Care Home: Bedrock Court

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What the care home does well The home has a small and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. Care documentation accurately reflects the individuals` needs and how they will be met. People who live in the home and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. The home promotes staffing levels and skill mix of staff in order to help ensure that people needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The home encourages and supports staff with training in order for them to develop their knowledge so that they have the required skills to meet the needs of the people in their care. What has improved since the last inspection? The home is well organised and managed by an effective, stable management that promotes the views and interests of all people who use the service. The home has continued to improve following the last inspection and further examples are detailed throughout the report. What the care home could do better: All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Bedrock Court 3 New Road Stoke Gifford South Glos BS34 8QW     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: Wendy Kirby     Date: 1 6 1 2 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 29 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 29 Information about the care home Name of care home: Address: Bedrock Court 3 New Road Stoke Gifford South Glos BS34 8QW 01179798746 01454772171 angelinegay@gmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Michael Gay T/A Nightingale Care Homes,Mrs Angeline Linda Gay care home 6 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 6 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Bedrock Court is one of three homes operated by Nightingale Care Homes. All three homes are owned and operated by the proprietors, Mr and Mrs Gay. The other homes within the group are Bedrock Lodge and Bedrock Mews. Bedrock Court is a mature detached house and is registered with the Commission to provide personal care and accommodation for six people with a learning disability. The home is situated within close proximity of the Avon Ring Road. There are bus routes approximately 300 yards from the home. There are local shops and the home is Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 1 1 1 1 2 0 0 8 Brief description of the care home within easy reach of Bristol Parkway railway station. Accommodation is on two floors. Mrs Anne Thomson has day to day responsibility for the running the home as the registered manager. Care Homes for Adults (18-65 years) Page 5 of 29 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: This was an announced Key Inspection which included a visit to the home. The visit was completed by one inspector over one day and lasted approximately eight hours. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained information about what the home considers it does well and what plans they have for further improvements in the coming year. Care Homes for Adults (18-65 years) Page 6 of 29 We also received completed surveys from the staff, and health and social care professionals, details will be referred to in this report. During our visit we spoke with the registered provider and the registered manager. We looked at two individual care files, which included pre-admission assessments, care plans and risk assessments. We also looked at a number of records and files relating to the day to day running and management of the home. We spent time in all communal areas of the home and some of the bedrooms. The manager received feedback about the visit throughout the day, she demonstrated a very caring, committed attitude to her roles and responsibilities in ensuring the home provides quality of care to the people who use the service. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 29 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 9 of 29 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. Peoples needs are assessed to ensure the home is suitable to meet individual requirements. Evidence: The manager had some experience with regards to assessment of prospective admissions to the home since her appointment in the home. People wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to help determine the suitability of the placement. Where possible the home also obtains comprehensive assessments, care plans and support from other health and social care professionals involved, for example, social workers and hospital staff. The manager emphasised the importance of trying to ensure the existing group living in the home and the prospective new admission are potentially compatible. Various initiatives help support this, including several discussions with any prospective client in order to identify needs, likes, dislikes, personal interests and preferences. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: Introductions are made to people already living in the home, this can happen in various ways including meeting in the home or going out for a meal. All people involved in the process are consulted and asked for feedback on how the meetings and introductions have gone. Pre admission assessments are comprehensive covering activities of daily living, a full health screen and personal history background. The information gathered pre admission should provide a sound benchmark of each persons ability, state of health prior to admission and subsequent needs when they move into the home. Care Homes for Adults (18-65 years) Page 11 of 29 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. The home ensures that the service provided to each individual takes into account their personal preferences, supported by both written information in care plans and risk assessments which are subject to ongoing review. Staff have a good awareness of individual needs and treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home are consulted on, and given opportunities to participate in, all aspects of life in the home. People are supported to take risks in their daily lives within their home and out in the community. Evidence: From the initial pre admission assessments staff had identified needs enabling them to Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: form written care plans. The plans that we looked at were fairly detailed and person centred, including personal preferences and likes and dislikes. Plans told us that people had specific requests and routines, this is good practice and helps demonstrate that people are involved in deciding how they wish to receive care. Each person has a portfolio with person centered assessments, which helps support that staff put the views, wishes, likes and dislikes of each person at the center of all care provided. The information was informative and useful enabling staff members to provide the appropriate care to support health and social needs. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and Key Workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. All staff surveys agreed that they are given up to date information about the needs of the people they support. Comments included, Communication and hand overs are very good and The manager aways keeps us informed of any changes. We asked health and social care professionals, Are peoples social and health care needs properly monitored, reviewed and met by the service?. One replied usually and one said sometimes. Comments included, They care for very complex clients who experience challenging behaviours, They are very good with people who are autistic, I have worked extensively with some staff who have been very well meaning and keen to do the best they can for the people living in the home and I have recommended different courses of action and staff have been flexible in adapting. Some people have complex needs with varying impairments and learning disabilities. We were told about individual communication requirements and through patience and time the staff had identified effective methods of communication with individuals. Risk assessments were examined and showed us that staff were mindful of keeping people safe within their home and out in the community. Individual risk assessments detailed for example, how much supervision is required when visiting the GP, what risks are involved with regards to road safety and preparing meals and drinks in the kitchen. The manager told us that the staff were empowering people to promote as much independence as possible but at the same time making sure that they do this as safely as possible. The AQAA asks the home how it has improved over past twelve months, We have Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: been more directly involved with community multi disciplinary teams and this has given us access to a wider range of help and support, including equipment. We have retained a regular staff group which has helped staff build longer team relationships. In turn this has enabled a better understanding of individual needs and choices. The AQAA also tells us about plans for further improvements in the coming year, We want to increase key worker time. One staff member told us in their survey about the importance of supporting, encouraging and further development of the key worker role, It would be good to spend more individual time with people living in the home, time to talk, go out together and give support when needed. The home is also looking at other ways to develop communication methods in order to support decision making and choice. Care Homes for Adults (18-65 years) Page 14 of 29 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 enjoy a range of activities and are supported to live a fulfilling life in and out of the home. People are supported and encouraged to maintain firm connections with families and friends. People take an active role in promoting and maintaining a healthy well balanced diet. Evidence: Care plans and discussions with the manager confirmed that the home was providing people with opportunities to develop social, emotional, communication and independent living skills. There was information on levels of independence and the level of support that was required by staff to support the people both in and outside of the home. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The manager told us that weekly activities and plans are reviewed with people, staff and families to ensure that they remain relevant to the individual. All individual tastes and preferences are taken into account. The information shared is produced in a Lifestyle Plan and provides staff with extremely useful information including, peoples personalities, essential things that are important to individuals, how people express emotions, things that people enjoy and how to support people successfully and keep them safe. Daily routines and activity plans were discussed, which included attending a private day center, people regularly go out and enjoy the local community amenities by visiting pubs, restaurants, leisure center, shops, and cinemas. The lounges in the home provides entertainment systems including television, video, DVD player and musical systems. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms or they can use the communal areas and garden when weather permits. People living in the home are encouraged to visit friends and family and communicate by writing letters, sending cards on special occasions and by using the telephone. Friends and families are invited to the home for coffee mornings, parties and other special events, which are held at the Registered Providers own family home. The size and layout of the dining room makes it possible for everyone to enjoy the social advantages of dining together, however people can choose to receive their meals in their rooms if they prefer. People make their own choices at mealtimes with the support from staff. The menus, which they have produced, offer a varied healthy diet plan. Alternatives are made available in the home and flexibility in meals was evident. People are encouraged to help prepare the meals. Staff in the home are mindful of educating and assisting people in maintaining a healthy balanced diet and peoples weight is monitored on a monthly basis. The kitchen was clean, tidy and well equipped. The stores, fridge and freezer had a good supply of food. People living in the home are involved in the shopping and use local amenities for their food supplies. Care Homes for Adults (18-65 years) Page 16 of 29 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 service had good systems for meeting and monitoring individuals physical, emotional and health care needs. People are supported to live the lives they choose. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Evidence: There does not appear to be any unnecessary rules in the home and it was clear that the manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Daily routines are flexible within the home, people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. The care plans we looked at gave good clear information about individual needs both physically and emotionally. Health Care needs are detailed in the Care Files. Records of visits to the General Practitioner and the outcomes are recorded. Specialist referrals and visits to other health professionals including, Consultants, Chiropractors and Dentists were seen. The manager explained that peoples health care needs are closely monitored in consultation with primary health care services and that access to health screening is undertaken. There is a regular review process in place for both care plans and risk assessments. Policies and procedures for receiving, storing, administering and disposing of medications are in place. There were photographs of each person on their medication charts to help ensure that medication was dispensed to the correct person. Medication fact sheets are available and tell staff how people like to take their medicine and why they need the medication. The administration charts were legible and continuity of administration was shown with a signature from the person dispensing. Up to date records evidenced that medication received in the home and medication being returned to the local pharmacy was being followed correctly. Staff training records evidenced that staff had received competency training, which is updated annually. Care Homes for Adults (18-65 years) Page 18 of 29 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. There are policies and procedures in place to manage complaints and people should be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and awareness of protecting vulnerable adults so that people living in the home are further protected from abuse. Evidence: The home has a complaint procedure. We know that the home maintains a record of complaints and there have been none since our last visit. The manager and the staff team have built good relationships and have a good understanding of the needs of the people living in Bedrock Court. Their good awareness of individuals helps them recognise if a person is sad or concerned about something, either through facial and vocal expression or changes in their behaviour. Care documentation includes information on how the individual communicates. All staff surveys told us that they know what to do if anyone using the service has a concern. Holding meetings for people living in the home, relatives, and staff has meant that communication and sharing information is effective. This further promotes people becoming less frustrated thus relieving anxieties and any potential complaint referrals. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: There are policies and procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and the understanding of their role in protecting vulnerable adults who live at the home. Policies and procedures given to staff include, Whistelblowing, How to make a grievance and Harassment in the workplace. The home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. A number of staff have either completed or are enrolled on the National Vocational Qualification (NVQ) in care award and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. Care Homes for Adults (18-65 years) Page 20 of 29 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. The home is clean and comfortable. Once the redecoration and refurbishment programme is completed it will provide a safe, peaceful and well maintained environment for the people living there. The communal rooms and facilities are suitable for their purpose and meet the peoples needs. Evidence: The home is located near available public transport. Many amenities are within walking distance, including, shops, supermarkets, pubs and takeaways. The home is on a small housing complex and has good relationships with its neighbours, the home blends in with its environment, giving people privacy and dignity within their local community. There is a good sized garden at the rear of the property, which provides a safe, private place for people to enjoy. The home provides accommodation for up to six people and in general is in fairly good repair. We had received comments in our surveys that people were concerned about the environment. Comments included, The physical environment is minimally adequate, it feels as if the service is being run on a very low budget and Furniture Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: and decoration could be improved in some areas. When we visited the home a redecoration and refurbishment programme had just commenced including, bedrooms, bathrooms, hallway, landing and stairs. We could see that some of the bathrooms and decor was outdated and not very homely. However we did see evidence of some of the new work in progress and the new bathrooms were of good quality and modern. The redecoration that had commenced made parts of the home bright and warm. We walked around the inside and outside of the home and viewed the bedrooms and the communal areas including the dining room and lounge. Room sizes are fairly spacious for their stated purpose. Some attention has been given to ensure that areas are homely, including photographs of the people living there. People are supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. The lounge area allows for people to be seated together enjoying the entertainment systems on offer. The laundry room is well equipped, supplies of gloves and aprons were seen throughout the home. People living in the home are supported should they choose to do their own laundry. COSHH (Control of Substances Hazardous to Health) substances are kept in a locked cupboard and risk assessments and safe systems of work are in place to protect people living, working and visiting the home. All staff are aware of the infection control policies in the home. Care Homes for Adults (18-65 years) Page 22 of 29 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 relationships between staff and people living in the home are good and create a warm positive environment to live in. People are supported and protected by the homes recruitment policy. The people are cared for by skilled staff that are trained, supported and supervised by management. Evidence: We know the home follows a good recruitment procedure. This will help ensure that the right people are employed to work at the home, and people living in the home will be further protected. Records contain completed application forms with a full employment history, two written references and Criminal Records Bureau (CRB) disclosures. Staff receive a job description, terms and conditions of employment, and GSCC (General Social Care Council) code of conduct. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and the Protection of Vulnerable Adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: induction process. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and staff are conscientious in attending training relevant to the needs of the people they are caring for. Courses are relevant to the roles they perform in order to understand the needs of individuals and to keep them up to date with current practice. The manager was previously a nurse tutor at a local college for twelve years and in total has twenty two years experience in the teaching profession. She is very proactive in providing training for the staff. In addition to this staff have a minimum of eight one to one supervisions each year. The management have established a formal recorded supervision procedure for all staff. A plan is devised for discussion relating to the people living in the home, work issues, staff issues, personal development and training. Although we did not speak with staff directly for this inspection we received some very useful information from them in our surveys. It was evident from the information provided that staff were respectful and sensitive toward the people they are caring for. We received various comments about what staff feel the service does well. Comments included, We are good at team work, all staff supporting one another, We have good training courses and we are supported afterwards, We are one big family and We follow advice and guidelines from outside agencies. The staff surveys agreed that they had enough support, experience and knowledge to meet the different needs of the people they care for. Care Homes for Adults (18-65 years) Page 24 of 29 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. Peoples needs and best interests are central to the management approach in the home. People benefit from a well managed and safe environment. There are good systems in place to protect and safeguard the people living in the home. Evidence: The manager has worked in the home for nearly three years and demonstrated good management skills that relate to the aims and purpose of the home. The manager and staff are very committed to the people living in the home and the roles and responsibilities expected of them. Staff are empowered by the manager to continually monitor and evaluate the services they provide to people. The ethos of the service is person centered with the views of service users actively being sought as part of this process, this is through one to one sessions and house Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: meetings. The manager told us about her plans to support staff to professionally develop and wants to encourage innovation within the staff team. The manager is planning a growth program for senior staff consisting of agreed responsibilities, set projects to achieve, and devising and implementing new ideas. This will give staff an opportunity to sample management responsibilities in a controlled structure, promoting confidence and self belief and good team building skills. The home continues to monitor and assess the quality of services provided, by giving people questionnaires to complete and holding meetings for people living in the home and their relatives, families and friends. Regular audits are also carried out in the home with regards to care documentation, environment, activities, medication, and other procedures in the home. There is a policy and procedure for holding peoples personal money, individual statements are kept, good accounting methods are maintained and receipts for sundries are available. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 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 28 of 29 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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