not been signed for so it could not be substantiated whether the cream had been given as prescribed on these occasions. The tablets for one person were counted and showed a slight discrepancy between the total in stock and the total recorded on the medication recording sheet. Staff explained that the discrepancy was probably due to some medication that was received from the hospital rather that through the pharmacy. The need to have a clear audit trail of medication received into the home was discussed with staff. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes policies, procedures and by staff having a good awareness of how to safeguard people from harm. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. This was displayed in the foyer of the main entrance to the home. Staff spoken to knew how to raise any concerns that they may have and had a good understanding of their responsibilities under safeguarding adults procedures. The home has not received any complaints and has not made any referrals to the Local Authority under the safeguarding adults procedures. The home has applied for, and been granted, authorisation under the deprivation of liberty safeguards to provide treatment for one person. Records show that the correct procedures were followed to obtain this authorisation. Advice was given to one of the directors about the need to reference the authorisation within the persons health action plans. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a spacious, well designed and comfortable living environment which meets their care needs. Evidence: Badby Park is a large detached property set in several acres of grounds. It has been renovated and extended to offer a high standard of accommodation. The home consists of three seperate units with additional facilities such as the activity room, therapy room, kitchen, laundry, training room and staff facilities. The home also has numerous storage areas which ensure that equipment can be safely stored in designated places. The day before the inspection the home had won a national award as part of the Health Care design awards for the best restoration and extension. The home has been decorated and furnished to a high specification and was noted to be clean and hygienic throughout. All of the bedrooms within each of the three units are single with an ensuite. The en suites do not have doors fitted to allow people to access the bathroom facilities more easily, this does not compromise peoples privacy as each of the bedrooms has a lockable door. One of the directors explained that where requested a bathroom door can easily be fitted with the use of specifically designed hinges. En suite bathrooms Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: have a walk in shower but one of the directors explained that if people need specific aids and adaptations these are individually assessed and fitted to meet the requirements of the individual. Each bedroom has a profile bed which can be adjusted to suit the needs of the person using it. Staff told us that people are encouraged to bring in items of their own to make their bedroom feel more personal. The wardrobes supplied by the home have been specifically designed so that they have shelving at the bottom where it can be reached by people using a wheelchair. One of the directors explained that there are four bedrooms which are available for relatives to stay in should they wish to. One relative we spoke to explained that she had stayed overnight when her relative was first admitted to the home, she told us that as a relative she felt that she had been treated very well by the home. Each of the units has a communal area where people can sit and take part in activities or watch television. These communal areas also have a small kitchenette for making drinks or light snacks. There are several other communal areas throughout the home where people can sit quietly or spend time with their visitors. An area within the Arbury unit is designated for people who want independent living. This area has its own kitchen that people can use with staff support if required. The Lantern unit has an area specially designed for people needing palliative care. The windows in the bedrooms in this area have been made so that they are low enough for people to be able to see through from their beds. The en suites in these bedrooms are fitted with doors so that visitors can use the facilities without having to leave their relatives rooms. The bedrooms in the critical care area have been designed so that they have access from the bedrooms onto a patio area where people can be wheeled in their beds. As well as the ensuite facilities there are several communal bathrooms, each with a freestanding roll top bath. One of the directors explained that these have been designed so that a hoist can be used in the bathroom and that the person can sit in the bath with the staff member standing behind them to allow them privacy while they bathe. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home is built over three floors with bed lift as well as stairs to access each floor. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being cared for by competent and caring staff team who have a good understanding of their needs. Evidence: One person staying at Badby Park told us What I am most impressed with is the friendliness and helpfulness of the carers. Another person commented on the Very good staff Observations made during the inspection showed that staff treated people respectfully and had a good relationship with the people staying at the home. One member of staff told us I love the fact that the care is very individualised and that staff have plenty of time to interact with all the residents. Another commented that the staff team worked together like a well oiled machine One relative described the staff as kind, happy, respectful, helpful, attentive. The recruitment of staff is generally well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with vulnerable adults. Advice was given to one of the directors about the need to have professional rather than character references as these give greater accountability. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff told us that they had an induction when they first started working at the home and that they attend training courses such as food hygiene, safeguarding of adults, infection control, fire safety and moving and handling. One of the directors told us about the range of staff development opportunities that the company offers. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate leadership, guidance and direction means that the home is managed in the best interests of the people who are staying there. Evidence: Staff told us that Badby Park is extremely well run. Staff spoken to had a good understanding of the homes fire procedures. Staff explained that fire drills take place on a regular basis but that the alarm for drills is usually silent to avoid unnecessary distress to the people staying in the home. Staff explained that the home were waiting for Oxygen warning signs to be delivered to put on the doors where oxygen is used or stored. Staff told us that there had been an incident on the day prior to the inspection where work men had cut through the power supply cable to the home. Staff described how they had worked together to respond quickly and efficiently and ensure that people were safe and that there were no adverse effects. Staff explained that they were able Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: to put in practice what they had learnt on recent training courses. The home carries out a number of quality audits and checks including audits of the medication, care documentation, health and safety and house keeping. Throughout the inspection observations and discussions with staff and the director who was present during the inspection, demonstated a strong committment to providing a high standard of care and support which met peoples individual needs and promoted their dignity. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 13 Where people use bed rails 30/06/2010 records must show how these have been assessed as appropriate and safe. To ensure the health and safety of all. 2 9 13 Any risks to individuals from 31/05/2010 activities that they take part in and from the environment must be fully assessed and the measures to reduce risks documented. To ensure the health and safety of all. 3 20 13 Medication records must show a clear audit trail of medication received into the home and when it is administered. To ensure that people receive their medication as prescribed. 31/05/2010 Care Homes for Adults (18-65 years) Page 28 of 30 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 Information relating to Deprivation of Liberty authorisations should be referenced within the appropriate sections of the persons individual plan of care. Pre recruitment checks should include two written professional rather than character references as these given greater accountability and hel to ensure that staff employed to work at the home are suitable to do so. 2 34 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. 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