Care Home: Cambria House

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 The way that the service assesses people`s needs before they are admitted to the home is thorough. The staff support people to be as independent as possible, to make decisions about their lives and to take part in the running of the home. People who use the service have opportunities to take part in a wide range of activities both in the home and the community and are encouraged to eat healthily. The home makes sure that people have access to health care services when they need them and provides emotional and practical support. There is a trained and qualified team of staff and an experienced and supportive manager, who listen to what the people who live in the home say they want. The home is run in a way that looks after people`s welfare and safety. People who use the service told us that they make choices about the things they do and that the staff treat them well. We asked what does the home do well and one person told us "organises activities. Food". Another person said "Cambria House is a nice place. I like looking after the plants outside, I like the garden". One person told us "getting repairs done". Comments we received from other agencies who are involved with the service were also positive. One health and social care professional told us "I believe the provider is excellent in the service they offer my service user. He has complex emotional needs and they provide a good service. I have been impressed with the progress my service user has made since moving to Cambria House". The other health and social care professional wrote " I have been involved with Cambria House for the last five years. The staff at Cambria House have always been fully supportive of the work that the Community Learning Disabilities Team are doing with the service users in Cambria House." What has improved since the last inspection? The service is now better at monitoring staff fire drill attendance and record-keeping. Changes have been made to the way that people`s support is planned, so that their individual needs and goals can be monitored better. One person is now managing his own medication and another person is being supported to do this more. The service has made improvements to many parts of the home, including the kitchen, laundry and bathroom, lounges and dining areas. What the care home could do better: The manager has identified areas for improvement and is taking action to address these, including the monitoring of people`s goals and key worker meetings. We asked people who use the service what could the home do better and one person said "Nothing, I like Cambria as it is". Another person suggested "get more staff". Key inspection report Care homes for adults (18-65 years) Name: Address: Cambria House 24 St Peter`s Street Winchester Hampshire SO23 8BP     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: Laurie Stride     Date: 1 0 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 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 29 Information about the care home Name of care home: Address: Cambria House 24 St Peter`s Street Winchester Hampshire SO23 8BP 01962865226 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: cambriahouse@choiceltd.co.uk Choice Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category 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 Cambria House provides a service to eight younger adults with a learning disability. The home has been developed to work with people with complex needs including those who challenge the services provided for them. The home is owned and managed by C.H.O.I.C.E Ltd. Links are established with the community team, specialist services and the support of the companys psychologist services. Accommodation is provided on three floors in a large house that has been refurbished and redeveloped to provide this service. All residents are accommodated in single rooms and there is a lounge with dining area. A garden with seating and decking areas is provided to the rear of the property. The house is situated in the heart of Winchester and is close to all local services. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 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: We (the commission), carried out an unannounced visit to the home on 10/08/09. This visit was part of a key inspection of the service, which takes into account all the information we have received about the service since the last key inspection on 10/07/07. The information included the annual service review we did on 31/07/08 and the homes Annual Quality Assurance Assessment (AQAA), which the registered manager sent to us prior to this visit. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Before our visit, we had sent survey questionnaires to the manager to distribute to people who use the service, staff members and health and social care professionals. At the time of writing this report we had received completed questionnaires from four of the people who use the service, six staff members and two health and social care professionals. During this key inspection visit we spoke with four of the people who use the service, Care Homes for Adults (18-65 years) Page 5 of 29 two staff members, the registered manager and the operations manager. We also spent time observing the interaction between staff and people who use the service and looked at samples of the records held in the home. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 7 of 29 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 29 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 29 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 conducts thorough pre-admission assessments of the needs and wishes of people who are interested in using the service, so that the service can be assured of meeting the persons needs. Evidence: The Annual Quality Assurance Assessment (AQAA) told us that there are well planned and effective transitions, resulting in all seven of the people who currently use the service being settled in the home. The previous key inspection had identified that good assessments are undertaken and the manager confirmed that there had been no new admissions since then. The home had recently received a referral regarding a potential new admission and we saw records relating to this. These included a detailed placement assessment report by the organisations referrals team and a plan to support the individual through the transition. The manager had developed this plan in order to involve the individual as fully as possible in the process. For example, the manager was going to meet the individual for lunch to discuss the persons expectations and those of the service. It was also planned for the person to meet someone who already lives at the home so that there would be a familiar face if/when Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: they came to stay. The person would be invited to take part in preparing their room at the home, in order to be involved in making choices from the start. The manager was awaiting further information such as care management and psychology reports as part of the assessment process. Two social and health care professionals who took part in our survey told us that the homes assessment arrangements