Care Home: Brooklands Care Ltd

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well Brooklands does well to provide prospective service users and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home by supporting regular visits prior to moving in. The home does well to support service users using a person centred approach, respecting their wishes, decisions and aspirations. It encourages service users to develop and maintain their independence, integrate into their local community and maintain contact with family and friends. The staff do well to ensure the physical and psychological needs of the service users are being met, providing service users with support to access health care professionals such as GP`s and dentists and to support them with their medication. The home listens to service users needs, wishes and concerns and acts promptly to deal with any concerns or complaints they or their representatives may have. Brooklands offers a homely and welcoming environment. It is spacious, tastefully decorated and furnished, and offers individual bedrooms that are personalised and decorated to the service users liking. What has improved since the last inspection? There is little evidence to establish if the home has made improvements since the last visit to the service, an example of this is the lack of progress made in the development of service users person centred plans (Essential Life style planning) and encouraging staff to undertake a National Vocational Qualification (NVQ). What the care home could do better: The home could do better to develop and implement a person centred planning process to ensure service users are at the centre of their daily care, supported to determine their lifestyles, future goals and dreams and aspirations. The report produced following the last visit to the home identified the service could do better to implement a training programme to provide all staff with training that is relevant to their role. It was evidenced during this visit that staff have not been fully equipped to meet the health and safety needs of the service users. Staff require abuse awareness training to ensure service users are protected from potential risk of abuse and health and safety training to protect service users from the potential risk of harm from their environment. This includes food hygiene. The home must ensure they are following the Skills for Care Induction programme which ensures staff receive mandatory training in the first three months of employment. The home must ensure that all areas of fire safety are followed as required by fire safety legislation. Key inspection report Care homes for adults (18-65 years) Name: Address: Brooklands Care Ltd 22 Brockhurst Road Gosport Hampshire PO12 3DE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Walsh     Date: 2 8 0 1 2 0 1 0 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 33 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 33 Information about the care home Name of care home: Address: Brooklands Care Ltd 22 Brockhurst Road Gosport Hampshire PO12 3DE 02392647674 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brooklands Care Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (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 (LD). Date of last inspection Brief description of the care home Brooklands Care Limited is a care home that provides care and accommodation for up to five people who have a learning disability. Each person has their own bedroom and shares the use of a lounge, kitchen, dining room and garden. The home is situated on the main road into Gosport, with shops and pubs in the immediate vicinity. There are regular buses to Gosport town centre and Fareham that stop outside the home. 0 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience good quality outcomes. This site visit formed part of the key inspection process and was carried over one day by Mrs C Walsh, regulatory inspector. The registered manager was not available at the time of the inspection. The inspector was assisted by staff working in the home. Information pertaining to staff recruitment was not accessible. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Care Quality Commission by the agreed date. The AQAA was not completed in full and did not provide enough evidence to demonstrate the service has fully self assessed its quality. The information obtained to inform this report was based on viewing the records of the Care Homes for Adults (18-65 years) Page 5 of 33 people who use and work at the service, speaking with the service users, and staff and observing care and support practices. A tour of the home took place and documents relating to health and safety matters were viewed. The people who live in the home are known as service users and therefore will be referred to as service users in the body of this report. Care Homes for Adults (18-65 years) Page 6 of 33 What the care home does well: What has improved since the last inspection? What they could do better: The home could do better to develop and implement a person centred planning process to ensure service users are at the centre of their daily care, supported to determine their lifestyles, future goals and dreams and aspirations. The report produced following the last visit to the home identified the service could do better to implement a training programme to provide all staff with training that is relevant to their role. It was evidenced during this visit that staff have not been fully equipped to meet the health and safety needs of the service users. Staff require abuse awareness training to ensure service users are protected from potential risk of abuse and health and safety training to protect service users from the potential risk of harm from their environment. This includes food hygiene. The home must ensure they are following the Skills for Care Induction programme which ensures staff receive mandatory training in the first three months of employment. The home must ensure that all areas of fire safety are followed as required by fire safety legislation. Care Homes for Adults (18-65 years) Page 7 of 33 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 33 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 home will ensure they can meet the needs of people who wish to use the service by carrying out an assessment prior to them moving in. Evidence: The Annual Quality Assurance Assessment tool (AQAA) informed us they do well to provide each service user with terms of residence and a statement of purpose and service user guide which is accessible for all service users, families and staff. The AQAA does not tell us how the service carries out the assessment process. A copy of the statement of purpose, service user guide and terms of residency for each service user were