Care Home: Beach House

What the care home does well Each person has an assessment and there is good information forming the basis of their individual support plan. People say they like the home. They say they like the staff. There is a good number of staff to support the people living in the home. People have good support to keep in touch with their families. There is a good range of training for the staff so that they can support the people living in the home well. What has improved since the last inspection? Each person has a care plan and these have got better. They are working with their key workers on their own person centred plan that is easier to understand and shows what is important to them. Some of the people living in the home can`t speak and need help to say what they want in other ways. The speech and language therapist has worked with the home teaching the staff and providing some communication aids. This is ongoing. Each person also has a health action plan. These are also being filled in with the key worker. If a person needs support with a health condition the staff receive training so that they understand it better. Staff know what to do if people need help to manage their behaviour. Other professional people like Doctors and psychiatrists give advice too. People are doing more things and going out more. The lounges look more homely and there is an entrance room to the home. Some of the bedrooms have been decorated. The way people are helped to manage their money is better. The home has a new manager who has now registered with us. The manager has made lots of improvements. The people living in the home said he is nice. The staff said they feel better working in the home now they have a manager. What the care home could do better: The staff are working with the people living in the home with communication support and different aids. This is going to continue so that everyone has an aid that they can use to help them say what they want to. The staff are going to continue to work with the people living in the home on their care plans and health action plans. Staff are going to continue to talk to the people living in the home to find out what activities they would like to try and continue to improve their lifestyle. A lot of the rooms in the home are locked this is to safeguard the people in the home. The manager is going to look at different ways to safeguard people to see if some parts of the home do not need to be locked. There are plans to improve the building inside and outside so that the home is more comfortable and homely The manager has written a development plan for the home. There is a list of what they are going to do but not how they are going to do it. The manager said he would add how they are going to make improvements in the plan. Key inspection report Care homes for adults (18-65 years) Name: Address: Beach House 110 Wellington Parade Kingsdown Deal Kent CT14 8AF     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: Julie Sumner     Date: 1 6 0 9 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 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) 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 30 Information about the care home Name of care home: Address: Beach House 110 Wellington Parade Kingsdown Deal Kent CT14 8AF . Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Family Care Homes Ltd Name of registered manager (if applicable) Mr Michael Britton Type of registration: Number of places registered: care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who may be accommodated is: Nineteen (19) The registered person may provide the following category/ies of service only: Care Home only - PC To service users of the following gender:Either Whose primary care needs on admission to the home are within the following category/ies: Learning Disability - LD Date of last inspection Brief description of the care home Beach House is a large home right next to the beach. 19 people can live in the home. Now there are 13 people living there. Everybody living in the home has their own bedroom. The home has a minibus to take people out. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 19 Brief description of the care home There is a large garden at the back of the house. There is good space for parking cars. It costs about £376 to £921 to live here but it would depend what the persons needs are. Beach House is owned by Family Care Homes Ltd who have other homes and a day centre in the area. 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 manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The AQAA was clearly written giving us a good range of information. We talked to the manager about including more detail in the AQAA next time. We sent 5 surveys out to the people living in the home and 15 to the different people who are involved with them. We received 13 surveys back. We read the surveys that people had filled in. This included people who visit the home regularly. They said some good things about the home. They also pointed out some things they thought could improve. We visited the home without telling anyone we were coming so that we could see what they do on a usual day. We were in the home from 10.30 in the morning to around 6 Care Homes for Adults (18-65 years) Page 6 of 30 oclock in the evening. We said hello and talked to all the people that were in the home. We talked to the staff and the registered manager. We walked around the home and had a look to see what it is like. We looked at some care plans and health records. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. 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: The staff are working with the people living in the home with communication support and different aids. This is going to continue so that everyone has an aid that they can use to help them say what they want to. The staff are going to continue to work with the people living in the home on their care plans and health action plans. Care Homes for Adults (18-65 years) Page 8 of 30 Staff are going to continue to talk to the people living in the home to find out what activities they would like to try and continue to improve their lifestyle. A lot of the rooms in the home are locked this is to safeguard the people in the home. The manager is going to look at different ways to safeguard people to see if some parts of the home do not need to be locked. There are plans to improve the building inside and outside so that the home is more comfortable and homely The manager has written a development plan for the home. There is a list of what they are going to do but not how they are going to do it. The manager said he would add how they are going to make improvements in the plan. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been carried out and it is agreed the service can meet the persons needs. Evidence: Beach House is an existing service that has been re-registered under a different company name but the actual service has not changed at this time and it has been registered for 19 people with learning disabilities for many years. The home has a statement of purpose that is clear. The manager has updated it with his details now that he is the registered manager. He has also made some changes to the content. The statement of purpose will change as there are plans to change the service. At the last inspection visit we looked at three assessments. One assessment was for a person who has moved into the home quite recently. The assessments were clear and gave good information. The assessment process has not changed so we did not need to look at the assessments again at this visit. A visiting professional commented in a survey that the home carry out thorough assessments. We spent some time with the person at the last visit and he looked very settled in the home. We Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: saw him again at this visit and he looked happy. He has communication difficulties but indicated that he was still content with the home as he smiled and laughed each time we asked him what he thought of it. At the last visit we had a discussion with the area manager and home manager about the number of people with very different needs and how they decide who should move into the home. Up until now, they said, this home has been chosen if people want lots of activity and like being with people. No one has moved in recently and this is because of the building work planned to improve the home. The home is going to be separated into 3 parts which will all have their own entrance. The decisions about who will move into which part have not been made yet. There has been discussion with families and care managers. The people living in the home have not had full consultation about future plans at this time. The manager said there will be no new admissions until the new home layout is complete. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is some good information to support personal care and people are helped to stay safe carrying out their day to day activities. People would from further support to help them express their wishes and make important decisions about their life. Evidence: At the last visit we looked at three care plans. These were much better than they used to be. The way the care plans are designed has changed. Now there are pictures and the writing in them is more straightforward. We looked at two care plans this time. We talked to the manager about the design of them because everybody needs a different style to help them understand. We talked about the involvement of each person with their key worker. One of the plans had photos of the person carrying out different activities. We saw that a good start has been made with person centred planning and this needs to continue developing so that everyone has an effective person centred plan. The manager showed us the picture cards that they are currently using to assist with Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: peoples communication. These were cards with photos of different objects and activities. They explained how they use these to help people to say what they like and do not like. There was a list using photos of the cards in one of the peoples service user plan. We looked at another plan that also had some pictures in and the manager explained that they had spent some time with the person finding out what they liked and formulated a plan to support him to change bedrooms as this was a necessary part of the preparation for the development of the building to make it into 3 homes. The manager explained that each key worker is spending time with each person to find out what is important to them and write in the care plan. There is information describing how people communicate so that staff can respond to facial expressions and behaviours as well as some words. This has happened with some people living in the home so far. There have not been any meetings for the people living in the home. We were given some feedback from some care managers and visiting professionals to the home. Some of this feedback was good and some of it said that people are not involved in the decision making in the home. This is an area that needs further development to enable all the people living in the home to express their wishes and be involved in the decisions that effect their lives. The manager agreed with this and it is included in his development plan as part of the communication support and person centred planning. Risk assessments were included as part of the plan. This is so that if people want to do something they are not stopped because it is thought to be unsafe. Instead staff work out what support is needed to make it as safe as possible. There were guidelines for staff so that they can minimise risk including what to look out for and what to do about it. They include assessments for activities inside the home like having a bath and for activities outside like swimming and going into town. The risk assessments need to be expanded to include developing skills and this was discussed with the manager who has plans to do this. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most people in the home lead active lifestyles and staff are developing the activities further to benefit less able people. People are helped to keep in touch with their families. Good quality meals are served. Evidence: The home was busy when we arrived and people were doing different things. We talked to the people living in the home and the staff about what is happening in the home and what people have been doing recently. Staff write out a daily information hand over sheet which lists what everyone has done that day. The activities we saw written on this sheet were arts and crafts, beauty session, relaxed in lounge playing with bricks, puzzles and attending the day centre. We asked about people going out. Some of the people take it in turns to go swimming and this activity is provided each week. The manager explained that he is encouraging Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the staff to find different activities that are in the community for ordinary people and not just provide activities for people with disabilities. At present there is a mixture. Some people have shown an interest in carriage riding but people had not started this yet. It is being organised. The staff also complete individual records to say what people have done each day and these are kept in each persons file. As time goes on these are stored but there is no way of finding out what a person has done without going through each of these files individually. Staff said that the people living in the home are going out more but it was not possible to see how much in the time that we had. It is good that the staff are keeping records. We talked about organising the information in the records so that it can be referred to, with the manager. An occupational therapist visits the home four times a week to carry out arts and crafts activities. During the visit the physiotherapist visited to carry out reflexology and massage which people said they enjoy. We saw that people spend periods of time in the home unoccupied and waiting for the next event in the day like mealtime. Each person is supported to maintain contact with their family and friends. The names of people who are important to them are written in their support plan and some also have pictures of the people. Arrangements are made to help family members visit the home and also to take people to visit their families at their home. The staff help with transport picking people up and taking them to visit. Visitors can come to the home at any reasonable time and do not have to give notice but may need to make sure that the person is in. People are also supported to stay in touch over the telephone. Some of the peoples relatives sent us some surveys with comments in. They said the home are responsive to family request and when I have concerns for (name of person)s health they are dealt with asap. People are supported to attend family events that are important to them. One person showed us an album of photos where he had recently