Care Home: Bankfield Road Care Home

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What the care home does well Bankfield Road Care Home presented as a warm and caring home. On the day of the visit, the environment was found to be homely, clean and generally well maintained. Service users appeared relaxed and content in their home environment and the manager and her staff team were seen to engage with service users in a positive, respectful and dignified manner. Staff spoken with confirmed they had access to induction, ongoing training and support and demonstrated knowledge and understanding of the needs of the people they cared for. Feedback received from the relatives of the people living in the home was positive regarding all aspects of the service provided. Comments included: "The staff are very attentive to my sister`s needs." "You can go anytime unannounced. You are always welcome and my daughter is always spotless." " The manager and staff are superb and have a great sense of humour." "All aspects of care are good and my daughter is well looked after." Service users were supported to participate in a range of activities and encouraged to maintain relationships with family and friends. The service enabled the people living in the home to take responsible risks and a range of risk assessments had been completed to identify and control potential risks. A care planning system had also been established to ensure the needs of service users were appropriately acted upon and medication and health care records viewed confirmed these areas were well managed and that service users had regular access to a range of health care professionals, subject to individual need. A programme of quality assurance and service monitoring had been established. Furthermore, a range of policies and procedures had been developed to provide guidance to staff and to ensure an appropriate response to suspicion or evidence of abuse and any concerns or complaints about the service. What has improved since the last inspection? Since the last inspection arrangements have been made for staff to complete training in the Protection of Vulnerable Adults from Abuse. Annual satisfaction surveys had also been sent to the relatives of the people using the service in order to obtain their views on the standard of service. What the care home could do better: The Statement of Purpose and Service User Guide should be dated and reviewed to ensure all the required information detailed in Schedule 1 and Regulation 4 and 5 of the Care Home Regulations 2001 is included. This will ensure prospective and current service users and their representatives have access to all the necessary key information on the service. A copy of the assessment of need completed by a care manager (health or social services) should always be obtained in addition to an assessment undertaken by the registered manager prior to admission. This will help to ensure staff understand the needs of service users and safeguard the welfare of the people using the service. Information on the ethnicity of service users should be recorded in each service user`s file to ensure best practice. A copy of the local authority`s adult protection procedures should be obtained for the manager and staff to reference. The registered manager should complete a National Vocational Qualification in Health and / or Social Care at level 4 to ensure she has the necessary qualifications for her role. A copy of the manager`s training record together with documentary evidence of training completed should be available for inspection at Bankfield Road Care Home. The registered manager should ensure that an up-to-date electrical wiring certificate is in place and that the fire alarm is periodically serviced and certified to safeguard health and safety. Key inspection report Care homes for adults (18-65 years) Name: Address: Bankfield Road Care Home 2a Bankfield Road Widnes Cheshire WA8 7UN     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: Daniel Hamilton     Date: 0 3 0 2 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 31 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 31 Information about the care home Name of care home: Address: Bankfield Road Care Home 2a Bankfield Road Widnes Cheshire WA8 7UN 01514205395 01512204712 bankfield@c-I-c.co.uk www.c-i-c.co.uk Community Integrated Care care home 6 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home 2a Bankfield Road is a care home providing accommodation and 24-hour personal care for 6 adults with learning disabilities. The home is owned and managed by Community Integrated Care, a not for profit organisation. The home is located off Liverpool Road in Widnes, on a bus route within easy reach of Widnes Town Centre and Hough Green station. The home is a purpose built dormer bungalow with only staff facilities upstairs. Residents accommodation is on the ground floor and comprises six single bedrooms, two assisted bathrooms, a separate assisted toilet, a large lounge / dining room, a kitchen and utility room. There are no en-suite facilities. There is a small parking area at the front and a garden with patio at the back. The staff team consists of the Registered Manager (Mrs Susan Owen) who is supported Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 6 Brief description of the care home by nine support staff and a housekeeper. The weekly fees at Bankfield Road are £87.65 paid by the service users and £912.83 paid by Social Services or other sources. Optional extras include personal items, transport costs, activities and hairdressing. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use the service experience excellent quality outcomes. This unannounced inspection took place over one day and lasted approximately 7 hours. Five people were living in the home at the time of the visit. A site visit took place as part of the unannounced inspection and a tour of the home was completed. Some care, staff and service records were also looked at. The registered manager and three support workers were spoken with during the visit and the five people living in the home were encouraged to join in with the inspection process using their preferred methods of communication. Telephone contact was also made with the relatives of four service users following the inspection and feedback has been included in the report. Care Homes for Adults (18-65 years) Page 6 of 31 Reference was made to an Annual Quality Assurance Assessment (AQAA) which was completed by the registered manager before the visit. This document enables the Provider (Community Integrated Care) to undertake an assessment of the service, prior to an inspection. All the key standards were checked and action taken in response to a requirement and recommendations made at the last inspection in January 2007 reviewed. Since the last inspection a new registered manager (Mrs Susan Owen) has been appointed to the home. Staff spoken with confirmed Mrs Owen was approachable and supportive and the people using the service were observed to communicate and engage with the manager and her staff team in a positive manner. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service User Guide should be dated and reviewed to ensure all the required information detailed in Schedule 1 and Regulation 4 and 5 of Care Homes for Adults (18-65 years) Page 8 of 31 the Care Home Regulations 2001 is included. This will ensure prospective and current service users and their representatives have access to all the necessary key information on the service. A copy of the assessment of need completed by a care manager (health or social services) should always be obtained in addition to an assessment undertaken by the registered manager prior to admission. This will help to ensure staff understand the needs of service users and safeguard the welfare of the people using the service. Information on the ethnicity of service users should be recorded in each service users file to ensure best practice. A copy of the local authoritys adult protection procedures should be obtained for the manager and staff to reference. The registered manager should complete a National Vocational Qualification in Health and / or Social Care at level 4 to ensure she has the necessary qualifications for her role. A copy of the managers training record together with documentary evidence of training completed should be available for inspection at Bankfield Road Care Home. The registered manager should ensure that an up-to-date electrical wiring certificate is in place and that the fire alarm is periodically serviced and certified to safeguard health and safety. 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 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information on the service and assessment systems are in need of review so that people thinking of moving into Bankfield Care Home have sufficient information to help them to make a decision whether the service can meet their needs. Evidence: A Statement of Purpose had been produced in the form of a Welcome to Bankfield Pack, together with a Service User Guide to provide key information on the service provided at Bankfield Road Care Home. The documents had been produced using large print and pictures. At the time of the visit both documents were in need of review. For example, the Statement of Purpose did not include details of; the name and contact details of the Care Quality Commission, details of the Registered Provider, age range and sex of service users, criteria for admission, arrangements for the review of the service users care plans, room sizes etc as required under Schedule 1 of the Care Home Regulations 2001. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: Examination of the Annual Quality Assurance Assessment (AQAA) for the service confirmed that a a procedure for referral and admission was in place. Only one new service user had moved into the home since the last inspection. The registered manager reported that the service user had visited the home for trial visits and that a multi-disciplinary meeting was coordinated to discuss the service users needs prior to admission. Discussion with the manager and examination of records revealed that the service had admitted the service user to the home without having received a copy of a care management assessment and no assessment of need had been completed by the manager. Another file was viewed for a service user who had lived in the home for over nineteen years and this was found to contain a copy of a recent re-assessment of needs and care plan completed by a Social Worker. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The changing needs of service users are appropriately planned and supported to promote independence, choice and wellbeing. Evidence: The Annual Quality Assurance Assessment (AQAA) for Bankfield Road Care Home confirmed the service has access to a policy on Individual Planning and Review. Two files were selected to view during the inspection. Both were found to contain Care Plans which were based around the activities of daily living model. Care plans outlined Needs / Problems, Objectives / Outcomes and Staff Instructions. Advice was given to the manager regarding the terminology used on forms to ensure best practice. A Health Action Plan and Essential Lifestyle Plan were also on file which provided person centred information on each individual. The information was informative, clear and concise and photographs had been used to illustrate personal goals and achievements. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: A range of supporting information was also available for reference. For example, person centred risk assessments, communication diaries, activity programmes, health care information and financial support plans etc had been completed. Service users were encouraged to participate in the inspection process using their preferred methods of communication and staff demonstrated knowledge and understanding of how to communicate effectively with the people they cared for. Likewise, the registered manager and staff on duty were seen to engage with service users in a positive, respectful and dignified manner. Service users continued to be supported to take responsible risks as part of their daily lives. Risk assessments had been completed to ensure personal, community based and environmental risks had been identified, together with the action and precautions required. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals, activities and routines are flexible and varied to enable service users to follow their preferred lifestyle. Evidence: Some of the service users continued to access day care and / or educational activities in addition to participating in a range of person centred activities within their home and local community. Bankfield Care Home also an accessible mini-bus to enable service users to access community facilities more easily, due to the service users complex support needs. Discussion with the registered manager and staff and examination of activity records confirmed the people using the service had accessed a wide range of activities / venues including; meals out, bowling, rugby, cricket, theatres, cinemas, churches, shopping, trips out, aromatherapy pools and visiting local pubs and parks etc. Records Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: also showed that some service users had participated in weekend breaks in Britain and foreign holiday breaks with staff. It was evident from speaking to the registered manager and her staff team that the service is passionate about supporting service users to experience different and meaningful activities and to be part of their local community. Previous inspection records detail that the staff team have worked hard to foster good relationships with neighbours and discussion with relatives confirmed the service users were supported and encouraged to receive visits from their family members at any reasonable time. Daily routines remained appropriate and person centred. Service users continued to complete household tasks such as shopping, cleaning and washing with staff support as necessary. The registered manager reported that the service had a budget of approximately £250.00 per week for food. Service users were assisted on an ongoing basis by staff regarding their choice of food and each service users dietary intake was monitored and recorded. Meals were served in the homes dining area at times convenient to the service users. Service users were encouraged to be involved in the preparation of their meals and support was provided from staff during meal times with eating and drinking. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive ongoing support with their personal, health care and medication needs to ensure a healthy lifestyle. Evidence: Examination of the Annual Quality Assurance Assessment (AQAA) for Bankfield Road Care Home confirmed policies were in place for medication and the value base of social care to provide guidance to staff. Information on each service users personal care needs was recorded within care plan documentation and the manager and staff spoken with demonstrated a good understanding of each service users physical and emotional needs, the principles of best care practice, equality and diversity issues and the need to promote privacy, dignity and independence when providing care to vulnerable adults. The general health care needs of the people using the service been recorded within health action plans and appointments with health care professionals had been documented in health care information forms. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Records viewed provided evidence of appointments with a range of health care professionals including: general practitioners, dentists, opticians, chiropodists, psychiatrists and dietitians etc subject to individual need. None of the service users had responsibility for managing their own medication at the time of the visit. A service user identification system had been established together with a staff signature checklist and copies of patient information leaflets had been filed for reference. The registered manager confirmed staff had completed in-house medication training in addition to electronic learning modules and competency assessments. Records had been maintained by the registered manager to confirm the same and specialised training had been completed for staff to enable them to administer medication using specialised techniques. Medication was securely stored in a lockable cupboard and a separate storage facility was in place for Controlled medication. Medication Administration Records had been completed to confirm the administration of medication and good standards of record keeping were noted to confirm the receipt, ongoing balance and administration of medication. Daily stock checks and auditing systems were also in place to ensure best practice. Feedback received from relatives of the people using the service regarding the care provided was good. For example, comments included: The staff are very attentive to my sisters needs. You can go anytime unannounced. You are always welcome and my daughter is always spotless. The manager and staff are superb and have a great sense of humour. All aspects of care are good and my daughter is well looked after. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems have been developed to listen and respond to complaints and to safeguard and protect service users from abuse. Evidence: A copy of the Registered Providers Complaints procedure was in place in the reception area of Bankfield Road Care Home. The registered manager was requested to ensure that the full details of the procedure were also included in the Statement of Purpose and Service User Guide. Examination of the homes complaint log confirmed no complaints, concerns or allegations had been received in the last 12 months. Likewise, no complaints or safeguarding issues had been brought to the attention of the Care Quality Commission. Several compliments about the high standard of service provided had been recorded in the complaint log from several health care practitioners and two parents and all relatives spoken with confirmed they were aware of how to complain. On the day of the visit the registered manager was unable to locate a copy of the local authority adult protection procedures. The Annual Quality Assurance Assessment for the service confirmed policies were in place for disclosure of abuse and bad practice (Whistle blowing). Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Discussion with the registered manager and staff and examination of training records confirmed staff had access to training in the protection of vulnerable adults as part of their training and development. The registered manager and staff spoken with demonstrated a sound awareness of the different types of abuse, reporting procedures and their duty of care to protect and safeguard vulnerable adults from abuse. Service users were observed to be relaxed and comfortable in their home environment and communication between staff and service users was positive. Feedback received from four family members confirmed they were all aware of how to raise any concerns regarding the service and were satisfied with the standard of care provided. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bankfield Road Care Home is pleasant and generally well maintained. This provides the people living in the home with a safe, clean and comfortable environment. Evidence: Bankfield Road Care Home is owned by the Registered Provider (Community Integrated Care) who hire contractors for specialised work and to maintain the grounds. The registered manager reported that property receives ongoing investment as required and a maintenance manual was on site for staff to record any maintenance jobs required. On the day of the visit the property appeared to be maintained to a satisfactory standard both internally and externally. The Registered Providers Head of Property Services was observed to be on-site reviewing the standard of work completed on the drainage system by a contractor and other contractors were observed to be repairing loose mortar joints in the external flags. Since the last inspection the medication cupboard had been moved to a more accessible area, a new pathway had been put in place in the garden to improve access and the building had been repainted. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: It was noted that some dining room seats were in need of replacement or repair as the covers were worn / damaged. Furthermore, the glass on a service users wardrobe was cracked. The registered manager reported that these issues were due to be addressed in the near future in addition to other maintenance issues including the installation of a new kitchen, rear door and water feature. A new television was also on order for the lounge. All areas viewed during the inspection were clean, tidy and hygienic. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems have been established to ensure staff are appropriately recruited and trained for their roles. This ensures the people using the service are protected and in safe hands. Evidence: Bankfield Road Care Home had a team of one registered manager, a deputy manager, nine support workers and a housekeeper. At the time of the inspection there were five people living in the property. Examination of rotas highlighted that the care home was usually staffed with three staff during the day. At night two waking night staff were on duty and another staff member undertook sleep-in duties. The registered manager also worked alongside staff during the day and was allocated two days per week supernumerary time (used for administration etc). Discussion with the registered manager, direct observation and discussion with parents and / or relatives confirmed the staffing levels were sufficient to ensure the needs of service users were met. The Annual Quality Assurance Assessment (AQAA) detailed that the Registered Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Provider (Community Integrated Care) had a policy on recruitment, including redundancy, and that satisfactory pre-employment checks had been completed for all new staff. Recruitment was co-ordinated by the Registered Providers Human Resources Department. The registered manager reported that three support staff workers had commenced employment at Bankfield Road Care Home since the last visit. The recruitment records for the three staff were viewed and all the necessary records required under the Care Home Regulations 2001 had been obtained for the new employees. This ensured the welfare of the people using the service was safeguarded. The Annual Quality Assurance Assessment (AQAA) for the service detailed that six of the nine staff (66.66 ) had completed a National Vocational Qualification (NVQ) in Care at level 2 or above. The Registered Provider had a training department, which delivered certain core training for staff. The organisation had also developed a CIC e-learning system which covered induction training; core skills; abuse; health and safety; food safety; first aid; fire safety; moving and handling; communication and record keeping etc. Practical training was also provided for moving and handling, first aid and basic food hygiene topics. It was not possible to view some training records on the day of the visit as the computer could not be accessed due to the electrical supply being interrupted. Additional training was coordinated on a regular basis and a training bulletin was sent out to the care home by the training department every three months. Staff spoken with during the visit demonstrated a good awareness of the needs of the people living in the home and confirmed they had access to induction and ongoing training and direct and indirect supervision from the manager. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bankfield Road Care Home is appropriately managed with systems, policies and procedures in place to ensure the health and safety of the people living there are promoted and protected. Evidence: Since the last inspection, the former deputy manager (Mrs Susan Owen) has been appointed as the manager of the service. Mrs Owen is Registered as the manager of Bankfield Road Care Home with the Care Quality Commission and has managed the service since approximately January 2007. At the time of the visit a training record and documentary evidence of training completed by the manager was not available for examination and the manager was requested to ensure these records are available at Bankfield Road Care Home for future inspections. The registered manager was able to provide evidence following the inspection that she had completed the level 4 National Vocational Qualification (NVQ) Registered Managers (Adults) qualification together with other training relevant to her role. The registered manager was advised to complete a NVQ level 4 in Care or Health Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: and Social Care to ensure she has the necessary qualifications for her role. Mrs Owens demonstrated enthusiasm and a clear commitment to the ongoing development of the service provided at Bankfield Roads Care Home and was observed to demonstrate a clear sense of direction to staff. Staff spoken with confirmed the manager was approachable and supportive. On the day of the visit the electricity supply to the premises was interrupted for several hours. Despite this the manager was noted to organise contingency plans for meals and emergency accommodation for the people using the service and dealt with the situation in a calm, organised and professional manner. The registered provider (Community Integrated Care)had developed a quality assurance policy and arrangements were in place for a senior manager to undertake monthly visits to Bankfield Road Care Home in accordance with Regulation 26 of the Care Home Regulations 2001. This involved carrying out an audit of key aspects of the service to ensure best practice. Systems had been established to ensure annual service reviews and internal and 6monthly quality monitoring audits were undertaken which involved service users and their carers. Annual surveys were also sent out from head office to service users and /or their relatives asking for their views of the service provided at Bankfield Road Care Home. The manager was advised to ensure the surveys were dated. Information received via the Annual Quality Assurance Assessment (AQAA) for the service confirmed policies and procedure had been developed on Health and Safety. Likewise, the dataset section of the document confirmed that the majority of equipment / services in Bankfield Road Care Home had been routinely serviced and /or tested. It was noted that the date of the last electrical wiring certificate was not recorded on the AQAA and the date of the last fire service was recorded as May 2000. These checks / service requirements should be checked to ensure they are in place and up-to-date. Fire records were viewed during the visit and confirmed that the fire alarm system had been tested each week and that the emergency lighting and extinguishers had generally been tested on a monthly basis. Records had also been maintained to confirm weekly health and safety checks had Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: been completed, which included the testing of the hot water outlets. An up-to-date fire risk assessment had also been completed for reference. Low surface radiators were in place and the registered manager reported that the hot water was regulated to a safe temperature via the boiler. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The Statement of Purpose and Service User Guide should be dated and reviewed to ensure all the required information detailed in Schedule 1 and Regulation 4 and 5 of the Care Home Regulations 2001 is included. This will ensure prospective and current service users and their representatives have access to all the necessary key information on the service. A copy of the assessment of need completed by a care manager (health or social services) should always be obtained in addition to an assessment undertaken by the registered manager prior to admission. This will help to ensure staff understand the needs of service users and safeguard the welfare of the people using the service. Information on the ethnicity of service users should be recorded in each service users file to ensure best practice. Another copy of the local authoritys adult protection procedures should be obtained for the manager and staff to reference, to ensure best practice. A copy of the managers training record together with documentary evidence of training completed should be Page 29 of 31 2 2 3 4 6 23 5 37 Care Homes for Adults (18-65 years) 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 available for inspection at Bankfield Road Care Home. 6 37 The registered manager should complete a National Vocational Qualification in Health and / or Social Care at level 4 to ensure she has the necessary qualifications for her role. The registered manager should ensure that an up-to-date electrical wiring certificate is in place and that the fire alarm is periodically serviced and certified to safeguard health and safety. 7 42 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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