seen in the home. The service user guide has been produced in a format which the service users can understand. There have been no new admissions since the last visit to the service. Staff spoke of work they undertook to support a prospective service user to move in. The placement was not carried through as it was established the service could not fully meet the Care Homes for Adults (18-65 years) Page 10 of 33 Evidence: prospective service users needs. Staff spoke about the process undertaken to support the prospective service user to move in, which included a thorough assessment of their needs and meeting with them in their current home with their carers. Staff also told us the service user was encouraged to visit the home with support of others involved in their care, they told us the process also involved the family, social worker and carers from the home they were moving from to assist in building a picture of the service users needs. We were also told by staff that as part of the assessment process they observed to see how the prospective service user would get on with others already living in the home. Care Homes for Adults (18-65 years) Page 11 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does well to ensure the people who use the service have their needs met using an individual approach. The people who use the service are supported to have a say about how they wish to receive their care and make decisions about their everyday lives. The risk to their personal health and welfare is minimised by using a risk management approach. Evidence: The AQAA informed us the service does well to have the following in place, the whistle blowing and confidentiality policy and to have allocated keyworkers. However the AQAA does not tell us what it does well to ensure individual plans reflect service users assessed and changing needs and personal goals. It does not tell us how it supports service users to make decisions and how the service users are supported to take risks. Evidnece was gathered at the time of the visit to support the judgement made for this Care Homes for Adults (18-65 years) Page 12 of 33 Evidence: area of the report. The pre admission assessment provides information on what the service user can do for themselves and what they need support with. Each service user has care plans in place, these provide detail on how the service user wishes to be supported. This includes assistance with personal care, day-to-day activities and social interests. In addition the home keeps a daily record which records how the service user has spent their day, from getting up to going to bed and describes how they have appeared during the day/night such as if they are happy, settled or anxious. This provides staff with information that allows them to support service users in a proactive and positive way. There is evidence that plans are reviewed and take place with the involvement of the service user if they wish to take part in the review. The AQAA told us the plan for the next twelve months is to further develop the service users person centred plans. (Person centred planning places the service user at the centre of their care, and includes consulting with them on how they wish to live their lives, how they want to be supported on a day-to-day basis (Essential Life Style Planning), goal setting, establishing important people in the their lives circles of support and identifying with them their dreams and aspirations). Two service users person centred planning documents used for recording the above information were viewed and noted to have limited information in them. A member of staff told us the home had been waiting for information from relatives before commencing and completing the plans. The home has been open a year and it would be expected that the person centred planning process would be more advanced than it currently is. During the course of the visit it was observed that service users are encouraged to make decisions about how they wish to spend their day, what activities they wish to engage in and making everyday choices such as what they would like to eat, drink and wear. This was also evidenced in the way the care plans are written, reminding staff to offer choices and listen to what the service users are saying through the way in which they communicate. The personal plan of a service user was reviewed and tracked for the purpose of the inspection visit. It was noted the daily record, records the choices the service user had made. The home uses alternative communication tools to assist service users to make decisions, this was observed on the day of the inspection. A resident said that they had been involved in making choices and decisions about the decoration and furnishing of their bedroom and planning what they do during the day. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: Each care plan is linked to a risk assessment and provides details of the risk and action required by staff to minimise the risks. The information was written in plain English and was easy to follow. The staff told us service users are supported to develop skills such as accessing the community, which includes the risks of crossing roads, using transport, and accessing help in an emergency. Behaviours that challenge staffs understanding are recorded using a risk management process and provides staff with indicators that trigger behaviours and cause anxiety to the service user. The risk management plan provides staff with information on identified triggers, how these can be minimised to avoid behaviours escalating. Care Homes for Adults (18-65 years) Page 14 of 33 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. The home does well to ensure the people who use the service are supported to maintain an active lifestyle that suits their needs and individual interests. The home does well to ensure the people who use the service maintain contact with family and friends and socially engage with their peers and the local community. The home does well to ensure the people who use the service have their rights respected, are provided with opportunities to make decisions and develop individual living skills. Evidence: The AQAA informed us the home does well to provide one-to-one sessions with service users, and to support service users to have full involvement in community based activities and daily living activities. The AQAA also told us the home does well to have Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: a visitors policy and encourage service users to plan their daily meals. Each service user has in their personal file an activity plan that identifies the activities they enjoy and a record of activities they have been involved in each day. The records included a number of activites such as bowling, having a meal