Care Home: Brooklands

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What the care home does well The atmosphere was friendly and congenial. Staff enable people to make choices and treat them with respect, interaction between them was observed to be friendly and open. When talking about people, staff did so in a supportive and respectful manner and written notes were also written appropriately. The service is well organised and has kept people informed of all the changes that have taken place to the respite service in the last few months and they are still supporting people as the changes continue and the old building is knocked down and the new one begins to take shape. The activities provided are varied and are well suited to people`s individual needs. The house is clean and homely, the bedrooms are suitable for short stays and people are encouraged to bring whatever they need to help them enjoy their stay there. The home is well managed and has an experienced and well trained staff team. What has improved since the last inspection? The manager has acknowledged that mistakes were made in the past that left people vulnerable to abuse but has taken steps to improve the quality of information that is collected during assessments and has made risk assessments more robust. All the requirements made following the last inspection have been complied with; proper storage has been provided for the medication and staff have received safeguarding training and their understanding of it has been tested and discussed in individual supervision sessions and in staff meetings. What the care home could do better: The service provides good information about how to make a complaint but one person told us in their survey that they didn`t know how to make a complaint and hadn`t been told about the complaints procedure. Steps need to be taken to make sure that everyone gets this information, that they all understand how to make a complaint and who they can talk to about it. Key inspection report Care homes for adults (18-65 years) Name: Address: Chestnut House Brooklands South Close Bury St. Edmunds Suffolk IP33 3JZ     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: Ann Wiseman     Date: 0 9 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Chestnut House Brooklands South Close Bury St. Edmunds Suffolk IP33 3JZ 01284352583 01284352584 Nicky.lawrence@socserv.suffolkcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Suffolk County Council Name of registered manager (if applicable) Mrs Nicola Lawrence Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Chestnut House offers a respite service to over ninety people with a learning disability and is provided by Suffolk County Council Social Services. The home accommodates eight people at a time and people can chose how they use their allocated respite time, they can take it as weekend breaks or week long stays, some people prefer to stay at the home during the week and plan their visits to correspond with their friends so they can stay together. The service have recently moved to the present premises so that their old building can be knocked down and rebuilt as a purpose built respite service. The work is in progress and it is expected that the new building will open later this year. The cost of a respite stay is £9.94 a night. 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection; we arrived during the afternoon so that we could meet people staying at the home once they got back from their day service. The manager was on duty when we arrived and was in the middle of interviewing for new staff. Whatever files and documents we asked to see were quickly produced and were well ordered. During the visit we talked to some of the staff who were open and friendly and some of the people staying there. We looked at information belonging to four people who have respite at Chestnut House and the personnel information of three of the staff. We were shown around the building and had a look at all of the bedrooms. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. Before the inspection the manager had sent us the Annual Quality Assurance Care Homes for Adults (18-65 years) Page 5 of 28 Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The AQAA was sent to us within our set timescales, was well written and contained information that showed that the service recognised areas that need further improvement. We had sent surveys for distribution among the people who stay at Chestnut House, their relatives and the staff, the response was very good. We received sixteen back from people who have respite, some of them were completed with the help of their family and ten of the staff returned their surveys. The overall comments were positive about the home and the service they provide. People told us that they were happy when they stay at Chestnut House. One relative said, My family have always found the staff to be kind and caring - we cannot praise them enough and we are grateful to them. Another person said, All who interact with my relative seem caring Someone also commented, I have always found the staff welcoming and helpful and pleased to see us on visits. They do everything they can to help my relative who finds changes in routine very difficult to cope with. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of using this respite service are offered enough information to enable them to make an informed choice and everyones needs are assessed before they have their fist visit or as soon as possible if it is an emergency placement. Evidence: The home only offers respite accommodation not long term care and has a core group of approximately ninety people who make return stays of varying durations throughout the year according to their assessed needs and the needs of their carers. The manager explained that there have been changes to the pre-admission assessment but not to the procedure since the last inspection and information provided on the AQAA confirmed this. They explained that as all referrals come to them via social services so all applicants will have had already received a full social care needs assessment and this document forms the basis of the information that the home initially receives and reviews. A recent incident which lead to a safeguarding hearing has highlighted the fact that Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: there were some areas of their assessment questionnaire that needed to be developed further to ensure that they detailed information and identified risks in all areas of peoples lives. We examined the assessment of a person who is preparing to take up respite, which had been done using the amended questionnaire. We compared it to others done using the old format, it was much more detailed than the previous ones and resulted in a good quality care plan. Most of the stays are planned well ahead but the service also takes in people in an emergency, with little or