always ensure that accurate information is gathered and that the right service is planned for people. Four people who use the service took part in our survey questionnaire. All indicated that they received enough information about this home before they moved in so they could decide if it was the right place for them. Care Homes for Adults (18-65 years) Page 11 of 29 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 supports people to meet their individual needs and goals and to make decisions about their lives. People who use the service are supported to take risks as part of an independent lifestyle. Evidence: The AQAA told us that all the people who use the service have individual support plans. We looked at a sample of three support plans. These were detailed and included sections called what is important to me?. We saw that one person had written sections of his own plan and another spoke about moving into another bedroom, which was an individual goal. Another individual told us that he knew what was in his care plan and talked with staff about it. At our last visit the manager was working on improving the system of recording how peoples goals were being met. Since the last inspection the home has put in place a new system of support planning, which makes individual goal planning easier and clearer. One person who enjoys cooking told us he was looking at college courses and for a job in a bakery. Other people had started attending a social skills group and we heard two of them talking about what they had Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: discussed in the group and saying that they would go again. The manager had identified in the AQAA that further work was needed to monitor each goal plan to make sure that all progressions and changes are recorded. During our visit we saw that the manager had developed action point monitoring forms, which were being introduced to the staff. We spoke with two staff members who both demonstrated their knowledge and understanding of the individuals who live in the home and their support plans. Six members of staff completed our survey questionnaire. Asked if they are given up to date information about the needs of the people they support, three staff members said always and three said usually. All told us that the ways that information about people is shared with other carers and the manager usually work well. Five of the staff indicated that they feel they usually have enough support, experience and knowledge to meet the different needs of people who live at the home. Another staff member said they felt they always do. Two social and health care professionals who took part in our survey indicated that peoples social and health care needs are always properly monitored, reviewed and met by the service. Both said that the service seek advice and act on it to meet peoples social and health care needs and improve their well-being. Risk assessment and risk management records were included in each support plan and staff members sign these to say they have read and understand the guidelines. Risks associated with everyday living are assessed in a positive way to promote peoples independence and examples included individuals accessing the community, kitchen and bathroom and managing their own medication. Three of the people who use the service and who took part in our survey questionnaire indicated that they always make decisions about what they do each day. One said they usually do. All four people said they can do what they want to do during the day, in the evening and at the weekend. The manager told us that one person who lives in the home is restricted on using the telephone and is supported by staff to do this. The reasons for this were recorded. Another person had restrictions on when he could leave the building and this was also documented. The manager showed us the restrictive practice statements that were being implemented in line with the new Deprivation of Liberty Safeguards legislation. Care Homes for Adults (18-65 years) Page 13 of 29 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 are supported to participate in a wide range of activities both in the home and the community and are encouraged to eat healthily. Evidence: The AQAA told us that people who use the service all access the community and have made acquaintances in the local shops and library. Some individuals have contact cards and a mobile when they go out in the community independently. We observed people coming and going throughout the time of our visit. We spoke with one person who told us he had just been to a wildlife park. The manager told us that this person had done car boot sales in support of animal welfare and keeps his own domestic cleaning materials so that he can be sure that these have not been tested on animals. Two social and health care professionals who took part in our survey told us that the service always respond to the diverse needs of individuals and supports people to live the life they choose wherever possible. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: The AQAA told us that a new day service organiser had been employed and this has improved the quality of recording individuals goals and activities. We saw that people had individual weekly activity plans, which included visits to local museums, cooking lunch for the house, music therapy, reflexology, using public transport, swimming and visits to the pub. One individual prefers not to have a structured plan and likes to decide what to do more on a day to day basis. This is supported by the home and recorded in the individuals support plan. We heard the person talking about a shopping trip he had been on that morning and a social skills group that he took part in later in the day. We saw a photograph of a trip the person had chosen to take with staff to an area he had previously lived in. Another person now works two full days at a farm shop and another had taken part in an exhibition of his pottery at a local library. Others attend colleges and social groups and there is a computer room at the home that people who live there use. We saw photographs of a boat trip on the Basingstoke Canal and some of the people who use the service had taken part in a sponsored charity walk. We heard the manager talking with one of the people who live in the home about going to see a truck racing event. The home supports people to keep in touch with family and friends if they wish. One person had been to France this year to see some of his family, which had been one of the goals in his support plan. Two previous inspection requirements had been met in relation to the service encouraging healthier meals and monitoring an individuals weight in line with the persons health plan guidance. We saw that losing weight is a goal in one persons support plan and that staff were monitoring and recording the individuals weight every two months. Part of the plan was for the individual to engage in more regular activities and for staff to give consistent guidance about food and diet. The manager said he took the person smimming every Friday and this was reflected in the persons activity programme. We saw a letter from a health professional that referred to the individual as now being on a healthy diet. A staff member told us they went