Care Home: Brook House

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What the care home does well The admission process ensured people`s needs were properly assessed. This helped make a good decision to admit people knowing the facilities and services could meet their needs and preferences and recognise their right to choose for themselves. Person centred care planning meant people using the service were cared for as they wanted and needed. There was evidence that the service understood the right of residents to take control over their own life and make their own decisions and choices. Staff interviewed considered the service did well by supporting residents to live a fulfilling life. To ensure personal care and support was provided in a way, which maintained residents dignity and respected privacy and lifestyle, care plans took into account what residents wanted and what was important to them. Decision-making was encouraged and residents were given time to consider the choices they made. Residents also benefited from additional specialist support where needed such as healthcare, and their care needs was reviewed regularly. Risk management was good and staff had enough information to know how to help keep people safe. Staff interviewed considered they were given enough information to care for residents properly. Residents right to confidentiality was respected. Residents lifestyle was centred on them and they did not have to conform to any institutional practice such as set times for getting up or going to bed, and their daily living routines were personal. Residents were supported by a named worker referred to as a key workers. They made sure that residents were given good opportunities to pursue their goals and aims in life. A wide range of activities helped residents make the most of their skills both inside and outside the home. They also went on holiday, went shopping, enjoyed trips out and had individual activities. They were supported to keep in contact with relatives and freinds. Meals provided met with residents tastes, needs, and choice. Those residents spoken to during inspection said the food was `good`. They said they could have what they wanted. Special diets were catered for and nutritional advice and support was sought where required. Residents who were consulted, said they knew who to talk to if they were not happy. Staff working at the home had been trained in adult protection and knew their responsibility in this area and were confident they would `report bad practice` if ever the need arose. Residents managed their own finances where possible, and were protected by the homes policies and practices in doing this. The home was well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Residents were satisfied with their bedrooms and living arrangements.Recruitment practices were excellent as residents took part in the process. Residents considered there was always sufficient staff employed to meet with their needs. Staff interviewed said they loved their work, had job satisfaction and felt appreciated and valued in the home. Communication was good and staff said they had the right knowledge and skills to care for residents with a learning disability. Records showed they were trained properly and had regular supervision and appraisals. This meant residents were cared for by a well trained staff team they helped to choose. Residents considered the staff working in the home were very good to them. Management responsibilities were clear and the home was very well managed. It was run in the interests of the people living there and staff employed, promoting equal opportunities for all. There was evidence of continuing investment to improve and maintain good standards and provide training for staff. Every effort was made to give people good opportunities to have their say in how the home was managed such as management, staff, and residents meetings. Residents were also given an excellent opportunity to appraise the performance of their key worker. They also took part in East Lancashire Service User Network, (ELSUN) allowing them to share their views and experiences with other people. Quality Assurance was carried out and the home had renewed Investors In People Award. Residents who completed surveys for this inspection were satisfied with the overall service provision. They said `I find it ok because there is nothing wrong with the home. There is no faults.` `I enjoy living here with everyone and get along with the staff`. Residents were involved in keeping safe. They had regular fire drills and knew what to do should this occur. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. What has improved since the last inspection? To make sure residents receive the right care they need and require, care planning is more person centred. This supported residents to be cared for as they wished and required.. Care plans seen, identified practical life skills for example where residents can manage to make their own breakfast. All financial support needed for residents such as saving and support with daily expenditure is recorded in their care plans, and the type and level of support agreed. Staff turnover is now relatively low and residents are involved in recruiting staff. This meant residents were cared for by regular staff they know and trust. Records of staff training showed staff had qualified in First Aid. This ensured that if an accident occurred residents will be attended to promptly by a person skilled to help them. What the care home could do better: The carpet leading to the laundry required some attention as the ripples seen were a potential hazard, particularly as there were residents identified during inspection as being unsteady on their feet. Key inspection report Care homes for adults (18-65 years) Name: Address: Brook House 391 Padiham Road Burnley Lancashire BB12 6SZ     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: Marie Dickinson     Date: 1 1 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Brook House 391 Padiham Road Burnley Lancashire BB12 6SZ 01282413107 01282835863 linda@brookandglencairn.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Hurrylall Gungah,Mrs Bibi Farida Gungah care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accomodated are: 10 Date of last inspection Brief description of the care home Brook House is a large Victorian house, situated within a short walking distance to Burnley town centre and is keeping with other houses in the neighbourhood. The home is owned by Mr and Mrs Gungah. Brook House is registered to provide personal care and accommodation for ten people with a learning disability. Accommodation is in ten single bedrooms with en suite facilities. There are two lounges, dining room and kitchen combined, bathroom, toilet and a utility room. Staff have sleeping in accommodation. There are garden areas to the front and rear with parking space. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home At the time of inspection the scale of charges was dependent on the level of need. The home has a statement of purpose and service users guide, which informs the current and prospective residents about the services and facilities available at the home. The registered person had also produced a brochure and CD. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A key unannounced inspection was conducted in respect of Brook House on the 11th september 2009. An annual quality assurance assessment (AQAA) was sent to us by the manager prior to this inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service, such as number of staff trained, and of essential maintenance to keep the home safe being carried out. An annual service review was carried out on the 13th September 2008. The outcome of this was, the service had continued to provide good outcomes for the people who use it. There has been no complaints received at the Commission about this service. There were written comments received from residents for this inspection. Care Homes for Adults (18-65 years) Page 6 of 30 Discussion took place with the manager, staff, and residents during inspection. Documents including policies, procedures, and staff and residents records were looked at. The premises were inspected as part of the process. Areas that had been required to improve were looked at for progress made. The home was assessed against the National Minimum Standards for Younger Adults. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: The admission process ensured peoples needs were properly assessed. This helped make a good decision to admit people knowing the facilities and services could meet their needs and preferences and recognise their right to choose for themselves. Person centred care planning meant people using the service were cared for as they wanted and needed. There was evidence that the service understood the right of residents to take control over their own life and make their own decisions and choices. Staff interviewed considered the service did well by supporting residents to live a fulfilling life. To ensure personal care and support was provided in a way, which maintained residents dignity and respected privacy and lifestyle, care plans took into account what residents wanted and what was important to them. Decision-making was encouraged and residents were given time to consider the choices they made. Residents also benefited from additional specialist support where needed such as healthcare, and their care needs was reviewed regularly. Risk management was good and staff had enough information to know how to help keep people safe. Staff interviewed considered they were given enough information to care for residents properly. Residents right to confidentiality was respected. Residents lifestyle was centred on them and they did not have to conform to any institutional practice such as set times for getting up or going to bed, and their daily living routines were personal. Residents were supported by a named worker referred to as a key workers. They made sure that residents were given good opportunities to pursue their goals and aims in life. A wide range of activities helped residents make the most of their skills both inside and outside the home. They also went on holiday, went shopping, enjoyed trips out and had individual activities. They were supported to keep in contact with relatives and freinds. Meals provided met with residents tastes, needs, and choice. Those residents spoken to during inspection said the food was good. They said they could have what they wanted. Special diets were catered for and nutritional advice and support was sought where required. Residents who were consulted, said they knew who to talk to if they were not happy. Staff working at the home had been trained in adult protection and knew their responsibility in this area and were confident they would report bad practice if ever the need arose. Residents managed their own finances where possible, and were protected by the homes policies and practices in doing this. The home was well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Residents were satisfied with their bedrooms and living arrangements. Care Homes for Adults (18-65 years) Page 8 of 30 Recruitment practices were excellent as residents took part in the process. Residents considered there was always sufficient staff employed to meet with their needs. Staff interviewed said they loved their work, had job satisfaction and felt appreciated and valued in the home. Communication was good and staff said they had the right knowledge and skills to care for residents with a learning disability. Records showed they were trained properly and had regular supervision and appraisals. This meant residents were cared for by a well trained staff team they helped to choose. Residents considered the staff working in the home were very good to them. Management responsibilities were clear and the home was very well managed. It was run in the interests of the people living there and staff employed, promoting equal opportunities for all. There was evidence of continuing investment to improve and maintain good standards and provide training for staff. Every effort was made to give people good opportunities to have their say in how the home was managed such as management, staff, and residents meetings. Residents were also given an excellent opportunity to appraise the performance of their key worker. They also took part in East Lancashire Service User Network, (ELSUN) allowing them to share their views and experiences with other people. Quality Assurance was carried out and the home had renewed Investors In People Award. Residents who completed surveys for this inspection were satisfied with the overall service provision. They said I find it ok because there is nothing wrong with the home. There is no faults. I enjoy living here with everyone and get along with the staff. Residents were involved in keeping safe. They had regular fire drills and knew what to do should this occur. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. What has improved since the last inspection? What they could do better: The carpet leading to the laundry required some attention as the ripples seen were a potential hazard, particularly as there were residents identified during inspection as Care Homes for Adults (18-65 years) Page 9 of 30 being unsteady on their feet. 