Care Home: Branwell Lodge Nursing Home

What the care home does well We saw good interactions by the staff with people using the service. Staff were polite and discreet in their work. People staying at the home looked happy and cared for, and the comments they made about the service were positive. Before moving into the home, people`s needs would be properly assessed. People`s individual needs are met, and people are given opportunities to express choices. The social needs of people are met, and the meals on offer meet their dietary needs. People`s health and personal care needs are met. People`s concerns and complaints are dealt with effectively and there is good awareness by staff of safeguarding issues. The home is well maintained. The needs of people are met by a well trained staff team. The staff recruitment procedures, which ensure people are suitable for employment before they start work, protect people`s well-being. The service is well run by a management team that are approachable, and fully aware of the need to keep people safe. What has improved since the last inspection? At a previous inspection various requirements were made regarding activities, health care and safeguarding issues. Action has been taken to meet these requirements. People are provided with greater opportunities to carry out activities which are tailored to reflect their individual needs. Efforts have been made to do this in order to provide people with a fuller and more active lifestyle of their choice. People`s health care needs have been reviewed to make sure they are receiving the support and health care they need. Any safeguarding issues are reported immediately to the Bradford Adult Protection Unit, and systems are in place to review serious incident forms regularly. What the care home could do better: The well-being of people is potentially put at risk due to risk assessments that are not specific and person centered. The use of recognized person centered planning methods would enhance the short and long term opportunities available to people. Best practice in the medication administration and training should be encouraged. The use of an annual satisfaction questionnaire would further enhance the systems the service has in relation to obtaining feedback from people about the quality of service provided. Key inspection report Care homes for adults (18-65 years) Name: Address: Branwell Lodge Nursing Home Smith Road Off Southfield Lane Bradford West Yorkshire BD7 3NJ     The quality rating for this care home is:   one star adequate 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: Tony Brindle-Wills     Date: 0 9 1 1 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 28 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 28 Information about the care home Name of care home: Address: Branwell Lodge Nursing Home Smith Road Off Southfield Lane Bradford West Yorkshire BD7 3NJ 01274521731 01274523279 andrew.moran@bdct.nhs.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brunel & Family Housing Association Limited care home 22 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: 22 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning disability - Code LD Date of last inspection Brief description of the care home Branwell Lodge is a 22 bedded registered care home providing nursing care for people with varying degrees of learning disabilities and challenging behaviour situated approximately 3 miles from Bradford city centre. The shops and local community facilities are within walking distance. The home is a purpose built property originally registered in 1980. There is a garden with a patio area and ample car parking space. The accommodation compromises of eight flats with single bedrooms, communal living and kitchen areas, and bathrooms. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 22 0 4 0 6 2 0 0 9 Brief description of the care home Brunel Support Works, who are responsible for the ancillary staff at the home and general maintenance, have been merged with Yorkshire Housing Association. The Bradford District Care Trust provides all the care and nursing staff. Copies of the inspection report are available on request from the home. Care Homes for Adults (18-65 years) Page 5 of 28 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: one star adequate 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: We visited the service and looked at the following records; care assessments and care plan files, care reviews, personnel and training records, staff meeting minutes, health and safety records. We talked to three members of staff who work at the home along with the acting manager who oversees the operation of Branwell Lodge. We sent surveys to people who use the service, their relatives, and professionals with an interest in Branwell Lodge. The comments we received were positive, with relatives stating that they believed the care and support being given by the home was very good. We made a request for an Annual Quality Assurance Assessment (AQAA) prior to out visit, which the manager completed and sent back to us in time for our visit. We used this document to to cross reference a variety in information and evidence we had gathered while visiting the agency. 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 Care Homes for Adults (18-65 years) Page 6 of 28 considered that 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. Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before moving into the home, peoples needs would be properly assessed. Evidence: The manager explained that there have been no new admissions to the home since 2006 and that the home is currently closed to new admissions. She explained that if the home did start to take new people in then in detail the admission process if someone wanted to move into the home. This involves obtaining a local authority care needs assessment if one is available; meeting with the potential new person and their family; completion of the services own detailed assessment document; visits to the service by the prospective new person and over night stays if appropriate. Staff spoke about how would undertake observations of, and discussions with the person if they visited in order to obtain further information about their needs and interests which would be used to support the admission assessment. Professionals and relatives who responded to our survey indicated that they were confident that the home could support their relatives and clients, as assessments take Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: place before people move in. Care Homes for Adults (18-65 years) Page 11 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual needs are met, and people are given opportunities to express choices. Peoples well-being is potentially put at risk due to risk assessments that are not specific and person centered. The use of recognized person centered planning methods would enhance the short and long term opportunities available to people. Evidence: Professionals and relatives who responded to our survey indicated that they were confident that peoples needs were being met, and that care plans are produced in a meaningful way and reviewed on a regular basis. The evidence we looked at, and our observations supported this. We found that people have up to date care plans that help staff provide support to people according to their needs and wishes. New style records have been introduced which are more person centered and a named worker system is operated to help people identify peoples needs better. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The information in the care plans was found to be detailed and contained peoples personal preferences and choices. We also found evidence to show that people had been involved the planning of their care. Where risks are identified, assessments are carried out that provide staff with the actions they need to take to minimize the risk. However, we noted that in some instances the risk assessments needed to be more specific and individualized. We told the acting manager that this was a point made at a previous inspection. She said that a review of the risk assessments would take place and action would be taken to make them more person centered. We discussed with the manager the use of recognized person centered planning methods for the people who use the service, and she agreed that in some circumstances, the use of these techniques would be of benefit to people at the home, as they could be used to identify and plan for short and long term goals for people. We found information about how the staff promote choice and independence in relation to the activities people are involved in such as dressing, bathing, eating, socialising etc. Feedback supplied by people who completed our survey showed that they were satisfied with the way peoples individual needs were met. One person said, The staff are very helpful and know my relative very well. People at the service confirmed that the staff talk to them them about how they would like to be cared for and supported. The daily records of the care and support provided to people were found to contain factual and detailed information. Care Homes for Adults (18-65 years) Page 13 of 28 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. Peoples social needs are met, and the meals on offer to people meet their dietary needs. Evidence: Professionals and relatives who responded to our survey indicated that people are treated as individuals and that they do get to take part in a variety of activities. The evidence we looked at, and our observations supported this. At a previous inspection action was needed to be taken to provide everyone with the opportunity to carry out activities which are tailored to reflect their individual needs. Efforts have been made to do this in order to provide people with a fuller and more active lifestyle of their choice. The service has a full time activities organizer and the records show that people are given the opportunity to join in activities both inside and outside of the home. Care staff staff were seen to have a key role in supporting people Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: to live fulfilling lives outside the home by supporting in a variety of activities. Staff told us there has been an increase in the provision of activity, adding that they are encouraged to organize activities and outings with people. The records show that people go to events such as meals out and to the theatre, as well as day trips to local attractions. People said that they enjoy going for walks to the local shops. We observed staff interacting with people at the home and carrying out a variety of different activities such as hand massages, art work and listening to music. The records show that some people do spend time outside of the home attending day centres. The menus were seen to offer people a variety of meals, with a good nutritional balance. Staff confirmed that people do take part in small meal preparation if they are able, but that the catering staff do most of the cooking. The catering staff explained that if required they can cater for people with an individualized diet e.g. diabetic or halal diet. Records held at the home home confirmed this. The records show that any restrictions placed on people in relation to access to the kitchen is well documented and all relevant third parties have been informed. People told us that they take part in activities that are based on their personal interests and needs, with one person saying, I go out and do the things i want to do. Staff at the home confirmed that people do make use of regular transport such as buses and taxis. Care Homes for Adults (18-65 years) Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met, however, this is spoiled by poor practice and a lack of training for the staff in the area of medication administration. Evidence: Professionals and relatives who responded to our survey indicated that people receive personal support from the staff in the way they prefer and want. The evidence we looked at, and our observations supported this. At a previous inspection action was needed to be taken to review peoples health care needs to make sure they are receiving the support and health care they need. Action has been taken to meet this requirement. The care plans were found to include a detailed list of health checks for each person, which showed that people are able to access local health care facilities such as the general practitioner, specialist nurses and the psychiatric services. Staff spoke about how they maintain peoples dignity when providing personal care ensuring that things are done at their pace, in the privacy of their own rooms or a bathroom, and in ways that suit them as per their care plan. The medicines held at the home were found to in kept a safe and secure room. Most of Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: the medicines are supplied by the pharmacy in a monitored dosage system, but some are kept in the original packaging. The medication administration records (MAR charts), which must show clearly the quantities of