Care Home: Byfield Court

What the care home does well The service has been fully operational for approximately 5 months with new service users moving into the home frequently. Despite these challenges the service has managed the change and transitions well. The home has been completely renovated and refurbished to a very high standard providing a conducive environment for the individual and collective needs of the service users. The home has benefited from the welldeveloped referral and assessment processes in the organisation. This ensures that the home can meet the needs of service users admitted to the service. A good range of leisure and recreational based activities have been developed with evidence showing that these have been established in response to resident`s needs and wishes. All service users have the opportunity to take part in activities in and out of the home with appropriate support on at least a daily basis. Residents are able, with support, to determine how they choose to spend their time and their decisions are respected. This was evident through observedpractice and positive care planning. One relative said, `I would recommend Byfield Court to any prospective referrers. I am very happy with the care.` The home supports service users with any healthcare issues recording all relevant information and ensuring any issues are referred to healthcare professionals. Medication processes are managed well and all records and facilities kept up to date. The home has managed complaints and concerns well introducing changes to ensure that people`s views are listened to and acted upon. There is a good staff training and support programme. All staff are within their first six months of employment. Many have completed all required training and additional service specific courses and over 50% of the team have achieved a National Vocational Qualification (NVQ) at level 2 or above. Sufficient staff are on duty at all times with staffing levels managed flexibly to ensure service user`s needs are met. The organisation has well established quality monitoring processes that are applied within the service. All health and safety records are kept up to date and recruitment processes well managed. What has improved since the last inspection? This is the first key inspection process conducted at the service. What the care home could do better: No requirements and 7 recommendations have been made as a result of this inspection process. It is recommended that the service up date both their statement of purpose and service user guide. Additional information should be added to both and the guide developed in a manner that maximises service user`s understanding and is accessible to referrers/families. Care planning processes have been developed to a good standard, but could be more focused on person-centred planning. similarly risk assessments could be further developed to reflect individual needs to a greater extent. It is recommended that the range of occupational and vocational activities are expanded, which is an area of improvement identified by the service. The home should consider the introduction of an evidence-based induction programme and should ensure that the staff training matrix is kept up to date. Key inspection report Care homes for adults (18-65 years) Name: Address: Byfield Court Byfield Court Sheppey Way Bobbing Sittingbourne Kent ME9 8PJ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joseph Harris Date: 2 2 0 1 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 31 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 © (2010) 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 31 Information about the care home Name of care home: Address: Byfield Court Byfield Court Sheppey Way Bobbing Sittingbourne Kent ME9 8PJ 00000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ACH Of London LLP Name of registered manager (if applicable) Mrs Denise Simpson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 11 0 care home 11 learning disability Additional conditions: The maximum number of service users to be accommodated is: 11 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 withiin the following categories: Learning disability (LD) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Byfield Court is a 11-bedded, recently registered service for people with learning disabilities. The home is located in the village of Bobbing close to Sittingbourne. The service aims to work with people of a younger age group with autistic tendencies supporting them to gain greater independent living skills. The environment has been fully renovated and refurbished to a high standard throughout. There is a large garden and car park. A good range of communal space and 11 en-suite single bedrooms. The home is managed by ACH Ltd, which is a growing organisation specialising in working with people who have learning disabilities. They have a number of regsitered social care services in the South East area. The current fees for the service start at £1285.00 per week. More information about fees and services are available from the service manager and are included in the service user guide. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home This key unannounced inspection process culminated in a site visit to the service on 22nd January 2010. The site visit commenced at 09:30 hours and lasted until approximately 16:00 hours. This was the first key inspection conducted for the service under the Care Home Regulations 2001 and Care Standards Act 2000. Prior to the site visit information that we have about the service was reviewed and evaluated. This included the Annual Quality Assurance Assessment (AQAA), which is a self-assessment tool that focuses on the outcomes for service users. It also provides some numerical and statistical about the service. We looked at any notifications received from the home letting us know about untoward occurrences. Information received from other people including key professionals and how the service has managed any complaints was also considered. During the site visit discussions were held with service users, staff, relatives and the manager. A tour of the premises was undertaken viewing some bedrooms and all communal spaces. The care and support of two service users was tracked including examining individual support plans, accident records and other relevant information. Staff supporting these individuals were spoken to and time Care Homes for Adults (18-65 years) Page 7 of 31 spent with the service users themselves. A range of additional documentation was examined including health and safety records, medication, staff personnel files, training records and other information related to the day-to-day running of the service. What the care home does well The service has been fully operational for approximately 5 months with new service users moving into the home frequently. Despite these challenges the service has managed the change and transitions well. The home has been completely renovated and refurbished to a very high standard providing a conducive environment for the individual and collective needs of the service users. The home has