Care Home: Barrow Hall Care Home

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What the care home does well The homes assessment process, ensures that a full assessment of need has been undertaken by people competent to do so, prior to a placement being offered. This ensures that the placement is appropriate. Prospective service users are given a statement of purpose and service user guide, which clearly describe the services that people can expect to receive. They also have the opportunity to visit the home prior to making a decision about moving there. The quality assurance systems within the home ensures that the views of people living there are sought on a regular basis and action is taken, where necessary as a result of these consultations. People living in the home are aware of the complaints process and were able to express their concerns. Staff are trained to a good standard, receive regular supervision and are supported in their roles. What has improved since the last inspection? At the last inspection visit a number of requirements were made. The home has worked hard to address these and improve the service. Training on Challenging behaviour, the Mental Capacity Act, Deprivation of Liberty, Mental health issues and safeguarding has been provided, giving staff a better understanding of individuals needs and how these can be supported effectively. There have been further aids made available in the Main hall promoting the independence of people with physical disabilities,making them less reliant on staff for assistance. Menus have been revised in consultation with people living in the home to ensure that there are adequate menu choices available at all meal times to ensure that all personal preferences can be catered for. Daily records have improved, providing a good level of information about individuals care delivery in an objective informative manner. There has been considerable progress within the improvement of the environment since the last inspection visit. Corridors have been fitted with new flooring, redecorated and new curtains fitted. Many of the bedrooms and accommodation in The Mews and Lodge have also been decorated and are in the process of further refurbishment to improve all areas of the accommodation for the people living there. What the care home could do better: A tour of the building identified that there were areas where there had been leaks,causing damp and damage to ceilings. Washbasins in three bedrooms and a shower were not in working order. Hot water to the rear of the building was found to be intermittent and two bathrooms were in need of repair and update. One bathroom facility consisted of three cubicles with either a bath or shower in them. When the environment was discussed with the manager, he produced an action plan of maintenance work to be completed within the home. This had previously been identified through the audit process and all repairs identified by the inspector were listed in an action plan of how the work would progress. A requirement was made to ensure that these repairs are completed within a reasonable timescale, to ensure that the people living in the home will be provided with a safe and comfortable place to live. Nine of the bedrooms in the Main hall are double and although there are privacy screens in place, this limits the amount of single accommodation available. There are no current plans to reduce the numbers of double rooms. Although many of the occupants of the double rooms are happy to share, there are situations where people would prefer their own room. A recommendation was made in respect of this. Key inspection report Care homes for adults (18-65 years) Name: Address: Barrow Hall Care Home Wold Road Barrow On Humber North Lincolnshire DN19 7DQ     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: Wilma Crawford     Date: 0 6 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 27 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 27 Information about the care home Name of care home: Address: Barrow Hall Care Home Wold Road Barrow On Humber North Lincolnshire DN19 7DQ 01469531281 01469532544 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Guardian Care Homes care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accodated is: 37 The registered person may provide the following categories 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 are within the following categories: Dementia Code DE, maximum number of places 37 Mental Disorder - Code MD, maximum number of places 37 Date of last inspection Brief description of the care home Barrow Hall is a listed building and retains many of its period features. The home is set in pleasant grounds in the village of Barrow, providing easy access to local shops and facilities. Barrow Hall offers personal and nursing care for up to 37 people with a mental health problem. The home is owned by Guardian Care Homes, which is a large national company. A choice of single and shared accommodation is available. In addition people who live in the home have access to a range of communal facilities including a dining room, sitting room and recreational area. Twenty-five beds are Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 0 37 37 2 1 1 0 2 0 0 8 Brief description of the care home provided in the main building, a further ten beds are provided in an adjacent building known as The Mews. The Mews consists of ten apartments. Two of the apartments have a separate bedroom, sitting room, kitchen and bathroom. The other eight apartments have an adjoining bedroom, sitting area and small kitchenette. All have separate bathrooms with showers, wash hand basins and toilets. Storage and telephone points are provided in all ten apartments. Two of the apartments have been adapted to accommodate service users with physical disabilities. The remaining two beds are provided in a self-contained house called The Lodge, which is situated at the top of the long driveway. The home has extensive grounds that people who live there have access to and there is ample car parking facilities. The weekly fees currently start from 550 pounds, this is based on information supplied by the manager during the visit on 6.10.2009. Care Homes for Adults (18-65 years) Page 5 of 27 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 2 star. This means the people who use this service experience good quality outcomes.We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. The inspection took place over seven hours, the manager was available for most of this time. The main method of inspection used was called case tracking, which involved selecting five people living in the home and tracking the care that they receive through the checking of their records,discussion with them , the care staff and observation of care practices. The premises were looked at and and the records of two staff were examined. The comments and views of people spoken to are included within the body of this report. Care Homes for Adults (18-65 years) Page 6 of 27 An Annual quality assurance assessment document requesting information about the home was sent out before the visit and information from this is also included. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: A tour of the building identified that there were areas where there had been leaks,causing damp and damage to ceilings. Washbasins in three bedrooms and a shower were not in working order. Hot water to the rear of the building was found to be intermittent and two bathrooms were in need of repair and update. One bathroom facility consisted of three cubicles with either a bath or shower in them. When the environment was discussed with the manager, he produced an action plan of maintenance work to be completed within the home. This had previously been identified through the audit process and all repairs identified by the inspector were listed in an action plan of how the work would progress. A requirement was made to ensure that these repairs are completed within a reasonable timescale, to ensure that the people living in the home will be provided with a safe and comfortable place to live. Nine of the bedrooms in the Main hall are double and although there are privacy screens in place, this limits the amount of single accommodation available. There are Care Homes for Adults (18-65 years) Page 8 of 27 no current plans to reduce the numbers of double rooms. Although many of the occupants of the double rooms are happy to share, there are situations where people would prefer their own room. A recommendation was made in respect of this. 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 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A full needs assessment is carried out and people are given enough information about the home and its facilities before admission, for them to be confident that their needs can be met by the service. Evidence: Individual care plans examined,demonstrated that peoples individual needs were assessed before any decision was made about whether the home could offer them a placement and meet their identified needs. Discussion with staff and the home manager about admissions, described the process as being the receipt of a community care assessment, followed by the home manager completing an assessment of the individual. This assessment includes looking at all aspects of the individuals personal history, clinical history (including mental health issues), previous employment and family. Once this has been completed people are given the opportunity to visit and,have a meal and an overnight stay, before making any decision about whether they wish to move in. This process ensures that new people are admitted only on the basis of a full assessment of need having been completed, by people competent to do so, ensuring Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: that the placement is appropriate. People in the home said that they had received a statement of purpose and service user guide and these clearly describe the what services and support they can expect to receive. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are able to make decisions and everyday choices as part of an independent lifestyle. Evidence: During the inspection the files of five people were examined.Individuals living in the home have a detailed care plan that fully describes their needs and the level of support they require.Details of peoples preferences in the way they wish their support to be offered and guidance for staff in how this can be achieved is also included. People living in the home are enabled to make decisions about everyday life in the home, evidence of this was seen in individual care plans and minutes of residents meetings. The notice board in the home displayed the date of the next residents meeting, which an external advocate was attending. The risk management system ensures that individuals are safe and risks are either eliminated or reduced to a minimum. the risk assessment process covers a number of identified areas including:verbal and physical aggression,communication difficulties,mobility, medication,weight loss,self harm,and sexualized Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: behaviours.Details of all areas of identified risk relevant to the individual, are available for staff and include information on how these can be reduced and what action staff should take. They also highlight at what point other professionals may be required and where they can be reached, should additional support be necessary. Risk assessments and behaviour management plans are discussed at supervision, giving staff the opportunity to raise any issues they may have. Once these are fully understood ,staff sign these to show they they have been discussed,are fully understood and what support they are expected to offer in different situations. This encourages a consistent approach from staff in managing difficult behaviours. Staff confirmed during discussion that this process is followed during supervision and that any new risk assessments, needing to be introduced quickly were raised at handover.The staff had a good understanding and knowledge of individuals care needs and risk assessments. People living in the home said that they were involved in all aspects of their care and decision making. There was clear evidence to show that care plans were regularly reviewed. During the inspection, two individuals approached staff to discuss their care plans with a view to making some changes in these and a time was agreed to complete this. Daily records were of a good standard,giving clear objective information about individuals care and well being. . Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have opportunities to access a variety of leisure activities, are supported to maintain relationships and have their nutritional needs met. Evidence: People living in the home are encouraged to maintain links with their families and friends, including staff being provided to support people to visit their relatives where this is needed. The home employs a full time activity coordinator who works flexibly and has developed a range of activities both within the home and the local community. Activities include attending a local adult education facility in the neighboring town, known as the knotted note, which provides an 18 week programme of planned activities including;cookery, food hygiene and IT facilities.Within the home the activity program provides a variety of planned activities including;gardening(some people have their own garden plots in the grounds growing herbs and flowers), crafts, art, Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: games, keep fit, baking, shopping, computer classes,CD morning,wildlife club,pub trips, pamper days, film afternoon, karaoke, WI fit and outings. The home has two mini buses for use. All activities are displayed on the notice board. people spoken with talked about forthcoming trips to Hull fair and days they had planned with their key workers to do their Christmas shopping. Holidays to Scotland and butlins had also taken place. The people living in the home are involved in the planning of activities and records of discussions were recorded within residents meetings minutes. Where people are reluctant to join in, the activities coordinator will work closely with them to engage them and plan opportunities of their own choosing to accommodate them. Religious services are available within the home. In addition to this additional social events take place, where other local care homes are invited, these include discos, barbeques and a forthcoming Halloween party has been planned. The menu is planned with input from the people living in the home and is based on individuals preferences. There are two choices of main courses at each meal, but discussion with the chef and people living in the home showed that a much larger choice of meals was available at each meal time on request. The food on offer is of a good quality and people receive a healthy varied diet. There are facilities in the home for people to make themselves hot or cold drinks throughout the day. Care Homes for Adults (18-65 years) Page 16 of 27 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 living in the home receive appropriate health care and personal support. The medication policy is adhered to and staff have been appropriately trained. Evidence: The home receives good support from outside agencies and can obtain consultant appointments immediately if required urgently. People living in the home have their health care needs met through the nurses that are employed at the home and support from their GPs and other health care professionals that are based in the community. A sample of five care plans were examined, these contained information to demonstrate that regular health checks and other health care appointments had taken place. Details of psychiatrist, optical, G.P, chiropody and other appointments were seen to have taken place. Information about the outcome of these visits was also available and care plans had been updated in accordance with any instructions made at this time. Medication procedures within the home are well maintained and adhered to. Stock levels and medication records are appropriately maintained. Care Homes for Adults (18-65 years) Page 17 of 27 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 using the service feel able to air their concerns without any fear of repercussions. The staff vetting procedure is sufficiently robust to ensure the safety of the service users. Evidence: Examination of the training records and discussion with the manager and staff, showed that all staff have now received training in the Safeguarding of Vulnerable Adults. Staff spoken with showed a good understanding of what their responsibilities were within this. The home has a clear complaints procedure. Discussion with staff and people living in the home showed that they have a clear understanding of the process and who they would approach with any concern or complaint they may wish to raise. There have been no complaints received by the home or the Care Quality Commission since the last inspection. Care Homes for Adults (18-65 years) Page 18 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have been provided with an adequate environment that is clean. Evidence: There has been considerable progress within the improvement of the environment since the last inspection visit. Corridors have been fitted with new flooring, redecorated and new curtains fitted. Many of the bedrooms and accommodation in The Mews and Lodge have also been decorated and are in the process of further refurbishment to improve all areas of the accommodation for the people living there. A tour of the building identified that there were areas where there had been leaks,causing damp and damage to ceilings. Washbasins in three bedrooms and a shower were not in working order. Hot water to the rear of the building was found to be intermittent and two bathrooms were in need of repair and update. One bathroom facility consisted of three cubicles with either a bath or shower in them. When the environment was discussed with the manager, he produced an action plan of maintenance work to be completed within the home. This had previously been identified through the audit process and all repairs identified by the inspector were listed with an action plan of how the work would progress. A requirement was made to ensure that these repairs are completed within a reasonable timescale, to ensure that the people living in the home will be provided with a safe and comfortable place to Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: live. Nine of the bedrooms in the Main hall are double and although there are privacy screens in place, this limits the amount of single accommodation available facilities available. There are no current plans to reduce the numbers of double rooms. Although many of the occupants of the double rooms are happy to share, there are where people would prefer their own room.These individuals are given priority when a single room becomes vacant.A recommendation was made in respect of this. People commented that they were happy with their rooms and that they had all been involve in the refurbishment process, choosing colours, furnishings and pictures. They were aware of the refurbishment programme and looking forward to the completion of the work. Additional moving and handling equipment has been put in place to enable all individuals to be as independent as possible and able to access the building without having to rely on staff for support to do this. All areas of the home were found to be clean and odour free. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by staff who are supervised and undertake training. The staff vetting procedure is sufficiently robust to ensure the safety of the residents Evidence: The staff spoken to by the inspector had all received a clear job description and interviews with the staff showed that they understood their own roles and responsibilities and those of their colleagues. New starters have an induction plan that follows the requirements of the Sector Skills Councils workforce strategy targets and all new staff to the home undertake an induction to the home, which must be completed within three months of their appointment. Staff training records and interviews with the staff show that they are effective in meeting the needs of the people living in the home. The staff rotas indicate that there are always appropriate numbers of staff available to the service users. Five staff returned questionnaires to the Commission, these were all positive in relation to the care of the service users and the management of the home. People living in the home opinions of the capabilities of the nursing and care staff were that they were good and had a good understanding of their needs. A great deal of professionalism and patience was seen to be offered by the homes staff to all of the service users, throughout the visit. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: 53 of the of care staff working at the home have achieved a National Vocational Qualification at level 2 or above.The remainder are working towards this award. Staff training records and interviews with staff supported that they receive all of the mandatory training and also receive specialist training to understand the needs of service users with mental health problems. The home has a large staff team consisting of trained Registered Mental Health nurses, carers and domestic staff. Additional support is also available from the manager, homes administrator, handyman,activities coordinator and catering staff. There has been an increase in staffing levels provided in the home since the last inspection. On the day of the visit there were three qualified nurses,five care staff, administrator, cook, kitchen assistant ,two domestic staff and a handyman on duty as well as the home manager. During the night there are three care staff and one trained nurse. Discussion with staff and people living in the home, confirmed that there were sufficient staff available to meet the needs of the people accessing the service. Staff meetings occur regularly and written evidence was available to support this. There has been considerable training opportunities offered to the staff team including; safeguarding of vulnerable adults,dementia,challenging behaviour, first aid, health and safety, basic food hygiene,Coshh, mental capacity act, deprivation of liberty,infection control, depression, mental health conditions, DICES risk assessment, psychosocial intervention and bereavement. The mental health related training in particular has been welcomed by the staff and has helped raise their awareness in understanding and responding to mental health and challenging behaviour issues. The files of two newly appointed staff were examined, this confirmed that the home undertakes appropriate checks including Criminal Records Bureau disclosure, POVA checks and two written references prior to staff commencing work. People living in the home are also involved in the recruitment process. Supervision records were examined and found that these were up to date and that all staff receive regular supervision. Staff commented that the manager is approachable and that he listens to them, they are now also feeling more supported by the new organisation. Comments made by relatives and professionals about the staff included;staff are always polite, helpful and courteous,staff carry out interventions as instructed in an appropriate manner,staff are able to manage service users with care and challenging behaviour issues effectively in a person centred way. Care Homes for Adults (18-65 years) Page 22 of 27 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 using the service live in a home that is run in their best interests, with their health and safety and welfare being promoted and protected. Evidence: The Registered Manager is a qualified Mental Health Nurse, who has considerable experience of working with people with mental health problems. Staff spoken with, and discussions with people living in the home,supported the evidence that the management of the home is open, positive inclusive and service users focused. Regular staff and service user meetings are held by the management to allow both groups to be able to offer their views on the development of services in the home. One person living in the home said the manager listens to you, and changes things. He is interested in us as people. Staff spoken to confirmed that they received regular supervision and were involved in hand overs and staff meetings. Direct and indirect observations made by the inspector during the site visit showed that the manager of the home does not restrict himself to an office, he walks around the home on a regular basis and integrates with the people living in the and staff. He was seen to be well received by all of the individuals living in the home and the staff. Two people Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: spoken to by the inspector together stated that the manager is very good, he has changed a lot of things here for the better. The homes quality assurance and monitoring system is undertaken corporately and the results are returned to the home. Information for the report includes questionnaires returned by service users and comments made by professional visitors when they visit the home. All visitors to the home are also encouraged to complete questionnaires. A sample of maintenance checks records recorded in the AQAA document corresponded to those in the home.The gas systems in the home all had up to date safety certificates. Fire systems are regularly monitored and serviced and all of the mobility aids in the home had been regularly serviced and maintained. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 24 23 Regulation 23(2)b The 31/03/2010 registered person shall having regard to the number and needs of the service users ensure that- the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. This would ensure that people living in the home could benefit from a safe, comfortable and homely environment. 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 25 The registered provider should consider how more single bedrooms can be made available for people who currently share double bedrooms. Care Homes for Adults (18-65 years) Page 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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