medicines received into the home and the stock for each person, were examined, and some errors were found. We noted that staff at the home were failing to carry forward medication from the previous month and so the running totals did not tally with the actual medication held on the premises. The acting manager explained that she would resolve this error quickly as it was a straightforward process. She added that she would also speak to the nursing staff about ensuring that proper procedures were always followed. Since our visit, the acting manager has informed us that the errors have been resolved, and supplied documentary evidence to support this. We found signatures to confirm that staff had administered the medicine. We found that there is guidance in place to help staff make decisions about when someone requires extra or one off medication. However, we found in some instances, this information needed to be more specific and detailed. The care plans we found to include information about all the medicine a person takes. The staff training records showed that some, but not all the nursing staff had had accredited training in the administration of medication. Professionals and relatives who responded to our survey indicated that people receive personal support from the staff in the way they prefer and want. Care Homes for Adults (18-65 years) Page 17 of 28 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. Peoples concerns and complaints are dealt with effectively and there is good awareness by staff of safeguarding issues. Evidence: We found that the home has a complaints policy which is displayed for people to see, and is given to people at the home. The acting manager explained that where necessary, advocacy support is available to people. The records show that the service has received only minor complaints that have been dealt with properly and to the satisfaction of the complainant. People who completed our survey said that they fully understood the complaints procedure. A relative who was spoken with gave details of how they would complain and to whom. Staff at the home told us that the procedure for complaining is displayed in the home, and is given to people within the homes Service User Guide. They added that efforts are being made to put the procedure into an easy read format, and that if people made a request, it could quite easily be put on an audio tape. The complaints records were seen and were in good order. At a previous inspection the service was required to make sure that any safeguarding issues were reported immediately to the Bradford Adult Protection Unit, and to put a system in place to review serious incident forms regularly. Action to meet these Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: requirements has been taken. Information in the staff training files shows that most staff have had training about how to protect vulnerable people and how to calm situations down when a person shows behaviour that is challenging. Information held at the home shows that any safeguarding issues are well managed and the relevant people informed, at the right time, in the right way. The detailed adult safeguarding procedures were found to be satisfactory, and the staff training records show that staff have had training in safeguarding, and other training training such as de-escalation techniques when dealing with people who challenge the service. One staff member gave a clear and detailed explanation of what to do if they suspected abuse or if it were alleged that someone had been abused. We found that the staff are completing incident forms so that the staff can identify any patterns in peoples behaviour or events in the home. These forms are reviewed by the acting manager and management team at their monthly visits. In addition staff from the Safeguarding Unit receive these forms and analyze their content, and regularly liaise with the management team about any issues that may arise. The acting manager explained that people are now provided with a independent advocate or a independent mental capacity advocate if required to support them in decision making or if needed following an incident. The records show that people are supported to manage their own finances. Each person has a bank account and detailed records are kept of all financial transactions carried out by the individual or by staff on their behalf. Peoples money is securely stored and is available to them at any time they want cash. The accounts were found to be very well organized, clear and accurate. People at the home said that felt safe there. Care Homes for Adults (18-65 years) Page 19 of 28 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 live in a clean home that is well maintained. Evidence: Bran well Lodge provides accommodation for people in eight flats, as well as having a shared sitting and dining room. The acting manager explained she undertakes a weekly walk round in order to identify any maintenance that needs to be carried out. People invited us into their flats, which were found to offer a comfortable, homely, personalized and pleasant living space. The home has a shared lounge and dining room are which is large, bright and airy. The manager explained that as the area can feel quite institutionalized and clinical, efforts have been made to make the area feel more homely and comfortable with the use of soft furnishings and scatter cushions. She added that the upstairs corridors do still felt clinical and institutional, which we agreed with, but she said that their redecoration is not a priority at the moment: the staff have concentrated upon the shared areas of the home and peoples own rooms. We had a discussion about how the staff support people to decorate their rooms, and the acting manager said that if they were allowed to, the staff would do more to help people in this area. However, there are restrictions on how much the staff can do in this area. We discussed issues relating to this such as risk assessments, using the staff as volunteers, developing the skills of the people at the home, and their inclusion Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: in tasks such as decorating their own room. The acting manager said that she would look into ways that opportunities could be created for greater involvement of the staff in this area. The staff told us that people have keys for their rooms and one person was seen to be using these to get into their flat. When we visited the home was clean and fresh. Staff have received training in infection control. Gloves and aprons, and hand