attended a family wedding with the support of the staff. Most of the downstairs is open and people were moving around the lounges, conservatory and hall and stairways. Some of the rooms in the home are locked. The people living in the home are able to go into the different rooms like the kitchen but need to ask staff first. We spoke to the manager about reviewing the need to lock the doors in the home and to consider other ways to safeguard the people living there without restricting access. The manager said that there was a need to safeguard individuals in this way but he would look at this with regard to good practice guidelines. The home employs a cook and when she is not working staff take it turns to be in the kitchen. We had lunch with the people living in the home. The food was hot and well Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: presented. People said they like the food. People do not generally participate in meal preparation as the kitchen is unsuitable. One of the people living in the home likes to help in the kitchen and does this when possible. New menus have been planned with the people living in the home. The kitchen needs refurbishment but this is part of the building works planned to make the home into three smaller units. There will be three kitchens and these will be designed so that the people living in the homes can use them. Care Homes for Adults (18-65 years) Page 17 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. Personal and healthcare support is responsive to the varied and individual needs and preferences of the people living in the home. Evidence: Staff have got to know each person well and have found out how they like to be supported with their personal care. Routines have been established for them and guidelines have been written in the care plan so that everyone is doing the same thing. Each person has a health action plan. We looked at three of these. The plan includes all the health needs they have and the support they need. People who have epilepsy have an epilepsy survey and chart which gives all relevant information on how the condition presents in the individual. This is so that if they need to go to the GP or epilepsy specialist all the information is there. Ok health checklists have also been completed for everybody living in the home. People are supported to access health care services. People are supported to attend the GP, dental services and any other health care specialist as required. People are also supported with their mental health and have access to specialists when needed. The staff were able to explain the current health of individuals and showed us the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: records to see progress being made. Medication is stored in a locked cupboard in a locked room which is cool. The Boots monitored dosage system is used to administer medication. At present none of the people living in the home administer their own medication. There is information for the staff about the medication that each person is taking. There is also information about the possible side effects to look out for and what to do. Controlled medication is stored securely. And there is a separate procedure and record for when people are prescribed this. All staff who give medication have had training. All the medication storage and administration is checked by the registered manager and also by the operations manager during the company monthly monitoring visits. Care Homes for Adults (18-65 years) Page 19 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. The service has a complaints procedure that is clearly written and easy to understand. People in the home are protected by the homes policies and procedures. Evidence: The company provides the complaints procedure in various formats to help people with disabilities to use it. A copy of the complaints procedure provided with widget symbols is displayed in entrance to the home. The people who talked to us said they speak to their key worker or the manager if they have a problem. Some people talk to their care manager. We saw descriptions of how each person communicates and how to interpret behaviour for individuals is in the care plan folders we looked at. Staff said they get to know individuals with communication difficulties and respond to signs, behaviour and facial expressions to gain understanding of what is being communicated to them. The speech and language therapist has been involved to assist with everyones communication who has a further need. We saw that staff are responsive to the people in the home and take time to understand people expressing themselves. Communication support is being developed and this needs to continue to enable people to express their wishes. We spoke to the manager about developing the opportunities for people to say what they think having had some feedback from people living in the home to say that they are not involved enough in decisions that affect them in the home. The company have reviewed the safeguarding procedures. They have produced a flow Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: chart to assist staff with what to do if they suspect abuse and who to report to and this goes up the line through the organisation to the directors. Staff said they have the additional support of the operations manager. Staff have had training in safeguarding and abuse awareness. They said they feel more confident and would report anything untoward to the home manager. People said they feel comfortable in the home and the staff are nice. We spoke to the staff about the procedures for supporting people to manage and spend their money. The procedures have changed to make them better. The staff showed us some of the forms so that we could see what people have spent their money on. There were receipts and two people signed when money is spent. Some people sign for their own money and have assistance with budgeting. Some people living in the home need support to manage their behaviour if they get upset. We looked at the care plans to see what it said staff should do in different situations when the person might need help with their behaviour. There were clear instructions for staff. There was a description of each behaviour and what staff should do. If someone gets upset staff write this down. The record includes what happened and when. The care managers are told too. Some people have the support of the psychologist and community learning disability nurse to help find out what the cause of the problem is. This means that people are getting better support in the home. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is basically comfortable. There is a programme to improve the building, decoration and furnishings. Evidence: The plans to improve the building and make it into three separate units have been approved and the first part of the building work is underway. The manager showed us the plans and talked about how they are going to manage the changes so that it causes the least amount of disruption to the people living in the home. We walked round the home and stopped and chatted to the people living in the home. The lounge has recently been redecorated and more modern prints have been hung to make it more pleasant. There is a large flat screen TV fitted to the wall. The dining room and second sitting room have also been decorated and new prints hung. Three people showed us their bedrooms and we talked to them in there. Two of the people have recently moved bedrooms as preparation for the building work. One person has a particular interest and this has been used to decorate his bedroom which has helped him cope with the move. One of the people talked about his interests and he has also been able to have part of his room as a sitting room. He is able to make his own drinks and has a kettle in his room which he said he was very pleased about. One person has sensory equipment as part of the decoration in his room. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Two people who have shared bedrooms have recently moved so that they have a bedroom each. We were told that one of these people likes to sit in her room and look out of her open door which we later saw. The home employs a cleaner. The manager has created a cleaning plan so that the staff participate in more cleaning with the people living in the home. This has made the home cleaner but much of the building needs repairing and this will help make cleaning more effective. Care Homes for Adults (18-65 years) Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have confidence in the staff that care for them. Evidence: The company have a recruitment procedure, which includes all safety and identity checks required by law for care homes. New staff have induction training that includes the Skills for Care common induction standards. We spoke to one of the new staff. He said he was enjoying his work. Staff do not work alone and unsupervised until their criminal records bureau check has been processed and they have had essential training for health and safety. Staff talked about their roles in the home and about the recent changes. The way the shifts are organised have changed and the staff said that this has improved the communication between them. We saw that there are enough staff to support the people in the home and so that people can do different things. We saw that staff are motivated and there is a much better atmosphere in the home. A good range of training is provided by the company. We looked at the training records and discussed them with the manager. Training is arranged to meet the needs of individuals in the home. Two of the senior managers of the company have become trainers in supporting and managing peoples behaviour. They are providing this training to the staff. The manager and staff have been working to improve the communication support to Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: the people living in the home. It was decided that the most effective way to help everyone who needs help with their communication skills would be to provide training to all the staff and the aids to support. The speech and language therapist is working with the home to provide both the training and design the aids needed with the staff. Senior staff have attended training on the mental capacity act and this is being planned for all staff. We discussed with the manager the benefit of this training to enhance staff awareness of the need to support individuals with decisions about their life and to develop independence and autonomy. We spent some time in the home during the afternoon talking to the people living in the home and the staff. We saw that staff are courteous and responsive to the people living in the home. We saw that there are still some institutional practices in the home, like everyone having a drink in a plastic cup at the same time. We talked to the manager about shaping attitudes and developing staff skills which he is working on. The manager holds one-to-one meetings with each member of staff and their competence, skill development and interests are discussed and training and support provided. The manager said he holds staff meetings with the whole team and the senior staff although these have not been as frequent as they need to be so that they are as effective as possible in promoting good practice. We received surveys from the staff and all the comments were positive indicating together with our observations that the staff are motivated and willing to learn and continue to develop their practice. We discussed with the manager that further person centred planning training would be beneficial to the staff and he said that he would provide this himself. Care Homes for Adults (18-65 years) Page 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has good people skills, understands the importance of person centred support and has a clear understanding of what needs to improve in the home. Evidence: The manager has been working in Beach House since September 2008. He has several years of experience supporting people with learning disabilities and has also worked as a manager in another company. He has a National Vocational Qualification (NVQ) to level 4 and the Registered Managers Award (RMA). He became the registered manager for both Beach House and Bon Secours in August 2009. There is an operations manager who has been in post since March 2008. She carries out unannounced visits to the home under regulation 26 to monitor and also provides a link between the senior staff, manager and directors of the company. Good practice within the company is passed from home to home via the operations manager. The company has developed a quality assurance system and questionnaires are sent out to families and people who are involved in the service. The manager explained Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: that the families had asked for regular information about how their relatives that live in the home are and updates about events and what is happening in the home. The manager and staff team have produced a newsletter that the staff complete each month for each individual and send to their families. We looked at these and could see that they were a good way to convey this information. We received mixed comments from conversations we had with people about the home and the comments in the surveys we sent out. Some people said the staff talked to them about what was happening and some people did not think they were given enough time to talk about what they feel. This was especially about the changes that are happening to the staff and the building. The manager explained that each key worker talks to the people living in the home. The manager is going to make sure each person has had a chance to talk with their key worker and that people who do not have a key worker at this time due to staff changes have one allocated. The manager talked about his plans for developing the service. Staff are progressing with person centred planning and communication support. There are major building plans which will have an effect on the way the home is organized and the style of the accommodation for the people living in the home. He is currently updating the development plan to reflect all these changes and how they are going to be managed. All health and safety checks are carried out to maintain the building safely. The staff have all attended essential health and safety training. Fire training is planned for the day after this visit. We discussed the fire safety and looked at the fire log. The operations manager is planning some further experiential training with the fire department to enhance staff awareness and confidence in dealing with emergencies. The maintenance person carries out the regular fire safety equipment and emergency lighting checks. Environmental risk assessments have been completed and the staff check the hot water temperatures routinely. Care Homes for Adults (18-65 years) Page 27 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 28 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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