Care Home: Beck Farm House

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What the care home does well People using the service and their relatives have information that is easy to read to help them know what to expect from the home. The needs of people using the service are thoroughly assessed to help staff know how to support them and whilst people using the service have a variety of complex conditions and specialist needs they are generally supported well to take part in a range of community activities and have holidays away from the home.The home is safe and meets the individual needs of people using the service in a comfortable way. People using the service are provided with single bedrooms that are decorated to their individual tastes which provide them with a space where they can spend time alone or see visitors and they are generally supported well to maintaincontact with friends and relatives. New staff are properly checked to ensure they are safe to work with people living in the home and the home has a registered manager who is qualified and competent to carry out her role. What has improved since the last inspection? The building has been redecorated and improved to ensure people living in the home have an environment that comfortably meets their needs.Support plans for people using the service have been improved to show how staff must meet their needs and are kept more up to date to ensure they reflect their current needs.Records of the times people need to be physically restrained are now kept and discussed by staff to see when its use has been useful. This is to ensure people using the service are safeguarded from harm.Up to date record of complaints are available and more information about how to people can complain have been developed that are easy to read to make them easier to understand.More staff have been employed to ensure there are enough of them available to meet the needs of people using the service.Menu choices have been developed to enable people living in the home to have more choice about meals served.More staff training has been provided to make sure they know how to meet the needs of people living in the home. What the care home could do better: More regular meetings with staff and people using the service should be held to enable them to contribute ideas for the running of the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Beck Farm House Beck Farm House Beck Lane Barrow upon Humber North Lincs DN19 7AF 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: Rob Padwick Date: 2 5 0 5 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 35 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Beck Farm House Beck Farm House Beck Lane Barrow upon Humber North Lincs DN19 7AF 01469532988 NOTKNOWNYET beckfarm@tiscali.co.uk Voyagecare.com Voyage Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Walker-Boyall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 care home 7 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 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 category: Learning disability Code LD, maximum number of places: 7 Date of last inspection 0 1 0 7 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Beck Farm House, registered August 2004, is a detached property in Barrow-on-Humber, providing care and accommodation on two floors, to 7 adults with learning disability. Young adults with very complex needs and particular disabilities and people that present behaviour that may pose a risk to themselves or others are placed in the home as stated in the homes statement of purpose and as a result programmes of care and behaviour management are very defined and strongly adhered to. All rooms are single with en-suite facilities. There are sufficient and suitable communal areas and an enclosed garden. Shops and services in Care Homes for Adults (18-65 years) Page 5 of 35 Barton are accessed by car daily and service users often walk to Barton as part of their exercise plan. Fees for people living in the home are based on a standard fee with additional charges for individualised packages of care based on their assessed needs. Care Homes for Adults (18-65 years) Page 6 of 35 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 Care Homes for Adults (18-65 years) Page 7 of 35 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use this service experience adequate 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 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. This inspection report is based on information received by the Care Quality Commission since the last key inspection of the home on 1st July 2009, including information gathered during a site visit to the home. The site visit was unannounced and lasted for five hours. In order to help the way we inspect services, someone known as an Care Homes for Adults (18-65 years) Page 8 of 35 Expert by Experience assisted us with this inspection visit. Information collected by him is included within this report. A senior staff member was available throughout the period of our site visit and as well as speaking to her, we talked staff who were on duty and people living in the home. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. Other information used included a self assessment by the home, feedback from surveys sent to us from people who use the service and official notifications sent to us by the home. This helps us to reach judgments about the service provided. Care Homes for Adults (18-65 years) Page 9 of 35 What the care home does well People using the service and their relatives have information that is easy to read to help them know what to expect from the home. The needs of people using the service are thoroughly assessed to help staff know how to support them and whilst people using the service have a variety of complex conditions and specialist needs they are generally supported well to take part in a range of community activities and have holidays away from the home. The home is safe and meets the individual needs of people using the service in a comfortable way. People using the service are provided with single bedrooms that are decorated to their individual tastes which provide them with a space where they can spend time alone or see visitors and they are generally supported well to maintain Care Homes for Adults (18-65 