washing facilities are available for people to use to help prevent the spread of infections around the home. Care Homes for Adults (18-65 years) Page 21 of 28 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. Peoples needs are met by a well trained staff team. People are protected by the staff recruitment procedures, which ensure people are suitable for employment before they start work. Evidence: There are currently twelve people living at Branwell Lodge. The staffing levels are currently six care staff in the morning and the afternoon, plus a nurse and usually the acting manager. At night there are usually two care staff plus a nurse. A check of the rotas and discussions with the staff confirmed that these are the normal ratios of staff. The staff said that there was enough people duty to meet peoples needs and provide support for people to take part in social activities. However, the acting explained that the service is short staffed at the moment, and that this is being addressed by way of an advertising campaign to recruit new staff, and that some interviews had already taken place to fill the vacant posts. Information held within the staff training files showed that there is a comprehensive training programme. All the staff complete a home specific induction programme, and a range of other training including health and safety training is provided on a rolling programme throughout the year. Specialist training such as break away, conflict resolution and the mental capacity act has been completed to ensure peoples specific Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: needs are met. Some gaps in peoples training were found, and the acting manager was able to produce an action plan to deal with this through planned training and in house updates. One staff member said that this provides them with the knowledge and skills they need to perform their work in a competent and professional manner. They added that the training provided is good and that the staff team is very supportive. Information held within the records showed that the staff receive supervision every four to six weeks and staff meetings are held regularly. We found that over half of the staff team hold a National Vocational Qualification Level 2 in Care, and that those who do not, are undergoing training in order to obtain this qualification. We checked the recruitment files of 4 staff who work at the home. All the files contained the correct information relating to pre-employment checks.The records show that people who use the service are involved in the recruitment and selection of new staff. People who responded to our survey said that they have a good relationship with the staff and see them as friends and helpers. One person at the home said that the staff are easy to talk to and good listeners. Care Homes for Adults (18-65 years) Page 23 of 28 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 service is well run by a management team that are approachable, and fully aware of the need to keep people safe. The use of an annual satisfaction questionnaire could further enhance the systems the service has in relation to obtaining feedback from people about the quality of service provided. Evidence: Professionals and relatives who responded to our survey indicated they believe the service to be run and managed appropriately, and that people are keep safe. The evidence we looked at, and our observations supported this. The service has not had a Registered Manager since June 2008. Since then the home has had 2 acting managers. The current acting manager is on secondment, and is looking to apply to the Commission for registration. However, she is unsure as to when her secondment will finish. The staff told us they find her approachable and supportive. Staff have had training in the Mental Capacity Act, and area aware of how their Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: actions and the actions can have an impact on peoples liberty. Good records are kept of any restrictions placed on people due to risks that face them, and the acting manager explained that if restrictions are placed on peoples movements, then all relevant parties would consulted including the person, their relatives, advocates and any relevant professionals.None of the people living at the home are currently subject to a deprivation of liberty order as prescribed by the Mental Capacity Act. The detailed and up to date records shows that there are effective quality assurance systems in place for auditing and monitoring the work undertaken at the home by the staff. Staff explained that alongside these, the management team undertakes spot checks on medication, care plans, money and the food prepared in the home. Staff also explained that the management team often undertaken observations of care practice in order to give feedback on the work they are doing. Satisfaction questionnaires about the quality of the care provided are sent out to people on an annual basis. The Annual Quality Assurance Assessment document we received from the home was detailed and contained good levels of information that we able to cross reference with evidence in the home. The accurate and up to date records showed us that appropriate health and safety checks are undertaken by staff at the home, and any issues that arise as a result of these are dealt with appropriately. The personnel and training records showed us that staff undertake relevant health and safety, and fire training. The organisation registered with us as the provider is Brunel Housing, although Bradford District Care Trust employ most of the nursing and care staff. The last survey was in July 2008 so it is now overdue. The acting manager said that she would organize for the surveys to be sent out. The acting manager showed us up to date copies of all the health and safety and insurance certificates. these were found to be satisfactory. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The introduction of recognized person centered planning methods would enhance the short and long term opportunities available to people. Risk assessments should be specific to the person and the activities they are involved in. Annual satisfaction surveys should be sent out to all relevant parties and a report produced based on the findings of those surveys. An action plan should be produced if required, to tackle any issues that come out of this process so as to ensure the service improvements take place. 2 3 9 39 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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