out, bingo, shopping attending college, going to the cinema and peer activities such as attending a weekly youth club. Photographs of service users engaged in various outings and activities are displayed throughout the home. During the visit service users were observed in various leisure activities, which included a service user attending college, another completing a large jigsaw and watching favoured videos and a service user having their nails manicured and hair styled with the support of staff. A relative told us. They all have a lot of time for my xxx, pampering fingernails and toe painting etc. The home has a sensory room and separate quiet room, staff told us service users can access these as they wish. These rooms provide service users with an alternative place to their own rooms to relax, receive stimulation and space away from others. Service users are supported to maintain contact with family and friends, evidence of this was recorded in service users personal files that informs the reader about relationships that are important to the resident and the contact the resident has with those people. Daily notes record if contact has been made with family and friends, which includes visiting the family home for the weekend and friends visiting the home. Service users have access to a phone, which allows them to call their family and friends when they wish. A relative told us. I have always been made welcome, as have all of my family. We are actively encouraged to visit and socialise with the residents and staff. No appointment needed. A member of staff told us they hold festive events in the home encouraging family and friends to visit and enjoy the activities. The activities included a bonfire party and a Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: barbeque in the summer. A relative told us. Brooklands is a very warm and welcoming home, they are open and honest and communication is excellent. They treat my xxx as an individual whose personality is encouraged, xxx needs are always met and xxx is treated with respect and good humour. Staff were observed speaking with services users in a respectful way, when asked what they considered important when supporting service users with their personal care and everyday lifestyles, they told us. To treat people with respect, preserve their dignity and privacy and ensure service users are encouraged and supported to develop and maintain daily living skills. Another member of staff told us she is aware of her roles and responsibilities in respect of providing an individual approach and valuing the person for who they are. This demonstrated the member of staff has an awareness of the importance of treating and respecting peoples individual rights and beliefs. Service users have access their own bedrooms when they wish and they have access to communal areas of the home. For those service users who require supervision for their safety, staff provide support to access areas such as the kitchen and garden. The homes mealtimes are led by the service users and their individual wishes, this includes service users taking responsibility to plan, shop for and prepare meals. A service user was observed preparing lunch and making drinks throughout the day. Staff commented on how the service user who did not do these things before moving into the home had become more confident in the kitchen. Staff told us they support service users to make healthy choices, offering advice when planning the menu to ensure they are considering foods such as fruit and vegetables. The menu was balanced and provided healthy options. Care Homes for Adults (18-65 years) Page 17 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does well to ensure the people who use the service receive the appropriate support with their personal care, health care and medication in the way in which they require and prefer. However staff require formal training in the administration of medication to ensure medications are administered using safe practices at all times. Evidence: The AQAA informed us the home does well to enable service users to have full involvement in the running of the home and lifestyle choices, they are registered with GP, Dentist, Opticians etc and have access to specialist community team should they require this. The AQAA goes on to tell us in the next twelve months they plan to develop individualised communication programmes to meet service users individual needs. The personal plans provide detail on how service users wish to spend their days including what time they like to get up, go to bed, bathe or shower and activities they wish to take part in. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: A member of staff said she was aware of service users individual support needs as the staff are encouraged to read the plans, be involved as a keyworker to support service users with their everyday needs and be involved in reviewing their personal plans with them. There was evidence of reviews taking place. Personal plans provided evidence that the home has links with primary care and specialist health care teams, such as GPs, dentists and opticians. Personal plans demonstrated that the health care needs of service users are monitored and reviewed. The plans provide information on service users specific health care needs and what action staff must take to attend to these health care needs, an example of this is the use of certain medications when a service user is having a seizure. The home has systems in place for the administration of medication. The home uses a Monitored Dossett System (MDS), supplied by a well known high street pharmacy. Medications are received, stored, recorded and disposed of using systems as stipulated in the Royal Pharmaceutical Guidelines. Each service users have a list of medications prescribed, which includes regular and as required medication. As required medications are supported by care plans that detail when the medication needs to be administered. The staff told us they had received coaching from the manager in respect of the administration of medication. Staff talked through the procedures for administration medications and appeared to be aware of the use of some medications. They told us they have received training in administering a drug used when someone is having a seizure from an expert in epilepsy (community nurse), they have not however received formal training from an expert. The service users and staff would benefit from formal training in medication administration, as errors could potentially place service users at risk of harm. Staff tell us they have not received any formal training in administration of medication Staff complete a daily audit and two staff check and sign that medications have been given correctly. Care Homes for Adults (18-65 