years) Page 10 of 35 contact with friends and relatives. New staff are properly checked to ensure they are safe to work with people living in the home and the home has a registered manager who is qualified and competent to carry out her role. What has got better from the last inspection The building has been redecorated and improved to ensure people living in the home have an environment that comfortably meets their needs. Support plans for people using the service have been improved to show how staff must meet their needs and are kept more up to date to ensure they reflect their current needs. Care Homes for Adults (18-65 years) Page 11 of 35 Records of the times people need to be physically restrained are now kept and discussed by staff to see when its use has been useful. This is to ensure people using the service are safeguarded from harm. Up to date record of complaints are available and more information about how to people can complain have been developed that are easy to read to make them easier to understand. More staff have been employed to ensure there are enough of them available to meet the needs of people using the service. Care Homes for Adults (18-65 years) Page 12 of 35 Menu choices have been developed to enable people living in the home to have more choice about meals served. More staff training has been provided to make sure they know how to meet the needs of people living in the home. What the care home could do better More regular meetings with staff and people using the service should be held to enable them to contribute ideas for the running of the home. Care Homes for Adults (18-65 years) Page 13 of 35 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Rob Padwick St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 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 set out on page 4. Care Homes for Adults (18-65 years) Page 14 of 35 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 15 of 35 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 16 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use this service are carefully assessed and training is provided on a variety of specialist conditions to ensure staff have the right skills and knowledge to meet their needs. Evidence: Whilst no one had moved into the home since the last time we visited the service, the case files of people living at Beck Farm showed evidence of a careful admission process to ensure their needs can be safely met by the home. The files of people living at Beck Farm contained assessments carried out by a range of professionals to ensure staff have relevant information about these and know what to do in these respects. People using the service have a variety of complex needs and information in the self assessment told us we work well as a team in putting together plans of support to ensure a Consistent approach is provided. There was evidence in the case files belonging to people living in the home of regular liaison with both in house and external specialists; including Behaviour Therapy, Psychiatry, The Prader Willi Syndrome Association and Advocacy services to ensure individual needs of people living in the home Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: can be met. The people who own the home have reorganised their training department since the last time we visited the service and there was evidence of a substantial amount work undertaken to implement a previous requirement to ensure staff have the right skills to meet the specialist needs of people that use the service. The deputy manager has responsibility for this aspect of the home and we saw evidence of additional training that had been given on a variety of conditions, including Prader Willi Syndrome, Dual diagnosis and Autism, together with further plans for this to be extended. Care Homes for Adults (18-65 years) Page 18 of 35 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 living in the home are able to make choices about their lives to ensure their wishes and needs can be appropriately met Evidence: People living in the home told us they were supported to make decisions about their lives and the case files belonging to them contained support plans on a wide range of their needs, together details of personal preferences to help staff assist them with these. The Expert by Experience said I found that residents could choose to go out individually with staff or with others and people living in the home told him about trips out to go swimming, bowling and pub visits together with support to help them to be independent. One person told him I like to cook curry. I cooked vegetable curry yesterday and we observed others returning from college and voluntary work in charity shops. Since our last visit ongoing work had been undertaken to improve the support plans of people using the service to ensure they are kept up to date and accurately reflect their assessed needs. We saw evidence these were now being regularly evaluated as Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: previously required and they continue to show evidence of a very personalised approach, with pictures and words to help people using the service understand and be consulted about them. Further training had been provided to staff to ensure they have more working knowledge on the specialist conditions of people living in the home. Regular daily recordings were being maintained in the case files together with a range of risk assessments to ensure people using the service are kept safe from potential harm whilst allowing them to take responsibility for making sensible decisions about these. The group of people living in the home have a variety of complex needs and some present behaviours that may pose a risk to themselves or others. We saw evidence of recent staff training on the use of physical intervention and following our last visit, information about the use of restraint had been developed to enable staff to evaluate its effectiveness and records for these were now being maintained as required. Care Homes for Adults (18-65 years) Page 20 of 35 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 living in the home are able to participate in a good variety of activities to ensure they can experience a lifestyle that meets their individual wishes and needs. Evidence: The home has a flexible routine