benefited from the welldeveloped referral and assessment processes in the organisation. This ensures that the home can meet the needs of service users admitted to the service. A good range of leisure and recreational based activities have been developed with evidence showing that these have been established in response to residents needs and wishes. All service users have the opportunity to take part in activities in and out of the home with appropriate support on at least a daily basis. Residents are able, with support, to determine how they choose to spend their time and their decisions are respected. This was evident through observed Care Homes for Adults (18-65 years) Page 8 of 31 practice and positive care planning. One relative said, I would recommend Byfield Court to any prospective referrers. I am very happy with the care. The home supports service users with any healthcare issues recording all relevant information and ensuring any issues are referred to healthcare professionals. Medication processes are managed well and all records and facilities kept up to date. The home has managed complaints and concerns well introducing changes to ensure that peoples views are listened to and acted upon. There is a good staff training and support programme. All staff are within their first six months of employment. Many have completed all required training and additional service specific courses and over 50 of the team have achieved a National Vocational Qualification (NVQ) at level 2 or above. Sufficient staff are on duty at all times with staffing levels managed flexibly to ensure service users needs are met. The organisation has well established quality monitoring processes that are applied within the service. All health and safety records are kept up to date and recruitment processes well managed. Care Homes for Adults (18-65 years) Page 9 of 31 What has got better from the last inspection What the care home could do better No requirements and 7 recommendations have been made as a result of this inspection process. It is recommended that the service up date both their statement of purpose and service user guide. Additional information should be added to both and the guide developed in a manner that maximises service users understanding and is accessible to referrers/families. Care planning processes have been developed to a good standard, but could be more focused on person-centred planning. similarly risk assessments could be further developed to reflect individual needs to a greater extent. It is recommended that the range of occupational and vocational activities are expanded, which is an area of improvement identified by the service. The home should consider the introduction of an evidence-based induction programme and should ensure that the staff training matrix is kept up to date. Care Homes for Adults (18-65 years) Page 10 of 31 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Joseph Harris The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 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 11 of 31 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 12 of 31 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. Service users representatives are able to make an informed choice about the service. Written information should be further developed in this regard. There is a strong assessment process. Evidence: The service have developed information to enable service users representatives to make an informed choice about the home and facilities, however this information would benefit from further development. There is a statement of purpose that covers the majority of information required, but aspects of this should be expanded upon including details of the facilities and services provided by the home, staff training and complaints. Refer to recommendation 1. The service user guide is provided to all prospective service users and their representatives, but this document would also benefit from further development. It is recommended that the guide is written and adapted in a manner that will aid understanding by prospective service users. The guide should also reflect more accurately the aims of the service and the facilities and experiences that prospective service users should expect. Information relating to the Care Quality Commission also needs to be fully updated. Refer to recommendation 2. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: The organisation has a well established assessment process and a central referrals team that screens initial referrals with the aim of matching prospective service users to the most suitable service within the organisation. The service became operational in September 2009, therefore all of the service users have been newly admitted. The preadmission assessment information for two individuals was examined and in both cases provided a very detailed assessment of needs with clear, well written and understandable information. All areas of need were addressed and the strengths and abilities of the service users reflected. The home also had obtained good levels of information from the previous placements of both people. The assessment information had clearly been used in the development of the initial care plans and risk assessments. The relative of one service user was spoken to during the site visit. She stated that the transition process for her son had been managed sensitively and professionally by the staff team and the organisation. She stated that she had observed this as the case for all of the people moving into the home that she knew of. Prospective service users are offered trial visits to the service ranging from short day visits to overnight stays if desired. The manager stated that the opportunity for people to become acquainted with the service, environment, staff and service users is a crucial part of the assessment process. Care Homes for Adults (18-65 years) Page 14 of 31 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 needs and risks pertaining to individual service users are planned for and addressed. Service users are able to take decisions affecting their day-to-day lives. Evidence: The individual service user support plans for two individuals were examined both of which contained up to date care plans showing evidence of regular review. The plans cover all key areas of need relevant to the individual and contain sufficient guidance to ensure that staff are able to meet residents needs and wishes consistently. The manager acknowledged that the service user information is still being developed to promote a more person-centred approach. Examples of how this will be achieved were examined including behaviour support plans and communication passports. Refer to recommendation 3. Individual preferences and dislikes are detailed in the plans. Service users were observed to be supported by staff in a calm and considerate manner. Staff enabled residents to engage in their activities of choice offering support and appropriate diversionary techniques to promote task completion. One person decided that he would like to make cakes, which care staff enabled him to do. Many service users receive 1:1 support and staff engage positively with residents in these circumstances. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The home has developed risk management processes, which would benefit from some further development. Individual risk assessments are in place addressing perceived risks. These assessments provide satisfactory guidance to staff and are supported by the care planning process. The risks assessments examined were generic in content with some additional information added and the home should endeavour to make these more person-centred. Refer to recommendation 4. However, the service has introduced community risk assessments that are completed by participating staff and service users, where possible, prior to engaging in an activity outside of the home. This ensures that potential risk factors are being regularly assessed and revised according to individual circumstances. Care Homes for Adults (18-65 years) Page 16 of 31 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. Service users have a lifestyle that meets their individual and collective needs. Evidence: A good activities programme has been developed ensuring that the choices of each service user are taken into account. Each resident has an activity planner that incorporates personal preferences. Activities outside of the home such as bowling, swimming, soft play centres, cinema and meals out have taken place over recent weeks. Residents also have access to in-house events such as movie nights, Wii games nights, art, karaoke and cooking amongst other things. Daily notes and activities records show the pursuits that service users are involved with on a daily basis. The home has access to a suitable vehicle and the organisation have recently agreed to a second vehicle purchase. The home is looking to expand the educational and vocational opportunities for service users at centres outside of the home. The majority of service users, all of whom have recently moved in, have previously lived at specialist boarding schools and have had relatively few opportunities to establish community links. The home are supporting Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: service users in making choices for longer-term goals and are supported to this end in the home. It was acknowledged that development in this area would be beneficial. Refer to recommendation 5. It was reported that family involvement with residents is actively encouraged and that all of the current service users have involved and supportive family input. A discussion was held with one family member of a resident who said, They (the care staff) have managed the transition for my son really well. I am so happy with the care that staff have given my son, he seems like a different boy since moving in. The family member went on to say, I would like to see more educational opportunities, but i understand that it is early days. I would recommend Byfield Court to any prospective referrers. There is a varied and flexible menu offered, which is very much based on individual choice and preference. Menu records show that a healthy and balanced diet is offered. Care staff are responsible for cooking duties and service users are encouraged and supported to participate in all aspects of food preparation from menu planning to shopping, cooking and cleaning up. There is an extremely well appointed kitchen that has suitable equipment for the purposes of the home. Care Homes for Adults (18-65 years) Page 18 of 31 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. The health and personal care needs of service users are met. Evidence: All service users require elements of support with their personal care needs. These are well documented within individual service user files promoting consistent support. Staff were observed working in a supportive and enabling manner with residents. Discussion were held with a number of staff member who demonstrated a good understanding of the individual needs and preferences of service users. Communication methods were positively employed with care staff interacting and understanding residents needs and wishes. The healthcare records are well managed for each person and there is evidence of regular support from healthcare professionals. Any issues of note are referred appropriately. All service users are registered with a local GP and some also receive support from psychiatric services as well as local community learning disability teams and their placing authorities. The manager stated that good relationships have been established with local healthcare services. Complimentary healthcare needs are met such as dentistry and chiropody. The healthcare records retained by the home ensure that the outcomes of any consultations are recorded and incorporated into care plans as required. The service has a dedicated medication room and a discussion was held with the staff Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: member who oversees medication issues in the home. All medication records are well managed and were up to date including administration charts and returned and destroyed medication records. The storage facilities are well ordered, clean and suitable for the needs of the service. Audits are carried out on a regular basis and the home reported no issues with the service provided by the pharmacy used. All staff receive appropriate training prior to administering medication. There is evidence that the service has worked with medical practitioners to ensure medication is kept under review. There is low level usage of sedative-type medications. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of service users and stakeholders are listened to and acted upon. Service users are protected from abuse. Evidence: The home has a clear complaints process in place. The manager needs to ensure up to date information about CQC is included. A copy of the procedure is provided to all referrers and is contained in the service user guide. The procedure is displayed and available in the home. There is evidence that the home have managed complaints and concerns well. A system has been introduced to enable relatives/professionals to write their concerns down as they arise. This has promoted positive and open relationships with families and services. No Adult Protection alerts have been raised in connection with the service. There are policies and procedures in place and a copy of the Kent and Medway Adult Protection protocols. All staff receive induction training covering adult protection and abuse awareness issues and go on to participate in formalised training on this topic. Staff have awareness of Mental Capacity Act and Deprivation of Liberty Safeguard issues and are offered training and information in this respect. Care Homes for Adults (18-65 years) Page 21 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the needs of the service users. Evidence: Byfield Court is located in a rural location near to the town of Sittingbourne. The home is set back from a main road within enclosed grounds. There is a large car park at the front of the service. The home has been completely renovated and refurbished throughout