years) Page 19 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does well to listen to and act upon the concerns raised by the people who use the service. The home could do better to ensure the people who use the service are safeguarded from potential risk of harm by ensuring staff receive training in abuse awareness. Evidence: The AQAA informed us the home does well to raise awareness in induction and regularly through meetings, the AQAA does not tell us in what context this statement is meant. The AQAA tells us it could do better to raise awareness with the service users about the complaints procedure and training on safeguarding adults. The homes plans for the next twelve months is to develop a more service users friendly complaints procedure The home currently does not have an accessible complaints procedure for service users. Staff told us service users show their displeasure through their behaviours and staff are proactive in supporting the service user to minimise their distress. The homes current complaints procedure provides information for relatives, stakeholders and staff on how to make a complaint and how the home will respond to concerns. The home encourages open dialogue with service users and relatives, holding meetings with service users and spending time with relatives sharing Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: information. A relative told us. Any hiccups, doubts or concerns I have had, have always been listened to and actioned promptly. Communication is so open and honest. Staff were clear about the procedure in responding to complaints. A training matrix which records staff training was provided by the registered manager following the inspection, this told us the registered manager has had train the trainers training in safeguarding adults in 2007. The training matrix did not provide evidence that staff have received safeguarding adults training. A member of staff told us she could not remember if she had had the training but had received the whistle blowing policy and knew what to do if she witnessed someone being abused. The home has been open for over twelve months, it would be expected that staff would have received safeguarding training in this period of time and during the induction period. The staff can access the local authorities joint safeguarding vulnerable adults policies and procedures as these are kept in the home. Care Homes for Adults (18-65 years) Page 21 of 33 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 does well to ensure the people who use the service live in a welcoming, comfortable and clean environment that meets their physical and social needs. Evidence: The AQAA informed us it does well to carry out regular Health and Safety checks, maintenance checks and have rooms that are spacious and well maintained. The home is a large detached building that has been extended. It is spacious, clean and well maintained throughout. The kitchen is large and fully equipped to allow the service users to participate in the daily preparation and cooking of meals. The home is decorated and furnished in keeping with the needs of the service users. Warm subtle colours on the walls, and quality furniture and soft furnishings. A service user showed us their bedroom, which again was spacious, bright and decorated in the colours the service user said they had chosen. The service users bedroom was comfortable, clean, furnished with quality furniture. The bedroom was personalised which reflected the personality and individuality of the service user. A member of staff told us the en suite shower room has enabled the service user to improve their personal hygiene skills. The same service user told us they liked their Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: home. A relative told us. The staff are good at getting my xxx to participate in household duties, cooking/washing etc. The home is clean and follows recognised practices in maintaining a clean hygienic environment and staff have received training in infection control. Service users are encouraged to be involved in the day-to-day cleaning of their home. At the time of the visit service users were seen carrying out domestic skills such as cleaning their shower room, hoovering, mopping floors and laundry. Protective clothing is in place such as disposable gloves to use when required. The home has a large enclosed garden with patio and lawn areas. Some areas of the garden such as paving and fencing is in need of repair. A member of staff told us repairs and improvements to the garden are planed in order service users can enjoy the garden when the better weather arrives. Care Homes for Adults (18-65 years) Page 23 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service must be supported by staff who are competent and qualified to meet all of their needs including their health and safety. Recruitment procedures could not be fully assessed on this occasion as staff recruitment records were not accessible. Evidence: The AQAA informed us the home does well to provide staff with clear and concise job descriptions, handbooks and management support. The AQAA told us it could do better to carry out more staff supervisions and went onto tell us that the home intends to enrol staff on a National Vocational Qualification (NVQ) in the next twelve months. The home was quietly busy at the time of the inspection visit as service users were undertaking various activities with staff support. This included supporting service users to go to college, supporting service users to carry out daily living skills and engaged in leisure activities. The staff appeared organised and confident. Staff told us they are aware of their roles and responsibilities. Its my job to support service users to develop their personal skills and integrate Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: safely into the community and to encourage self help and social skills. Another member of staff told us it is her responsibility to. To help support everyday need, to help develop understanding and help the service users to grow. The duty rota told us there are sufficient numbers of staff on duty to meet the current needs of the service users. Staff confirmed this. The AQAA told us only two of the eleven staff have a NVQ, this is well below the fifty percent of the recommended standard as detailed in the Care Homes for Adults (18 -65) National Minimum Standards. The AQAA tells us this is an area for improvement in the next twelve months and will be viewed during the next visit to the service. The inspector did not have access to recruitment files as staff did not have access to this confidential information. The AQAA told us that all recruitment checks are in place. A discussion with the manager following the inspection told us that all checks are