Care Home: Briardene

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What the care home does well People are happy and enjoy living at the home. One person said, "I like it here." Another person said, "It`s good here." We were told people go out on a regular basis and have a good lifestyle. One person said they enjoy going into Harrogate with staff. Another person said they like going for coffee and shopping with staff. Staff said people go out on a very regular basis. A relative told us the home provides excellent care and support, excellent links with the family home, a relaxed environment and excellent integration into the community. People eat good quality, nutritious meals, and are encouraged to decide what they want to eat. People who live at the home are supported by a competent and caring staff team. The majority of staff have worked at the home for several years and know the people who live there very well. They talked about people`s individual needs and gave good examples of how they provide person centred care. We asked the staff what the home does well; they all said the home provides a very good standard of care. One person said, "People have a really good quality of life and get choice in everything we can offer." Another staff member said, "It`s homely; everyone gets along." We looked at information that showed us people`s health is properly monitored. Healthcare records have good information about appointments and showed us that staff are vigilant and look for changes in well-being. What has improved since the last inspection? At the last key inspection we recommended that staff should complete medication training. In the AQAA the manager told us all staff who administer medication have a recognised and accredited qualification. Staff said the medication training was good. At the last inspection we asked the home to amend their adult protection procedure. They have done this and the procedure for report allegations is clear. What the care home could do better: A better care planning process should be introduced. This will make sure people`s are needs and wishes are met. More information should be recorded about the people who live at the home. This will help make sure a person`s needs are being successfully met and their quality of life and welfare can be properly monitored. Risks to people who live at the home should be more carefully assessed. This will make sure the risk of harm is identified and minimised. A more robust system should be introduced for monitoring people`s personal monies.This will make sure finances are protected. The home`s recruitment procedure should be more carefully followed to make sure every recruitment process is robust. This will make sure people who live at the home are protected. The home should have policies that identify how often staff should attend each training course. This will make sure staff practice is kept up to date. The home should have more effective quality monitoring systems in place, which includes monthly visits by the registered provider or a representative. This will make sure people receive a quality service that meets their assessed needs. The registered manager should complete an appropriate qualification. This will make sure the manager has the right skills and knowledge to manage the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Briardene 63 East Parade Harrogate North Yorkshire HG1 5LP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Carol Haj-Najafi     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Briardene 63 East Parade Harrogate North Yorkshire HG1 5LP 01423562667 01423524441 briar.dene@ntworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Appleview Homes Limited Name of registered manager (if applicable) Mrs Josephine Ann Ross Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Category (LD(E)) refers to two named service users over the age of 65. Registered for 13 service users with a Learning Disability some or all of whom may have physical handicap Date of last inspection Brief description of the care home Briardene is a care home registered by Appleview Homes Limited to provide personal care and accommodation to up to thirteen adults with learning disabilities. The home consists of a large, late Victorian property developed from a previously semi-detached house and one storey of the adjoining semi, now connected together. The home is situated in the centre of Harrogate town and has good access to all the towns facilities. All thirteen bedrooms are for single accommodation and are sited on several floors. Whilst the home does not have a passenger or stair lift, all areas are accessible to those residents currently living there. The home does not have level or ramped access. Current information about services provided at Briardene in the form of a statement of purpose, service user guide and the most recent inspection report Care Homes for Adults (18-65 years) Page 4 of 32 care home 13 Over 65 0 13 Brief description of the care home published by the Commission for Social Care Inspection are available by contacting the home. They will also provide information about the fees for the home. Care Homes for Adults (18-65 years) Page 5 of 32 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: 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 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 The last key inspection was carried out in December 2006. Before this unannounced visit we reviewed the information we had about the home which included an annual quality assurance assessment (AQAA) that the manager completed. We used this information to help us decide what we should do during our inspection visit. Care Homes for Adults (18-65 years) Page 6 of 32 Surveys were sent out to people who live at the home and other people who have an interest in the service. We received 12 surveys from people who live at the home, 10 staff and 1 relative survey. Comments from the surveys have been included in the report. One inspector was at the home for one day from 09.30am to 4.15pm. During the visit we looked around the home and talked to five people who live at the home, four staff and the deputy manager. We observed how staff interacted with people who live at the home and looked at care plans, risk assessments, daily records and staff records. The deputy manager confirmed that the weekly fees for the home range between 650 and 725 pounds. Feedback was given to the deputy manager at the end of the visit. What the care home does well: What has improved since the last inspection? What they could do better: A better care planning process should be introduced. This will make sure peoples are needs and wishes are met. More information should be recorded about the people who live at the home. This will help make sure a persons needs are being successfully met and their quality of life and