to a very high standard. The house is set out over two floors. The ground floor consists mainly of communal space and some bedrooms. There are two large lounges, a quiet/meeting room and a large dining area. There is access to the garden which contains a Summer House and garden furniture and games. The manager stated that there are plans to use the Summer House as an activity centre in the future. All of the bedrooms are single occupancy with en-suite facilities. Service users are actively encouraged to personalise their rooms according to taste. Many people have created a space that they enjoy spending time in and meets their individual needs. Bedrooms are all lockable from the inside with easy open locks. Key access is required from the outside. Those assessed as able to keep their keys can do so. There are toilet, bathing and showering facilities located conveniently through the home. There are facilities for non-mobilising and physically disabled service users should the need arise. The quality of furniture and furnishing throughout the service are of high quality. The Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: home has been decorated in a homely manner, but with safety in mind, providing bright and comfortable surroundings. The kitchen and laundry areas are newly equipped, designed and well appointed. Care staff stated that all of the equipment is in perfect working order and the space available is appropriate for working with service users in a supporting role. Staff employ universal precautions and necessary infection control measures. Hazardous substances are stored securely. Care Homes for Adults (18-65 years) Page 23 of 31 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 a suitably qualified and experienced staff team. Staff are supported in their roles and recruitment processes followed. Evidence: Over 50 of the staff team have achieved an NVQ level 2 or above. The staff that have not yet achieved this qualification are expected to enroll and aim towards this achievement. Discussions were held with a number of staff on duty all of whom demonstrated good knowledge and understanding of service users needs and requirements. They were able to show how learnt skills have been applied into practice. The home operates with between 5 and 6 care staff on duty throughout each day. The staffing numbers, it was stated, are determined by the activities arranged and current needs of the service users. The manager reported that she is supported by the organisation regarding the staffing needs of the service. There are 2 waking night staff on duty throughout the night. The service has been active for less than 6 months. Many of the care staff were employed prior to the service opening and went through an intensive induction programme that included all mandatory training. Other training specific to the needs of the service have also been provided including management of aggression, communication, Mental Capacity Act. medication amongst others. It is recommended that the home introduces an evidence-based induction programme in accordance with the Common Induction Standards for all new staff. Refer to Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: recommendation 6. There is evidence that staff who have joined the service since opening have attended mandatory training courses and staff training needs are being met. The manager is advised to ensure the training matrix is kept up to date identifying when refresher courses and repeat training is due. Refer to recommendation 7. Two staff personnel files were examined both containing all of the information required to ensure the safety of service users. The files included interview notes, two written references, proof of identity, CRB and POVA checks among other required documentation. Staff spoken to said that they feel supported in their roles and that the organisation and manager provide all required support. They confirmed that they receive suitable supervision and training. Team meetings occur on a regular basis and staff stated that they would feel comfortable raising any issues with the management team. A cascading system of 1:1 supervision has recently been introduced. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the service users and health and safety issues well managed. Evidence: The manager has been in post since the development phase of the service. She has attained all of the required qualifications for her post and has significant experience working in and managing learning disability care services in the past. Staff and relatives spoke positively about her management style and she has ensured that staff take ownership of the service through effective delegation and support. The organisation has well-developed quality assurance processes in place. The service receives a monthly monitoring visits from the area manager linked to the home. A number of reports were examined showing consistent action plans and updated information. The service has only been active for around 5 months therefore no satisfaction surveys have been sent out to date. This exercise is planned in the new year and will follow the organisations established procedures according to the manager. All records relating to health and safety issues are up to date and in place. It was reported that the home meets the requirements of the fire safety and environmental health departments. All service safety certificates are in place including gas safety and Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: electrical wiring amongst others. Fire records are maintained and accident reports completed. There are policies and procedures in place covering safe working practices and staff receive mandatory training in the first 6 months of employment. Environmental risk assessments have been completed and audits are carried out covering key topics on a regular basis. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes  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 Care Homes for Adults (18-65 years) Page 28 of 31 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 To develop the statement of purpose ensuring that it accurately reflects the aims and facilties of the service in accordance with Schedule 1 of the Care Home Regulations 2001. To develop the Service User Guide to promote greater accessibility for prospective service users and ensuring up to date information. To continue to develop person-centred care planning processes. To ensure risk management plans provide clear guidance using person-centred methods. To provide a range of educational and vocational opportunities for service users based on needs and preferences. To introduce an evidence-based induction programme in 2 2 3 4 5 6 9 12 6 35 Care Homes for Adults (18-65 years) Page 29 of 31 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 accordance with the Common Induction Standards. 7 35 To keep the training matrix up to date. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 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 © (2010) 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. 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