carried out, including obtaining two references, criminal record bureau (CRB) disclosure and protection of vulnerable adult (POVA) now know as Independent Safeguarding Authority (ISA). A member of staff confirmed that she had completed an application, attended an interview and provided identification and names of referees. The member could not confirm if all checks were in place prior to starting work in the home. Following the inspection a discussion took place with the manager on the phone, who was informed of the importance of having recruitment records available for inspection. Recruitments records must be avialable in order that it can be evidenced that the service is ensuring the risk to service users safety is minimised. A member of staff told us she was inducted into the home and was supported by other members of and the manager to become familiar with the needs of the service users, the ethos of the home and the way in which the home operates. A training matrix sent to us following the inspection told us that staff receive some of the training required by law (mandatory training), such as moving and handling, first aid and fire safety. The AQAA told us the home could do better to provide safeguarding and food hygiene training. In addition staff receive training specific to the needs of the residents such as communication, managing challenging behaviour, medication and epilepsy. The AQAA tells us medication training is to be sourced Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: externally. Staff confirmed that they have recieved training that is specific to the needs of service users and some elements of mandatory training such as moving and handling. Staff told us that they had not received abuse awareness training and food hygiene, these topics are mandatory and must be covered in the first three months of working in the home as directed by the Skills for Care Council. Care Homes for Adults (18-65 years) Page 26 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager could do better to ensure the people who use the service receive a service that considers all aspects of their health and safety, such as training for staff and ensuring the homes fire safety procedures are correctly moniotred. Evidence: The AQAA informs us the home does well to regularly review its policies and procedures and could do better to quality monitor the service. The registered manager was not present at the time of the inspection as she was rostered to work a night duty. Feedback took place following the visit and the registered manager was made aware of areas of good practice seen on the day of the visit and areas where the home could improve. The AQAA told us it could do better to quality audit the service. Current quality audits include meetings with service users to seek their views, and staff double signing medication to ensure correct medications are given. However the service feels Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: is could do better in seeking service users and others views. At the time of the visit it could not be established that the home receives a monthly unannounced Regulation 26 visit. (These visits are necessary to audit the quality of all practices in the home including those associated with the services users, such as care planning, reviews and those practices associated with the running and administration of the home, which includes health and safety and staff training). During feedback with the registered manager following the inspection she confirmed that regulation 26 visits do take place and where the records could be located. The AQAA has not been completed to a standard that provides evidence that the registered manager, who completed the AQAA has fully assessed the quality of the service. Service users are supported with their finances. The home has systems for managing and monitoring service users spending, and supports service users to develop their personal skills in managing their own money. A money management recognition board is used to assist in this process. The home is equipped with fire safety equipment and an alarm system. Fire records tell us staff take part in a minimum of two fire drills a year and there is evidence that checks are made on fire safety alarms by the home and external fire safety contractors. However the manager should check with the fire safety service if they have to undertake checks on fire door closures and emergency lighting, as records told us this is currently not being done. Substances which may be hazardous to health are securely locked away and there are notices discreetly displayed around the home reminding people of good hygiene practices. All serviceable utilities including gas and electrical appliances are checked to ensure they are in good working order. Training records and confirmation from staff provided evidence that they have received moving and handling and first aid training, however records also tell us that no staff have food hygiene training. Food hygiene is a mandatory training and must be undertaken by all staff during the induction process and updated as required by law. Service users could be placed at risk of food poisioning if staff do not follow correct hygiene procedures for handling, cooking and storing foods. Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The home must ensure staff receive medication training. So that the people who use the service receive their medications using safe medication practices. 30/04/2010 2 23 16 All staff working in the home 30/04/2010 must receive abuse awareness training. So that the people who use are protected from the risk of abuse. 3 34 19 The home must ensure recruitment records are accessible and avialable for inspection. So that it can be evidenced that the people who use the service are supported by staff who are safe to work with them. 30/04/2010 4 43 24 The home must consult with the fire safety service to 30/04/2010 Care Homes for Adults (18-65 years) Page 31 of 33 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 ensure they are following correct fire safety monitoring such as checks on fire door closures and emergency lighting. So that the health, safety and welfare of the people who use the service is promoted and protected. 5 43 18 The home must ensure all staff receive training that is required by law, such as food hygiene. So that the people who use the service are supported by appropriately trained staff. 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 30/04/2010 1 32 It is recommended the home ensures a minimum of 50 percent of staff have or are in the process of undertaking a National Vocational Qualification. So that the people who use the service are supported by competent and qualified staff. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!