welfare can be properly monitored. Risks to people who live at the home should be more carefully assessed. This will make sure the risk of harm is identified and minimised. A more robust system should be introduced for monitoring peoples personal monies. Care Homes for Adults (18-65 years) Page 8 of 32 This will make sure finances are protected. The homes recruitment procedure should be more carefully followed to make sure every recruitment process is robust. This will make sure people who live at the home are protected. The home should have policies that identify how often staff should attend each training course. This will make sure staff practice is kept up to date. The home should have more effective quality monitoring systems in place, which includes monthly visits by the registered provider or a representative. This will make sure people receive a quality service that meets their assessed needs. The registered manager should complete an appropriate qualification. This will make sure the manager has the right skills and knowledge to manage the service. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 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. Systems are in place to make sure peoples needs are properly assessed before they move into the home and they are assured their needs will be met. Evidence: In the AQAA the manager told us they always make sure the service is suitable for people who move into the home. They described the homes procedure, which involves gathering information from different people including the person who wants to move in, and arranging visits. The manager said people at the home are consulted before a decision is made. One person has moved to Briardene since the last inspection. We looked at this admission process. The admission did not follow the homes planned procedure because it was an emergency admission. The deputy manager and staff said they obtained a comprehensive assessment from social services when the person moved into the home. The homes assessment was Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: completed soon after the admission. We looked at the assessments and these contained good information about the type of support required. People that worked with the person at a previous day placement worked with staff and the person for several weeks to make sure the transition was as smooth as possible. Staff said this worked very well because the person who moved into the home was with familiar people and staff had chance to get to know the person. Care Homes for Adults (18-65 years) Page 12 of 32 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. Staff know people who live at the home very well but because the care planning process is not effective peoples needs could be overlooked. Evidence: We talked to people who live at the home. Generally they told us they are happy living at the home. One person said, I like it here. Another person said, Its good here. One person said they were not very happy but had talked to the deputy manager and family about this. They said, It isnt about the home, its just too big. The deputy manager said the persons social worker is aware and is looking at what other options are available. The majority of staff have worked at the home for several years and know the people who live there very well. They talked about peoples individual needs and gave good examples of how they provide person centred care. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: We asked the staff what the home does well; they all said the home provides a very good standard of care. One person said, People have a really good quality of life and get choice in everything we can offer. Another staff member said, Its homely; everyone gets along. Staff also talked about privacy and dignity and gave us good examples of how they do this. Part of the day was spent talking to people and observing the support being given to people. Everything was done at a relaxed pace. Staff treated people with warmth and respect and were kind and courteous. The home has a keyworker system, which staff and people at the home said works well. People who live at the home said they talk to their keyworker about what they want to do. We looked at three peoples care plans and assessments. These contained some good information but some care needs were not identified. The plans are not used as a working tool. People who live at the home benefit in many ways because staff have worked at the home for a number of years and know people very well. The deputy manager felt this was the main reason that the care planning process was not as effective as it should be. One person moved to the home five months before the inspection but a care plan has not been developed during this time. Other plans were not dated and much of the information was out of date. One persons care plan said the person went to college and pottery classes. The person had not attended these for a couple of years. The person prefers to eat alone but the plan did not reflect this. Peoples specialist needs were not identified. One person has mental health needs but this was not identified in the persons care plan although they need support with this. One person has epilepsy. The persons plan did not provide specific guidance on when to take action. The plan said staff must call an ambulance after a prolonged period. The deputy manager said the person was attending an appointment the following week and they are planning to obtain further guidance from other professionals involved. People had risk assessments but these were not up to date. One person had an assessment for physical abuse. The assessment was for when the person might abuse Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: other people and when the person could be a victim. These are different risks and should not be grouped together. One person had fallen out of bed. Following this staff completed a risk assessment and wrote may fall to depth perception- monitor at regular intervals when in bed. The deputy manager did not know where the depth perception originated. Regular intervals does not provide staff with clear guidance. After the risk assessment was completed an entry was made in the persons daily notes. On floor this morning (7am) left shoulder a bit red. Care plan reviews have been held but these have not been effective. The care plans and objectives have generally remained the same over a long period of time. In January 2007, one persons review stated objectives all remain the same. The same outcome was recorded in January 2008. Staff record important information about people and should also record what people have been doing. These records are not always filled in so it is not possible to monitor if peoples needs are being met. For example one persons record over a 10 day period only contained information about