no notice. There may be no time for a home visit or to carry to out a full needs assessment before their arrival at the home. We saw evidence that shows that if this happens, a care plan is compiled as soon as possible after their arrival and further details were added as information becomes available and once a community care assessment has been carried out by a social worker. The manager explained that although the home had good knowledge of all the people using the service it is important to reassess their current care needs whenever they stay at the home. This is so that they can adjust the service offered to meet peoples needs, which may well have changed in the months since their last admission. Having current information of their medication arrangements is also very important and families and carers are asked to complete a medication information sheet every time their relative uses the respite service. All the care plans and reviews we saw were signed either by he person using the service or a family member, this is evidence that they are involved with the pre-admission procedure and with any subsequent care reviews. The service has recently been re-registered as they have moved into temporary accommodation while the old home is being knocked down and a new purpose built home is being built on the same site. Therefore the homes Statement of Purpose and the user guide have been recently assessed as part of the registration process and they were found to accurately reflect information about the service. People thinking of using the respite service are given the opportunity to visit them before they decide to whether to use it or not. Information given to us in the AQAA says that the manager visits people in their own home or invites them to the home to carry out the assessment, it also says, We give people time to settle in, their Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: transition into the service is governed by them not us, if they need more tea visits before commencing to overnight stays this is fine. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this respite service have good quality care plans and are assisted to make decisions about their life and are consulted about the way they want to live. People are enabled, through risk assessments, to take risks as part of an independent lifestyle. Evidence: We examined four peoples care plans, the format demonstrated a person centred approach; they provide detailed information and clearly show how people using the service wish their identified needs to be met. They need to be detailed because people use the respite service for only a short period a few times a year so it can take staff longer to get to know people really well. The plans are also updated regularly being reviewed each time people visit the home. Everyone has an individual night time protocol, which details what time people prefer to go to bed or get up, if they want or need to be checked during the night, if they want the light on and whether they would like the door open or shut. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The individual plans also include risk assessments which ensure that people staying at the home can lead a safe life but still undertake activities of their choice. Since an incident in the home risk assessments are being reviewed and new sections have been added to the assessment questionnaire to collect more information about some areas of peoples lives to ensure they are safe while they are using the service, this shows that the service has been able to learn lessons from its mistakes and takes action to avoid bad situations reoccurring. We were able to evidence this as a new referral has been made recently and their assessment and care plan was already in place ready for them to start using the respite service in the near future. Both the documents were very detailed, so were the risk assessments and there was a whole new area detailing how the person interacts with other people and whether they were able to manage personal relationships or if they needed support in that part of their life. The completed care plan was made available to staff and there was a note in the message book asking them to familiarise themselves with it before the persons first visit. People using the respite service make decisions about the home and the things they do while they are staying there. The care plans detail how people have made their choices, and how these choices are achieved. At meal times the small group of people all eat together, including the staff, and they take the opportunity to discuss and plan what they want to do during their visit. They also hold group meetings where they get a chance to make future plans and to make suggestions for improving the service they get. Records show that staff induction training includes the importance of keeping confidences and we saw that, when not in use, private information is stored in a locked cupboard in the office and is not left lying around in communal areas. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A full range of activities is offered in and out of the house that makes people a part of the local community. The food offered is varied and can be eaten in comfortable surroundings. Evidence: The manager and staff talked about their ethos of people being given opportunities to develop their skills and being free to make their own choices with guidance and support. The service continues to maintain links with the local community and people using it enjoy a variety of local facilities and pursuits including the local pubs and restaurants, shopping, sports and leisure facilities, they go to the local theatre together and during the weekend a variety of activities are offered. To give people ideas of what to do leaflets about local attractions are displayed in the entrance lobby along with an album Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: full of photographs of people taking part in activities and outings. We also saw evidence in the records that people are involved in deciding what they wanted to do and where to go. There was a room with a pool table, an air hockey game and a playStation as well as other indoor activities. There was also a keyboard and an Ipod connected to a speaker dock so that people had a wide choice of music they could play. All of the bedrooms had a television and DVD player and the home had a collection of DVDs for people to use. Out of the sixteen user surveys returned to us, all except two, thought they had plenty to do and that they were usually able to make decisions about what they do during their stay, one commented that they liked that, The weekends are very quite and relaxing. another person who thought otherwise said, More activities would be appreciated. When staff talked to people it was evident that they had a good understanding of peoples communication needs, they took time to talk