Care Home: Budge Lane (21)

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What the care home does well People who use the service are assisted to live ordinary and meaningful lives. They are out in the community using local facilities, going to college and keeping their rooms tidy and clean. People are given choices at every level, this includes what colour to decorate their bedroom, being on interview panels, being free to come and go as they wish, and as the expert by experience said, `Residents have choices of meals. Residents are involved in the menu planning, but if they chose to have something different on the day or at mealtimes, staff would always oblige to offer them something different. Residents have a choice of when to go to bed or get up. D said he can go to bed when he wants and get up when he is ready to. Staff do not tell him when to.` The commitment to training and supervision that is provided to staff ensures that the staff team are of a high calibre providing to the changing needs of the people who use the service. What has improved since the last inspection? There have been three main areas of improvement since the last key inspection. Historically, there have been issues regarding the administration of medication within this home. It is therefore very positive to note that these difficulties appear to have been resolved and that no errors were found in the administration of medication. Secondly, staff are now all receiving the required levels of supervision. This should enhance their ability to provide people who use the service with high quality care. Finally, the fabric of the home has been much improved. This includes the installation of a new kitchen, redecorated dining room and two lounges and the majority of the bedrooms. This ensures a more homely and comfortable environment for people who use the service. What the care home could do better: This home has undergone major changes over recent years. In January 2007 there were eleven requirements made, a new manager and commitment from the staff team have reduced this number to two requirements at this inspection. The issues identified at this inspection relate to the monitoring of people who use the service and their weight. This must be done on a regular basis and recorded to ensure the welfare of people who use the service. Secondly, the home must ensure that staff training is up to date with particular emphasis on those members of staff who have worked at the home for a considerablelength of time. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Budge Lane (21) 21 Budge Lane Mitcham Surrey CR4 4AN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rin Saimbi     Date: 2 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Budge Lane (21) 21 Budge Lane Mitcham Surrey CR4 4AN 02086405169 02086405169 budgelane21@walsingham.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Walsingham care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 21 Budge Lane is a residential care home that was first registered in January 1997 to provide care for up to six adults with learning disabilities. The home specialises in providing a service to people who have a learning disability and who may also have a secondary physical disabilities. The accommodation compromises of six single bedrooms. There is a communal lounge towards the rear of the building overlooking the back garden, and a secondary lounge towards the front of the premises. Other facilities include a dining room, kitchen, laundry, garage, staff sleeping in room and staff office Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home The home itself is located on a new estate, which has a mixture of housing association and private properties. The nearest shops are some 15 minutes walking distance away; it is not the most convenient place for some forms of public transport, however the home does have its own transport. The home is owned and run by Walsingham, which is a registered charity that has a Christian ethos. The current costs of the placement were not available. The most recent figues are for year 2007/08, and range from £1,214 to £1,379 dependent upon need. Placing authorities are advised to contact the home directly for more detailed information. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the homes first key inspection since July 2007. It was an unannounced inspection that started at 11.15 am and took five hours to complete. As part of the inspection process we were fortunate to have an expert by experience and their personal assistant. The expert by experience was on site for two hours and able to spend much of that time talking to people who use the service. Their views and comments are represented throughout this report via quotes. The Commissions inspection took the form of brief discussions with some of the people who use the service, staff on duty and observations of staff interaction. In addition, there was a tour of the building and looking through documentation, which related to Care Homes for Adults (18-65 years) Page 6 of 30 people who use the service to make sure that they were relevant, accurate and up to date. This case tracking ensured that all documentation relating to two people was checked thoroughly. We also checked documentation coming into the Commission, so that this report reflects the home over the year, rather than a snap shot of findings on the day of inspection. We received from the home their Annual Quality Assurance Assessment which is a self assessment by the home which provided us with some numerical information. This home is running extremely well and is moving towards excellent in the Commissions ratings. The expert by experience summed up the home by stating that, Residents are well supported by the staff as was witnessed during our visit to the home. The resident we talked to said he has been living in the home for a long time and would not want to change anything about the home. He said, staff are nice and treat me well and will listen to me if I have a problem. We would like to thank the people who use the service, the expert by experience, their personal assistant and the homes staff for their time and co operation during the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: This home has undergone major changes over recent years. In January 2007 there were eleven requirements made, a new manager and commitment from the staff team have reduced this number to two requirements at this inspection. The issues identified at this inspection relate to the monitoring of people who use the service and their weight. This must be done on a regular basis and recorded to ensure the welfare of people who use the service. Secondly, the home must ensure that staff training is up to date with particular emphasis on those members of staff who have worked at the home for a considerable Care Homes for Adults (18-65 years) Page 8 of 30 length of time. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home gathers information from a variety of sources and then completes their own thorough assessment for all new people. This process would be completed in conjunction with the new person themselves and their family, friends and advocates. The aim would therefore be that people who use the service would not just be fitted into a vacancy, but that people themselves would make an active choice about the accommodation that they wanted to live in. Evidence: The home has been open since 1997, all people who use the service arrived at that time with an assessment. These documents have been checked at this and previous inspections and were of variable quality. The home has subsequently devised a care assessment for each of the people who use the service. This document contained general information, which was gathered from the original assessment plan, and from the home.s own assessment process. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: This support plan is individualized to each person and gave detailed information about the person and how they like to be cared for. From reading these documents it was easy to visualize each person, categories include how I like to be supported and what support I need. The home had developed at a new service users guide, which comprises of photographs, drawings and some written text, which is in plain English. The document is specific to the home in that it includes photographs of the local area, amenities and the home itself. It also includes a photograph and a brief pen picture of the people that are currently living at 21, Budge Lane. The home is able to meet the needs of people who use the service either by the skills and experience of the staff team, or by the use of outside professional agencies. A physiotherapist and dietitian are available if necessary. All people who use the service are able to communicate their needs either verbally or through gestures. The staff team all have the necessary skills and understanding of the varying forms of communication so that they can meet the needs of people who use the service. From observations it was evident that this was the case. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are generally given opportunities to make choices regarding daily activities what they eat and when, through to senior staff appointments. The home has mechanisms in place to monitor the changing needs and aspirations of people who use the service, this ensures in part that people can have meaningful and independent lives. Evidence: We case tracked two sets of documents for people who live in the home, this means that we looked through files and information in detail regarding two people. At the previous inspection the home was in the process of introducing Person Centered Plans (PCP), although this had been halted so that staff had the opportunity to be Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: trained. It was positive to note that PCPs are now in place for all the people who use the service. They have been completed on standardized Walsingham forms and are clearly live documents. In one example, the PCP had been reviewed in February and outlined the goals for the person using the service and divided them into goals for the next month, next three months and longer. Each person who uses the service has a weekly meeting with their key worker, there was a record of each meeting held and what the outcome was. We were informed and there was evidence via the minutes that statutory reviews had taken place for all the people living within the home. The home continues to use whole life risk assessments which are reviewed regularly. There are also risk assessments specific to the each individual, these included for one person, assessments regarding the home environment and eating and drinking. From the expert by experience report the following statement was made about independence and choice. Residents independence is promoted in the home. We witnessed one resident making his cup of tea in the kitchen and another resident on a wheelchair was by the door watching the goings on in the kitchen. Another resident went into the kitchen to make his lunch. One person within the home has been on interview panels for staff for many years. He has been trained to be on panels and receives a payment for attending. Two of the people who use the service attend regular meetings entitled Walsingham against Cotton Wool, this is a meeting facilitated by an outside advocacy group where people who use the Walsingham services are given an opportunity to voice their views. People who use the service are able to come and go as they wish, although this is something that they often do not do. One person regularly takes himself off to a sister home, the front door is alarmed, purely to alert staff that someone has left the premises. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service within the home live ordinary and meaningful lives, and participate and contribute to the communities in which they live. There is an emphasis within the home of developing and maintaining personal and family relationships. This allows people who use the service to feel that they belong, and that there is someone external to the organization that can consider their welfare. Evidence: People who use the service are encouraged to maintain friendships and family contact. Four of the people who use the service do not have any family contact. The home has managed to get two people an independent advocate, both of whom are very involved. Where there is contact with family, friends or advocates the home will try to maintain this. Everyone has a birthday party, if they chose family are invited into the home at Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: formal events such as Christmas and are welcome at other times. Four people who use the service currently participate in spiritual activities and are encouraged to attend specific churches of their choice. The expert by experience said about holidays, Residents are involved in the planning of their holidays, and as a resident said, he has been to many places over the years and every holiday is something to look forward to and enjoys every moment as the staff do support him well. One person is keen on jazz music. The home is able to access live jazz music in the community, which includes at pubs and music venues. This individual usually attends a jazz holiday every year. This person is also saving up for a cruise