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 10 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission process ensured peoples needs were properly assessed. This helped everyone involved, decide if the facilities and services could meet needs and preferences of individuals and support a decision to offer a placement in the home. Evidence: Information received from the home for this inspection included details of what they did well such as, provide a service around individual aspirations and needs with a person centred process involving family and social contact. To find out more information about the home, the facilities offered and staffing arrangements details can be viewed on a website, a brochure and CD. There was a protocol to follow when people are being admitted. Procedures followed show stages to accepting people to the home and included health and social agency referral and assessment, and an assessment by the home. There had been no new admissions to the home since the last inspection; however one resident had been re admitted following a stay in hospital. Care notes showed Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: how admissions were managed. Copies of assessments completed by health and social care professionals were available for reference. Residents identified needs linked to their plan of care, for example, personal care, mental health care needs, family, communication, diet, and medication. The assessment had also considered relatives wishes and the residents right of choice to live where they wanted. Written comments from residents showed they had been consulted about living at the home. They said they were asked if they wanted to stay there and had enough information to help them decide if it was the right place for them. One resident said, I asked to move into here myself. Care Homes for Adults (18-65 years) Page 13 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good person centred care planning meant residents were supported to make decisions about their lives that considered their rights, choices, and safety. Evidence: The standard of peoples care records was good, and included an up to date assessment of needs. Assessments linked well to care plans. There were clear directions for staff as to the type and amount of support people needed. The method of care planning used was person centred planning. Care plans appeared to be completed with residents and guidance written for staff in providing support was clear. Short term and long term goals were listed such as going swimming and going on holiday. The goals included the type of support required and identified who would take responsibility to help residents achieve this. Residents did not have a copy of their care plan in an easy to follow format, however they knew how staff helped them. The key worker system allowed staff to work on a one to one basis with residents. It was the practice of the home to support responsible risk taking, and risk Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: assessments and management strategies were available for staff to work to. Methods to reduce or manage the risk were completed providing staff with clear guidance what they should do to support people. Residents benefited from being involved in writing their own care plans. Each person had a member of staff referred to as a key worker to help him or her with special activities such as keeping in contact with their family, personal care and daily living. Residents in the home said they were pleased with their carer, and were given opportunities to comment on their performance in meeting their needs. Care plans were reviewed regularly showing progress and changes needed in meeting needs or achieving goals. These were easy to follow. They showed who would do what to reach the desired outcome. Residents were supported to invite people who were significant in their lives to attend their reviews. The key principles identified in the home show people using the service are in control of their lives and can direct the service. They also had their own house rules and charter of rights, that covered the right to receive a service that took into account their individuality, dignity, privacy, choice and independence. Confidentiality was included in induction training and in the staff handbook for reference, and was explained to residents completing surveys as means secret. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for personal development, family contact, and social activities was very good which meant residents were supported to live a fulfilling lifestyle in the home and in the wider community. Evidence: There was evidence the service has a commitment to enabling residents to develop their skills, including social, emotional, communication, and independent living skills. Records of people living in the home show how they are supported to identify their goals, and work to achieve them. This is done through care planning, and key workers having an active role in supporting residents accomplish this. There was no institutional practices observed during inspection. Written information from the service indicated they did well by supporting residents access community resources, maintain contact with relatives and friends and enjoy a Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: full stimulating lifestyle with a variety of options to choose from. Residents who provided written comments said they could do what they wanted all the time. They made decisions about what they did each day. Several people were at home during the inspection who discussed what they did and of their achievements. Part of care planning was to help people identify what their own goals are, and what they want and need to do. One resident commented in her key worker appraisal, Got me back into College and I thanked her for that. Records showed for review of care meetings residents were supported to send out invitations to people they consider able to help them achieve these. This can be any person a resident considers important to them. Records also showed goals set were achievable, with everyone involved knowing what their role was for example support a resident to go swimming, and daily exercising. This meant individuals had support to access a wide range of leisure activities according to interests, and capabilities. The philosophy of the home to enable people to live full independent lives, and be involved in the community was central to the homes aims and objectives. People in the home discussed the type of activities they did. They had weekly planners to help them remember what to do and where to go. They usually did something different every day. For example they knew when they cleaned their bedroom, and what day they went to College