to people in a way they understood and gave them plenty of time to reply. People can ask to stay at the home at the same time as their friends and use the visit as an opportunity to catch up and spend time with them, to socialise and make new friends. This a respite service and families welcome the break they get and dont usually visit their relatives when they are there but the manager assured us that family members and friends are welcome to visit the home. We were also told that people are encouraged to contribute to the day-to-day working of the home, such as tidying their personal rooms, doing their laundry and helping with housework. While we were at the home we saw people helping to set the dinning tables and to clear up after the meal. The menu offers a varied and appetising diet, people are given a choice of two main dishes, while other options are readily available if requested, including a vegetarian alternative. We spoke to the cook who proved to be knowledgeable about peoples eating requirements and allergies. She told us that over the years she had got to know people well and was happy to prepare a special meal if they asked her to. The dinning room is a large and attractive room and the mealtime was relaxed with everyone, including staff, eating together discussing the day and planning for the evening. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home records peoples personal care needs in a way that enables them to be supported as they want to be and people have access to doctors. Medication is managed properly. Evidence: We looked at four peoples care plans and found that their support needs were recorded and they were written in a way that reflected their personal preferences. The care plans are reviewed every time people stay at the home and we saw evidence that changes are made when peoples care needs change. As a respite service the home does not usually arrange routine appointments, but arrangements are in place to support people to attend appointments is they are due during their stay. We found evidence, in the files we examined, that people have access to medical practitioners if they fall ill during their stay. On admission relatives are asked if they want to be contacted if their family member becomes ill during respite and they are also asked to complete a medication form, which lists what medication is taken, why and how often. This is signed as correct and allows the home to check that their records are up to date. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We examined the medication and its records and found that they were as required. Managing medication in a respite service is complicated as people come and go, sometimes people will only stay a couple of nights before they go home and new people come to stay. However we saw that medication could be tracked from its arrival to when people go home and that it was managed in a way that would protect people from harm. When we did a spot check on two peoples medication we saw that they were recorded properly with no omissions and the number of tablets held at the home corresponded to number recorded on the record sheet. All the medication is checked and signed for at the beginning and end of the visit. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaint policies and procedures are robust and complaints are investigated. Systems are in place to properly record complaints and concerns and peoples money is managed appropriately. People are protected from abuse by staff being properly trained in safeguarding. Evidence: The home has complaint and safeguarding policies in place and the complaints procedure is displayed throughout the home. It is a local authority run home and the councils complaints procedure is used, which is comprehensive and robust. As well as the corporate version of the procedure, it is also available in the home in a format of pictures and diagrams which is more easily understood by this services client group, which is people with a learning disability. However, one person responding to our user survey said they didnt know how to make a complaint and had not been told how to, it is recommended that the home issues a copy of its complaints procedure to all the people using the respite service to inform and remind people how to complain if they are unhappy with the service they receive. Complaints and concerns are recorded in a way that makes it possible to follow them from start to finish easily, although they are recorded on loose leaf pages and are not numbered and so could get muddled and lost. We have not received any new Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: complaints made directly to us since the last inspection. The manager told us that she always makes herself available to talk to people and prefers to deal with issues before they become a problem. There is an ongoing complaint that was instigated before the last inspection regarding the way the service, the local authorities and other agencies handled a safeguarding disclosure. The service has acknowledged its failures on this occasion and have made changes in the questions they ask new users and considers more information when doing risk assessments in an effort to better protect people from abuse. We examined the way that the home looks after peoples personal money if they arent able to do it themselves. Small amounts of spending money are given to the home to look after at the beginning of a persons stay. It is checked on arrival and any money spent is recorded and receipts are kept. It is stored in individual purses that are locked away in the office for safe storage. Any outstanding money is returned at the end of the stay. We examined three purses and found that the amount of cash in the purses corresponded to the totals recorded on the record sheet. Staff training includes safeguarding and all of them have received updates so that they can identify abusive situations and have been reminded how to manage any disclosures made to them. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is safe, comfortable, clean and hygienic. Bedrooms suit peoples needs and lifestyle and there are sufficient bathrooms and toilets. Evidence: The service is temporarily using this building while the old one is knocked down and rebuilt, it is quite old but is fit for purpose although the kitchen is not domestic in nature and its use is restricted to staff. However there is a homely and relaxed atmosphere in the building and it is well decorated. The communal rooms are light and airy with high ceilings and the bedrooms have the necessary furniture to make the stay comfortable. As respite rooms they are not personalised but do offer a TV and DVD player. People can bring small personal items to make their stay more comfortable. There is a large garden that is well maintained and is fenced which keeps it safe and secure. There is also a large patio with easy access for wheelchairs which makes the garden accessible to everyone. Bathrooms and toilets are sufficient to meet peoples needs and they have been fitted with equipment and aids to maximise independence. All of the communal rooms and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: bedrooms were clean and hygienic and there were no health and safety issues highlighted during this inspection. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of their roles and responsibilities and are qualified. The home has recruitment policies and procedures in place to safeguard people. Evidence: Staff records were examined as part of the inspection process and they clearly demonstrated that the recruitment processes are robust and offer protection to people living in the home. The local authority manages recruitment centrally, but local interviews are held, and all the required records were available to be seen in the home. The training provided to staff is comprehensive and is provided via the local authority training facilities. The manager gave us a copy of the training matrix which records what training staff have undertaken and when it was done, we saw training certificates on the three staff files we examined, which included the mandatory training as well as other more specific courses such as sexuality awareness, communication skills, risk assessments, service values and principals, COSHH and epilepsy. During the inspection we spoke to several staff members who confirmed that all the checks that safeguard people were carried out before they started work in the home. We also observed them working with people, It was evident that they have a good Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: knowledge of the needs of the those they care for and have developed good relationships with them. Information given to us in the Annual Quality Assurance Assessment (AQAA) completed by the manager tells us that the home has met the required minimum of 50 of its staff having attained the NVQ 2 in care or its equivalent, in fact we saw records that evidenced that all the permanent staff have either attained an NVQ level 3 qualification or are working towards it. On the day of our visit the levels of staffing was seen to be adequate to offer people individual uninterrupted time, continuity of care and to be able to manage emergency situations. On the same day, interviews were taking place at the home to fill the present vacancies. Taking advantage of a day centre for people with learning disabilities that occupies part of the building, the prospective staff were observed interacting with people using the day centre as part of their evaluation. Information in the AQAA tells us that supervision is carried out and the staff we spoke with confirmed this. We also saw the supervision notes in the staff files we looked at. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well run and the ethos of its management is empowering to the people using the service and their views underpin its running. The policies and procedures and the record keeping protect peoples rights and best interests and health and safety is promoted. Evidence: The manager was at the home at the beginning of the inspection but was in the process of interviewing for new care staff. They gave us access to the records and files, which we examined until they had finished the interviews. The manager then facilitated the rest of the inspection and was able to produce everything we asked for, she was knowledgeable about the running of the service and the people using it. It takes a lot of skill to run a complex respite service that caters for ninety people like this one. The people staying at the home changes weekly and sometimes daily and mistakes in its day to day planning and running would adversely effect many people as well as their families and carers. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Through discussions with the manager we saw that they are able to accept that they have made mistakes in safeguarding people in the past and are willing to make changes to the service to ensure that people are listened to and that they are safeguarded from abuse in the future. The manager told us that the home sends annual surveys to its staff, people using the service and their relatives. Once they are returned the information is collated and action is taken when shortcomings are highlighted. House meeting are held where people are encouraged to speak their mind about how the service is run and how it can be improved. Parent/carer meetings are also held at intervals throughout the year. Records are kept of these meetings and we were able to see them. In the AQAA the manager told us that after consulting with people they have, with their help, bought a more comfortable sofa, arranged more outings and have used their amenity fund to supply sky digital TV. During the process of planning for the rebuild and the temporary move to allow the old building to be knocked down and rebuilt, the service has taken steps to keep everyone informed and involved in the process. Meetings were held to discuss the implications and plans of the new building are on display in the entrance hall. People are taken to the site so they can see what work has been done and photos of these visits are also displayed, this will help to reassure people who are worried by change. We were also told that people will help chose new furniture for the new building when the time arrives. The polices and procedures are those of the local authority who runs the service and were comprehensive and robust. Information given in the AQAA indicated that they are reviewed and updated as legislation dictates. Records are kept up to date and are stored appropriately. Personal details are stored in a locked cupboard in the office and are not left unattended so that people can be sure that information about them is kept private. Staff are asked to read and sign the policy on confidentiality when they start working at the home. A sample of the health and safety records were inspected and were found to be in order. The fire records show that the fire points are tested weekly and fire equipment is tested annually. Fridge and freezer temperatures are taken and recorded daily. We did not observe any health and safety risks as we looked around the home so people can be confident that their health and safety is being protected. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 22 Although the policy is displayed in the home, we were told that someone hadnt been informed about the complaints procedure and didnt know how to make a complaint. We recommend that the manager takes steps to ensure that all of the people who use the respite service are given the information they need to be able to make a complaint in a format they will be able to understand. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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