to enable the needs and wishes of people using the service to experience a lifestyle that meets their individual wishes and needs. On the day of this visit some people were out at college or doing voluntary work in charity shops and we were told that since the last time we visited more staff had been employed, to ensure their individual specialist needs can be better met. The Expert by Experience said people using the service told him they took part in a variety of activities and were supported to maintain links with their relatives and we saw evidence of support with letter writing and regular visits to see friends and relatives in the case files we inspected. There continues to be evidence people using the service are supported well to maximise their independence with support with cooking and doing their household chores and we were told one person was soon to move into more independent Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: accommodation. People living in the home are encouraged to eat a healthy diet and we saw evidence of a variety of meals provided to ensure their nutritional needs are met. Some of those using the service have specialist conditions which mean they have difficulties in managing a correct nutritional intake, but we saw evidence of the involvement of specialists in this respect. The Expert by Experience said Residents have a separate menu where they could choose from a list of alternatives, if residents would like something that was not on either menu they could discuss it with staff. Care Homes for Adults (18-65 years) Page 22 of 35 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. The needs of people living in the home are met with appropriate monitoring of health and personal to ensure staff provide a consistent approach to supporting them. Evidence: The group of people using the service are generally independent in relation to personal care and there continues to be evidence they are supported and prompted with these. Feedback from people using the service was generally positive and indicated staff treat them well and respect their wishes about the way they are supported. Support plans are available on range of the health conditions of people that use the service and we saw evidence of further staff training on these to ensure they have the skills needed to meet these. As previously noted, support plans were now being kept up to date and we saw evidence of the involvement and liaison with a range of professionals to ensure any changes are monitored appropriately. Comments from people using the service confirmed their health and personal care needs were met and we saw evidence of support provided for them to attend appointments in relation to these. Policies and procedures are available to guide staff in the safe administration of medication to people living in the home and staff training has continued to be provided to ensure they know how to keep them safe in relation to these. We saw evidence of regular medication checks by the manager and those medication records inspected were up to Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: date and satisfactorily kept. Care Homes for Adults (18-65 years) Page 24 of 35 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 concerns of people using the service are taken seriously with appropriate staff training provided to ensure they know how to safeguard them from potential harm. Evidence: Comments in surveys from people living in the home were generally positive and one person told us I like living here whilst the Expert by Experience said; The two residents who I spoke to said they would talk to Sandy Walker (The manager) or staff if they had any problems (or) did not feel safe or needed to complain. There are policies and procedures to ensure the concerns of people living in the home are taken seriously and information in the self assessment stated We provide a clear and effective complaints policy and ensure all service users, staff, family and other agencies are aware of its existence and how to use it. The service has pictorial I am worried cards to help people know how to make a complaint and details of how to access independent advocacy services were displayed on the office notice board. We made a previous requirement to ensure an up to date record of complaints is appropriately maintained and the homes complaints log contained evidence of appropriate action to resolve these. Policies and procedures are in place to ensure people living in the home are safeguarded from abuse and staff training had been provided about these. Since the last time we visited, there had been a reduction in the amount of notifications received concerning incidents of challenging behaviour and we saw evidence of up to date training on the use of physical intervention to staff know how to use this safely. Care Homes for Adults (18-65 years) Page 25 of 35 Care Homes for Adults (18-65 years) Page 26 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are provided with an environment that is comfortable, clean appropriately maintained. Evidence: Beck Farm is situated in a detached cottage in Barrow-on-Humber and provides care and is registered to provide accommodation on two floors, to seven adults with learning disability. The group of people living in the home have a variety of very complex needs and some present behaviours that may pose a risk to themselves or others placed in the home. All bedrooms are single with en-suite facilities and there are sufficient and suitable communal areas and an enclosed garden. Since our last visit improvements requirements we made to ensure the environment was improved had been appropriately implemented, with a new kitchen installed and communal rooms refurbished. The Expert by Experience said Beck farm is nicely decorated and seemed clean and tidy, the home had two living rooms, one had two televisions and a large fish tank, the other a shelving unit with games and activities on. A member of staff showed me the newly fitted kitchen, which was also very nicely decorated. Maintenance records contained evidence of regular checks to ensure the health, safety and welfare of people using the service is promoted and the Expert by Experience said Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: Bedrooms were full of the residents own belongings