in 2010. Other holidays planed for this year include one person going to Spain, another Cornwall and two going abroad together. We looked at the weekly activities schedule, in one example activities ranged from tea dancing, a meal out, to going to church and cleaning their bedroom. During the inspection there was a feeling of comings and goings from people who use the service, this included two people going tea dancing, one to college, one out for a walk to get a particular drink and one getting ready for an evening out. The expert by experience stated in her report after talking to someone who uses the service, Resident said he loves going out shopping, to the cinema, and to the local Civic Centre where he has a lot of friends and is always looking forward to going there. He said he buys his videos and DVDs and he keeps his money in his room. The expert by experience stated about the choice of meals, Residents have choices of meals. Residents are involved in the menu planning, but if they chose to have something different on the day or at mealtimes, staff would always oblige to offer them something different. Meals are taken in a congenial setting that has recently benefited from redecoration. Care Homes for Adults (18-65 years) Page 16 of 30 Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general it seems that the staff within the home are able to provide personal care that ensures privacy and dignity at all times. There is awareness and understanding that people who use the service have the right to expect the same health care as others in the community, action is taken to ensure that this happens. Evidence: People who use the service are supported to manage their own health care needs, some are able to take themselves to their own GP and have a private consultation, and others need support to do this. There were also strategies in place for maintaining peoples health even though they may resist it, such as going to the dentist. The home uses a medical form which outlines all the health appointments that have been kept, and when future appointments need to be made. We looked at the medical form which showed evidence of appointments with the GP, dentist, opticians and other Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: health care professionals. People who use the service within the home receive sensitive personal support, which maintains their privacy and dignity. This was confirmed via observations and discussions with staff. People who use the service are able to choose their own clothes and toiletries, and there are always a range of clean clothes available. We looked at the storage and recording of medication. Medication arrives in the home in Dossette packs on a monthly basis and is stored in a locked metal cabinet which is situated in a locked cupboard. We checked the Medication Administration Records (MAR) sheets and found no errors. In the past there have been issues regarding the recording of medication, it was therefore positive to see no errors. The previous requirement relating to this issue has therefore been withdrawn. There have been two recent incidents were one person who uses the service has missed medication. This has occurred because the person has been out at lunchtimes when the medication should have been given. On both occasions the home has acted appropriately and contacted the GP and received advice. The Commission have also received notifications about the issue. We were informed by the manager that this issue has been addressed and action has been taken in order to minimize it occurring again. The homes medication system is externally audited on a six monthly basis, the last visit to the home took place on the 21.5.09. People who use the service should be having their weight monitored a monthly basis, this is a way of monitoring well being. It is of particular importance within this home given that three people are on special diets and are under weight. However, we found that records were incomplete and in one example it appeared that someone had not been weighted since August 2008. We were informed by the manager that some people are weighted at another venue where they have special scales for wheelchair users. This could not be verified and therefore a requirement has been made that everyone must be weighted monthly. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general it appears that people who use the service feel listened to and confident that their views will be taken seriously. This acts as an added safeguard to ensure that their safety is paramount and that they are protected as far as possible from risk as vulnerable adults. Evidence: The home has a general complaints policy which contains information about the process, how long it should take and what to do if you are not satisfied with the response. The form is written in easy words and pictures, and a number of copies were seen around the home. The home does have a complaints log, which had one entry. This complaint is on going and has resulted in a recent meeting with the complainant. It seems that all the procedures have been followed by Walsingham. The home has robust polices and procedures in place to make sure that people who use the service are safe. There is Walsinghams own vulnerable adults policy and in addition they have a copy of Suttons own procedural guidelines. The home has a whistle blowing policy. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Two members of staff were asked a question regarding vulnerable adults as a way of testing their knowledge and understanding of the policies and procedures. It is positive to note, that both members of staff were able to give a reasoned and correct answer to the scenario. In addition, both had a working knowledge of the whistle blowing policy and its effects. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is supplied with specialist aids and adaptations required for daily living so that people who use the service can be as independent as possible. A number of changes to the fabric of the building have been made or are in the process of being made, thereby ensuring that people who use the service live in a homely, comfortable environment. Evidence: The homes accommodation is all on the ground floor and has been made wheelchair accessible by allowing sufficient width in all the doorways. The home is in keeping with its environment. The home has some moving and handling equipment, this includes overhead tracking hoists observed in the bedrooms, and a shower trolley. There were adaptations in the bathrooms and toilets, which included grab rails. Electrical sockets and light switches were in accessible places for wheelchair users and there was evidence of a call alarm system throughout the building. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The expert by experience said of the home, The rooms are wheelchair accessible. There is a large garden to the rear of the home which also is fully wheelchair accessible. I managed to get around the house easily on my wheelchair. One resident we talked to said it was nice in the summer as they do have barbecues in the garden. The furniture and fittings of the home are generally of good quality and domestic in style. People who use the service have their own bedrooms, all of which have been redecorated recently, with the decor being chosen by them. People have their own keys to their bedrooms which some of them use, and in addition a lockable space in their bedrooms. There have been a number of significant changes made to the fabric of the home. At the last inspection a new kitchen was in the process of being installed, this has now been completed. The dining room and both lounges have been redecorated as have all the bedrooms. This has meant that the home feels comfortable and homely for all the people who use the service. We conducted a tour of the building and found that it was also clean and hygienic throughout. A recommendation is being made that the rubbish that is currently in the garden should be removed so that it does not represent a health and safety issue. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an emphasis at the initial stages that staff receive a full induction so that they have the skills in order to provide a good service to people within the home. In general staff receive the training and support to ensure a high quality of care. Evidence: All new staff at the home receive a six week induction, followed by core skills training, which covers areas such as health and safety, food hygiene and manual handling. Walsingham emphasis the importance of the training for their staff group. Records checked indicated that staff have all had the required level of training, that is to say at least five days per year. We examined three sets of staff records and found that although everyone has the required levels of training, one person who had been at the home for some considerable time, had not received refreshers courses within the timescales. Consequently her First Aid course was out of date, and the last abuse training that she had attended was in 2000. A requirement has therefore been made in this regard that all staff must receive refresher courses at the required level. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: We were informed that the home currently has one vacancy, this is covered by a regular agency member of staff. This is to ensure continuity and stability for the people who use the service. There are three members of staff on duty on any shift, we were able to confirm this by checking the staff rota on a random basis. Within the home there are four men and two women resident, all of whom are white European. The staff team compromise of three men and nine women from mixed ethnic groups. It is positive to note that there are male staff within the home, and although not in ideal numbers, still encouraging. We looked at supervision records for three members of staff. There had been a period when supervision levels were sporadic, however in the recent past this has improved. One member of staff had had four supervisions sessions this year, another three. This level is well within the levels of supervision recommended by the National Minimum Standards. All supervision sessions were recorded and signed by both parties. A requirement made at the previous inspection regarding the levels of supervision is therefore withdrawn. Recruitment files are not kept within the home, but centrally. This is with the agreement of the Commission. Recruitment files are instead checked by a senior officer from the Commission on a regular basis. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Walsingham have policies and procedures in place to ensure the welfare and safety of people who use the service and staff. The calibre of the manager affects the quality of the care provided within the home, so people who use the service and staff feel valued and listened to Evidence: Ms. Mandy Barton, has been in post since March 2007 and the registered manager of the home since September 2008. Ms. Barton has worked in the field of learning disability for thirteen years, she is qualified with a National Vocational Qualification Level 4 and has the registered managers award. In discussions with people who use the service and staff, there was a positive response to the manager. One member of staff said, she was very supportive. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The Walsingham group have all the appropriate polices and procedures in place to ensure the safe running of the home, there are reviewed and monitored centrally. The staff within the home in general appear to have knowledge and understanding of the policies and procedures that are in place. In the recent past there has been a significant improvement in the paperwork and administration of the home. All records viewed were up to date and in good order. Information relating to people who use the service is kept secure within the office. People living within the home do have a choice to read and amend information held about them, but in reality we were informed that this does not tend to happen. We checked all certificates and documents relating to health and safety and found that checks were all up to date, these included the landlords gas certificate, electrical, portable appliance test and Legionella check. There is certain amount of quality assurance that is undertaken within the home, in the main this is via the Regulation 26 visits that are in general undertaken on a monthly basis. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 15(1)(b) All risk assessments must be 19/10/2007 reviewed in a timely fashion Staff must all be made aware 19/07/2007 of the policies and procedures for the handling and administration of medication, and abide by them Supervision of all staff must 19/08/2007 be completed at the required level Fire drills must take place 19/08/2007 throughout the day, including at night 2 20 12(1)(a) 3 36 18(2) 4 42 23(4)(e) Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 All people who use the service must have their weight monitored on a regular basis. This is to ensure the well being of all 25/07/2009 2 35 16 All staff receive training refresher courses at the required level. This is to ensure the well being of people who use the service. 25/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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