staff contact with family members. Nothing was recorded about the person. Another persons record had no entries for 6 days. One person was very unsettled during the night but the records did not provide a clear account of this. One staff member wrote night staff reported screaming; awake most of the night. One persons care plan review stated that the person appears to have become more aggressive but there was no evidence to support this. Some records did not provide a clear picture of events. For example staff have used terms such as quite verbally abusive, quite agitated and very volatile. There should be sufficient information to monitor peoples welfare and determine if needs are being met. Care Homes for Adults (18-65 years) Page 15 of 32 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 living at the home and have a fulfilling lifestyle. Evidence: People told us they enjoy living at Briardene and regularly go out with staff. One person said they enjoy going into Harrogate with staff. Another person said they like going for coffee and shopping with staff. Staff said people go out on a very regular basis. One person said, I have no problems. My mum checks Im happy. Staff always ask if Im ok. One relative told us they are very happy with the care the home provides. When asked what the home does well they gave many examples including excellent care and support, excellent links with family home, relaxed environment and excellent integration into the community. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: In the AQAA the manager told us people are encouraged to participate in various activities of their choice which includes college, day centres and supported work. The manager also told us they have improved in the last twelve months because everyone is encouraged and supported to access public transport. People who live at the home told us they make decisions about what they do and choose what to do on an evening and weekend. They said they get up and go to bed when they want. We talked to people who live at the home about daily living skills. Everyone told us staff are responsible for cooking the meals but people who live at the home sometimes assist. People make their own packed lunches. Some people said they do different tasks, which includes washing up, laundry and vacuuming. Each person has an allocated day when they clean their room and do their laundry. Staff said independence is promoted and the level of support depends on the individual. People who live at the home said the meals are good. They said they tell (name of staff who plans menus) what they want to eat. Staff told us meals are varied and nutritious, and the quality and choice of meals are good. The person who is responsible for planning the meals said people are asked individually or at house meetings what they would like to eat. Care Homes for Adults (18-65 years) Page 17 of 32 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. Peoples health and personal care needs are well met. Evidence: Staff said the home is good at meeting peoples personal and healthcare needs. People who live at the home said they have good daily support with their personal care. In the AQAA the manager said, We regularly undertake the dignity in care training questionnaire at team meetings to keep the importance of protecting dignity fresh in our minds. At the last inspection we recommended that staff should complete medication training. In the AQAA the manager told us all staff who administer medication have a recognised and accredited qualification. Staff said the medication training was good. We looked at information that showed us peoples health is properly monitored. Healthcare records have good information about appointments and showed us that staff are vigilant and look for changes in well-being. Care Homes for Adults (18-65 years) Page 18 of 32 Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are safeguarded. People are confident that they will be listened to and that appropriate action will be taken when necessary. Evidence: Surveys from people at the home told us they know who to speak to if they are not happy. One person said they tell their keyworker if they are unhappy. Another person said, I can talk on my own to any member of staff and there are resident meetings too. Staff surveys told us that they know what to do if people have any concerns about the home. The deputy manager confirmed they had not received any complaints since the last inspection and they have not had any safeguarding incidents. The deputy manager said most staff have attended safeguarding training with the local authority. Further training is planned for March. At the last inspection we asked the home to amend their adult protection procedure. They have done this and the procedure for report allegations is clear. Some information in the adult protection procedure and the complaints procedure was Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: out of date/incorrect. The deputy manager amended these on the day of the inspection. Care Homes for Adults (18-65 years) Page 21 of 32 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 homely, pleasant and safe environment. Evidence: Surveys from people who live at the home told us the home is always clean. When we looked around the home it was clean, tidy and looked homely. The home is well maintained, and furnished and decorated to a good standard. Each bedroom is personalised and people said others only come in when they are invited. Bedrooms are very different and reflect peoples tastes. People said they like their rooms. One person said, I had my own bedroom decorated how I liked. There are sufficient well-equipped bathrooms and toilets that are situated on various floors throughout the premises. We checked water temperatures around the home. These were satisfactory. In the AQAA the manager said equipment has been serviced or tested in line with manufacturers guidance or regulatory body. We looked at electrical equipment and fire equipment test dates; these corresponded with what had been recorded in the AQAA. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Clinical waste is properly managed and staff wear protective clothing when attending to the personal care needs of people who live at the home. Care Homes for Adults (18-65 years) Page 23 of 32 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 who live at the home are supported by a competent and caring staff team. Staff are skilled but because all training needs are not properly identified some training needs could be overlooked. Evidence: People who live at the home told us staff treat them well. One person said, The staff are very kind. In the AQAA the manager told us the home has a low turnover of staff and said, It has been commented on several times by people visiting Briardene in a social or professional capacity that it has a very friendly and relaxed atmosphere. And the staffing consistencies have benefited people who live at the home providing them with stability and continuity of care. Staff told us staffing levels were generally good. Four surveys said there are always enough staff. Six surveys told us there were usually enough staff. Staff said they enjoy working at the home and everyone works well together. Several people talked about the good atmosphere and good teamwork. Staff also said Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: everyone has a good understanding of their role and they regularly meet with management to discuss how they are working. Staff said training and training opportunities are good. Staff told us they receive training that is relevant to their role, and helps them understand and meet the needs of people living at the home, and keeps them up to date with new ways of working. In the AQAA the manager said, Well over 50 of the current staff at Briardene have NVQ qualifications at level 2 and above, and all staff are keen to undertake further training to improve their confidence and knowledge. The deputy manager could not confirm which training courses staff had completed during the last 12 months because the training matrix could not be located. A training development programme was not available. Some staff had taken their certificates to complete their NVQ training portfolios. We therefore could not verify which courses staff had completed. This information should be readily available. The homes does not have policies or guidance for the frequency of attendance for some training courses. Staff have worked at the home for many years, some as long as fourteen years. It is important to identify how often staff should attend training courses to make sure their knowledge is up to date. A member of staff that has worked at the home for nearly two years talked about the recruitment and induction process. They confirmed that they attended an interview, and had to wait for a criminal records check and satisfactory references before they could start work. They also discussed the induction process which they said was very good. All staff surveys said their employer carried out checks, such as their Criminal Record Checks and references, before they started work. We looked at two induction workbooks which showed staff covered all important aspects of the home and the principles of care as part of their induction. Only two staff have started working at the home in the last two years. One person started nearly two years ago, the other person nearly eighteen months months ago. We looked at the pre employment records. All the information that is required as part of the recruitment process was available, apart from one file only had one written reference. The deputy manager said he was very surprised the file did not have two written references because they always carry out a thorough recruitment process. He said he knew the manager had obtained a verbal reference but could not find a record of this. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: As part of the pre employment checks, information received in another language was translated into English and foreign Police checks were carried out. Care Homes for Adults (18-65 years) Page 26 of 32 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 home is well managed and everyone feels well supported. The registered provider is not monitoring the service adequately which could lead to changes in the quality of the service going unnoticed. Evidence: People told us they were very happy with how the home is managed. One staff said, It is very well organised. Another staff said people who live at the home, their families and staff are very well supported. The registered manager is very experienced in the management of care services. She has been the registered manager of Briardene for a number of years. At the last inspection, we identified that the registered manager should complete an appropriate qualification. This recommendation has not been achieved. People who live at the home attend regular meetings and are asked to complete surveys about the quality of the home. Survey results from June 2008 had been Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: gathered and discussed with people who live and work at the home. We asked to look at monthly visit reports (Regulation 26 reports). Visits should be carried out by a representative of the organisation to check that people are receiving a satisfactory service. One report was carried out in February 2008 although this was written by the deputy manager. Regulation 26 visits should be carried out as part of the quality monitoring process. The manager tells us about important events that happen at the home. Since the last inspection we have received regulation notifications when significant events have occurred. No concerns around safe working practices were seen on the day of the inspection. In the AQAA the manager told us they have policies and procedures in place. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Peoples needs and 31/03/2009 aspirations must be properly identified through a care planning process. This will make sure peoples are needs and wishes are met. 2 6 12 Sufficient information must be recorded about people who live at the home. This will help make sure a persons needs are being successfully met and their quality of life and welfare can be properly monitored. 28/02/2009 3 9 13 Potential risks to people who 31/03/2009 live at the home must be properly assessed and risk management strategies agreed. This will make sure the risk of harm is minimised. Care Homes for Adults (18-65 years) Page 30 of 32 4 39 26 The home should have effective quality monitoring systems in place, which includes regulation 26 visits This will make sure people receive a quality service that meets their assessed needs. 31/03/2009 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 23 A more robust system should be introduced for monitoring peoples personal monies. This will make sure finances are protected. The homes recruitment procedure should be more carefully followed to make sure every recruitment is robust. This will make sure people who live at the home are protected. Individual staff training needs should be identified and the information made available at the home. This will make sure training needs are identifed and met. The home should have policies that identify how often staff should attend each training course. This will make sure staff practice is kept up to date. The registered manager should complete an appropriate qualification. This will make sure the manager has the right skills and knowledge to manage the service. 2 34 3 35 4 35 5 37 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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