and Felt very personal to them. Care Homes for Adults (18-65 years) Page 28 of 35 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 using the service are supported by staff who are appropriately recruited and trained to ensure they have the skills needed to do their jobs Evidence: Since the last time we visited improvements had been made to develop the staff team and we observed good staffing levels with one to one support provided as identified in the case files of people who live in the home. Some staff comments however indicated times when this could still be a problem, although we were told an additional four new staff have been recently appointed with another one due to join the bank team soon. The manager told us she monitors staffing rotas closely to ensure there is sufficient staffing availability to meet the individual needs of people living in the home and comments from people using the service were generally very positive and told us I like living here it Serves good food and Makes sure I have a good choice of activities. The self assessment indicated staff had undertaken a range of appropriate mandatory training and we were told the deputy manager has now been given responsibility for this and that the provider company had restructured its staff training department since the last time we visited. An up to date training matrix was available that identified individual training in First Aid, Food Hygiene, Health and Safety, Infection Control, Medication Awareness and Knowledge set for medication and common standards induction, whilst staff records inspected contained evidence of other service specific training provided on Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: Dual diagnosis, Prada Willis Syndrome, and Physical intervention to ensure staff have the specialist skills and knowledge to meet the needs of people living in the home. Staff who we spoke to indicated they Worked well as a team and were committed to doing their jobs well and we saw evidence of debriefs following incidents in the home and of meetings held with specialists to ensure they follow a consistent approach. There has been a significant drop in the reporting of incidents to us in the home since the last time we visited and evidence that staff had completed safeguarding training and were now reporting incidents of potential harm to people using the service to the Local Authority as required. Interactions between staff and people using the service were observed to be friendly and supportive and the Expert by Experience said I felt staff had a good relationship with the residents and they all seemed friendly and were polite. When the Expert by Experience asked people using the service what they thought about staff one told him They are good. Hes my buddy whilst another answered I think the staff are good. The files inspected of newly appointed staff contained evidence that appropriate recruitment procedures continue to be followed by the service. The files of four staff we inspected all contained evidence of Criminal Records Bureau, Protection of Vulnerable Adults (POVA) checks and references followed up to ensure staff are safe to work with people living in the home. Care Homes for Adults (18-65 years) Page 30 of 35 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. Appropriate management systems are in place to ensure the health, welfare and safety of people living in the home are promoted. Evidence: The registered manager has been in post for five years and has the relevant skills and experience to manage the home. Since our last visit management arrangements have been consistent with the manager working four days per week and support from a full time deputy and two senior support officers. The manager has extensive appropriate qualifications and we saw evidence of an open and encouraging approach, with close working relationships amongst the staff team. Staff told us The home has a very good team that work together well and we observed friendly and supportive interactions between them and the people who use the service. People told us I like living here and comments from them were generally very positive. The home had sent us a satisfactory improvement plan following our last visit to the service and we saw evidence this was being monitored and regularly updated by the manager to ensure the requirements we made were implemented. Whist there was evidence of consultation and meetings with staff and people using the service to ensure a sense of direction is provided, a recommendation is made that these are held more regularly to enable them to contribute Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: ideas and participate further in the running of the home. Quality monitoring systems were in place to ensure the service is monitored against its aims objectives, and we saw evidence of regular monthly reports form a senior manager from the parent company. Good progress had been made with implementing the requirements and recommendations made to improve the record keeping systems and staff training opportunities in the home and an operational plan had been completed on the development of further activities for people using the service with another one planned on active and healthy eating. Whilst surveys are issued to enable the views of people using the service and others with an interest in the home to be considered, the manager told us these had not yet been circulated at the time of our visit. A range of maintenance records inspected showed evidence of appropriate checks to ensure the health, safety and welfare of people living in the home is promoted and staff training records confirmed training undertaken to ensure staff understand their responsibilities in this regard. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes  No  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 33 of 35 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 Description 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 Description 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 39 The Registered Person should ensure meetings with people using the service and staff are further developed to enable them to contribute ideas for the running of the home. Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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