and clubs. Staff helped them where needed. Residents also considered they had plenty of activities arranged for them to enjoy. They had been on a holiday of their choice, celebrated birthdays and other festive days. They had enjoyed a barge trip, went shopping and used community resources at their leisure. Residents were also involved in East Lancashire Service User Network (ELSUN). This meant they could meet up with other service users from other homes and discuss various topics. Family links were encouraged and one resident spent time at home with her mother on a regular basis. The visiting policy enabled residents to have visitors at any time they wished. Residents were supported to manage their own money. Care plans identified the type and level of support they required. Everyone said the food was good. They chose their menus, and sometimes helped with making meals. What meal preparation residents managed was recorded, such as can make her own brakfast of cereal and toast. There was no reference to main meal participation and staff said they generally made this. However observations were made of residents helping out such as washing dishes and setting tables. Special diets were catered for and the services of a dietician sought where required. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents preferred method of support allowed them to enjoy personal care in a non institutional and dignified way. Their healthcare needs were sufficiently monitored which supported them maintain their general well being. Medication policies, procedures and staff training promoted good practice. Evidence: Individual care plans set out the level of personal support people required. Staff helping residents with personal care had sufficient instructions to help them according to their need and what they liked or was important to them such as appearance recorded on assessment and reviews. How people needed to be supported was also recorded in their care plan. For example Will try to manage before asking for help. Staff to encourage her to ask for help with personal care otherwise health issues likely to arise etc. Comments from residents living in the home indicated staff treated them well. Healthcare needs had been properly assessed and were included in each persons care plan. People were registered with a General Practitioner and had regular routine health screening. Daily records showed how healthcare was closely monitored, and Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: appointments for routine health care were made and staff support offered where needed. There was also evidence of other professionals, such as dietician and speech therapist, being involved in meeting residents healthcare needs. All staff were trained to care for people with a learning disability and in other topics relevant to their work. This included medication. Records of medication was kept for each individual that included information staff should be aware of if someone was not well. Residents could self medicate following an assessment to make sure this would be safe. Medication storage was secure and tidy. Medication administration records were up to date. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and way the home was managed, made it very easy for residents to raise any issues or concerns they had. Good practice in employment, and training for staff in adult protection, helped protect residents from abuse, neglect, and self harm. Evidence: Information received at the Commission for this inspection regarding the complaints stated they Have clear guidance and policy on dealing with concerns, complaints and protection. Operate good vetting and practice in employment. Involve service users in key worker appraisal. And Instruct service users how to keep safe. Those residents spoken to during inspection said they had no complaints. They considered they were well looked after and had the right support from staff. There is a complaint procedure they can use and residents said they were aware of it. Staff spoken to said they had been instructed and knew what to do if residents or other people had any concern. Information was passed on well. There was one recorded complaint in the home that had been dealt with satisfactorily and no complaints received at the Commission. Policies and procedures for safeguarding adults were available for staff to follow. Records showed staff training in Protection Of Vulnerable Adults (POVA) was provided and also covered in induction of new staff. Staff interviewed during inspection were Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: clear of their responsibility and obligation to follow correct procedures in reporting under POVA should this be necessary. Staff had formal agreements to abide by the homes code of conduct and practice that included protection issues such as financial protection for residents. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a clean, well-maintained, comfortable environment for people living there. Evidence: Brook House is a large spacious Victorian style property building set in its own grounds. Accommodation is provided in ten single rooms, all of which have an ensuite facility. The shared space is provided in two lounges and a dining kitchen. The home is located approximately two miles from Burnley and is situated on a main public transport route. The home was decorated to a very good standard and furnishings and fittings were homelike in style and of a good quality. There is a garden area to the front and back that were pleasant for residents to enjoy. There was evidence of ongoing maintenance, with obvious continuing investment made to keep good living standards for residents. As planned at the previous inspection the hallway and staircase had been redecorated. A member of staff had been assigned to monitor the house for repair and renewal. Information received at the Commission showed relevant health and safety maintenance of equipment had been carried out. Residents were alos provided with Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: additional personal aids in their bedrooms such as grab rails in their en suite to support them maintain their indpendence. Residents had access to all parts of the house. On inspection the home was very clean and people were relaxed and very much at home and said they were happy with their accommodation. They were able to personalise their rooms according to their own tastes and preferences. Furniture provided met with their approval and bedding, carpets and curtains were coordinated to match. All the residents spoken to said they liked their rooms, and were happy to show off how nicely they kept them. Laundry facilities were sufficient organised and clean. The carpet leading to the laundry required some attention as the ripples seen were a potential hazard, particularly where residents were identified as being unsteady on their feet. The premises were comfortable, clean, and free from offensive odours, in all areas seen. Information provided for this inspection said they were proactive in infection control, for example they use specialist equipment and engage in NHS infection control meetings. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent recruitment practice, training provided and staff deployment meant residents were cared for by sufficient qualified and competent staff they helped to choose. Evidence: Information received at the Commission indicated that a high percentage of staff were trained in National Vocational Qualification in Care (NVQ) level 2 and above. Records available showed a wide range of other training was provided and included, full induction, first aid, moving and handling, health and safety, food hygiene, challenging behaviour, Protecting Vulnerable Adults, medication, learning disability, principles in care, and infection control. Certificates of training were kept on file with staff training records. The recruitment practice was excellent as it involved residents, who were supported to be part of the interview panel and ask the applicant questions. Responses were recorded and residents views noted. There had been several new staff appointed since the last inspection. The home operated an equal opportunity policy. Application forms had been completed, references requested, and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check had been applied for and received, prior to employment. Employees were given job description and a contract of employment. A training agreement was signed. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Written comments from residents showed they considered staff looked after them properly and took into account what they needed and wanted. They listened to them. The manager had a well established supervision programme and staff appraisal to ensure all staff were continually monitored in their work. Records showed supervision was structured and included; review of work performance, future work targets, training, support, and development. An action plan following supervision was completed. Residents took part in staff performance evaluation. Staff meetings were held on a regular basis. Minutes of meetings held showed good structure and relevant topics discussed. The meetings gave the opportunity to staff to share experiences and develop teamwork. Staff considered the atmosphere in the home was very good. They were a good team and were confident they would be supported in their work with advice and training provided if required. Staff on duty said they enjoyed their work and the training provided. The skill mix of staff meant that at all times senior support workers were on duty. Staff worked to a key worker system and this involved helping people with personalised goals such as independent living skills, and one to one support. The numbers of staff on duty was sufficient to support residents with planned programmes for daily living. Changing needs of residents was considered in staffing numbers and how they were deployed for example, assessments of individuals showed in one instant a resident required the attendence of a carer and this had been provided. The skill mix and gender of staff was well balanced. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was managed and run in the best interests of the residents. Evidence: The registered manager is qualified in management and care, and has many years experience in managing a care home. The manager had completed an Annual Quality Assurance Assessment for this inspection. Overall the assessment indicated the conduct and management of the home ensured it was run in the interests of the residents, respecting individuals rights and ensured residents best interests were safe guarded. The ethos was that the home, its decisions, its policies, and procedures, belong to the residents and are managed on their behalf. To ensure Equality and Diversity is considered, all staff had a working knowledge of the policy through training and were expected to challenge discriminatory language or behaviour appropriately and sensitively. Residents had regular meetings. Their views were taken seriously and they were kept informed of all aspects of home management. Residents were also given opportunities to provide feedback on their key worker support. Comments recorded included for Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: example, very friendly, and very nice lady. Staff interviewed during inspection said they had regular supervision and appraisals. They considered communication was good and records of staff meetings provided evidence they were consulted about good practice issues. The management approach appeared to be open and friendly. Relationships within the home were positive, and residents were relaxed in staffs company. Residents who sent written comments about what the home did well stated I find it ok because there is nothing wrong with the home. There is no faults. I enjoy living here with everyone and get along with the staff. Residents felt they were listened to. Quality assurance was monitored and the home had renewed its Investors In People award. There was evidence of equal opportunities for all. Good examples of this were with residents involvement in staff recruitment and opportunities for them to live a valued life in the wider community. To make sure staff follow the policies and procedures of the home, as outlined in their staff handbook, these are discussed during supervision. Action was taken to help staff understand them by formal training provided, such as caring for people with a learning disability. The health and safety of residents was safeguarded. Policies for safe working practices and staff instructions in fire safety were available. Safe working practices in the home were evidenced. Information received at the Commission showed routine servicing and testing of essential household services and safety equipment was carried out. Staff had received health and safety training, which included moving and handling, food hygiene, infection control and fire safety. The number of staff trained in first aid ensured they knew what to do and had the skills to deal with an emergency situation. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The carpet leading to the laundry room requires some attention as the rippling is potentially a hazard to residents. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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