for long walks with people who live in the home and we saw that staff and service users were active throughout the day. We spoke with two staff members, one of who does the food shopping and menu plans with the people who live in the home. Both staff members talked about how they encourage healthy eating while respecting the choices and independence of individuals living in the home. Two individuals have their own separate menus. The other five people plan their menu on a weekly basis with individual meal choices on the nights they help to cook. We observed one person making their own lunch in the kitchen and the manager giving them advice about Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: what they were eating, without restricting the persons independence. Fresh fruit was available in the dining area. Care Homes for Adults (18-65 years) Page 16 of 29 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. People who use the service have their physical and emotional needs met and are supported to manage their own medication. Evidence: Two of the people who use the service told us that the staff support them in a way that meets with their wishes. The way that personal support is to be given is documented in individuals care plans and staff we spoke with were aware of the guidelines and peoples needs. Health action plans were in place for all people using the service, with the dates when these were reviewed. The records showed that people are able to access health care services as and when they need them. Two social and health care professionals who took part in our survey told us that the service always respect peoples privacy and dignity. The organisation has its own psychology service and we saw records of a session in March 2009 in relation to three people who live in the home. This involved looking at individual behaviours and at obstacles to staff responses to these and at more effective ways to respond. The manager told us that intervention strategies for challenging behaviour are now more analytic and involve talking with and supporting Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the individual to reflect. One person who lives in the home talked about the anger management skills he had developed and how he would talk things through with staff. A member of staff told us that they received training in physical intervention but that the type of intervention used in the home was of talking with people and trying to deescalate potentially challenging situations. We saw examples of the Immediate Intervention records for one person, which showed that staff involve the individual in counting down when he is feeling angry or agitated. There is a checklist for staff to go through, for example asking if the person is in pain, how he is feeling and what he would like to do. A social and health care professional who has contact with the service told us The staff at Cambria House have always been fully supportive of the work that the Community Learning Disabilities Team are doing with the service users in Cambria House. They have always been to appointments and been fully open when there have been incidents of challenging behaviour. The home has suitable storage facilities and recording processes for medication, including controlled drugs. The temperature in the medication cabinet is monitored and there are individual records kept of when as required medication is given, such as paracetamol. There is a list of authorised signatories and the manager said that a medication competency assessment for all staff was scheduled for the next month. We also saw that the training records for staff included medication management. One person who lives in the home manages his own medication, based on a risk assessment and reviews involving his doctor. Another individual had also had a recent medication review and was now on less medication and leading a more active lifestyle. The two social and health care professionals who took part in our survey told us that the service always support people to administer their own medication, or manage it correctly where this is not possible. Care Homes for Adults (18-65 years) Page 18 of 29 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. People who use the service are protected by the homes policies and procedures and know that any concerns they have will be listened to and acted on. Evidence: The home has a complaints procedure that indicates who will investigate any complaint and the timescale for resolving the issue. The AQAA told us there had been one complaint in the last twelve months and we saw a record of how the service had responded within the timescale and the issues had been resolved. Two social and health care professionals who took part in our survey indicated that the service always respond appropriately if they or another person have raised any concerns. Each of the people who use the service who took part in our survey indicated that they know who to speak to if they are not happy and how to make a complaint. During our visit we observed that the atmosphere in the home was friendly and open and that people who use the service expressed themselves freely. A staff member told us that, in the case of an individual who does not communicate much verbally, staff would know if the person was unhappy through his behaviour and that his relatives visited the home frequently and kept staff informed of any changes. Each person who lives in the home has two key workers who they meet with once a month. The manager said in the AQAA that he was developing a monitoring tool to record how any issues raised at key worker meetings are followed up. The six members of staff who completed our survey questionnaire all indicated that they know what to do if someone has concerns Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: about the home. We saw that the home has a copy of the local authority safeguarding procedures and the manager said that the guidance is used to assess staff knowledge and understanding at their individual appraisals. We asked two members of staff about the procedure for safeguarding people who use the service. Both said they would report any suspected abuse immediately and told us that they had received relevant training and discussed the procedures at team meetings. A protocol with the local police is also in place. The AQAA told us that Criminal Records Bureau checks have been updated for staff who have been employed for three or more years. Care Homes for Adults (18-65 years) Page 20 of 29 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. People who use the service live in a homely, comfortable and clean environment that meets their needs. Evidence: Cambria House is a large detached property situated in the centre of Winchester, close to local shops and amenities. Accommodation is provided over three floors with bedrooms on each floor. A recently re-decorated lounge and dining area and a refurbished kitchen are on the main floor. Since the last inspection the managers office has been relocated on the lower ground floor and a new quiet lounge built in place of the old office. The new lounge is equiped with a wall mounted television, games consol, pictures and soft furnishings. A new laundry room with hand washing facility has been built, making way for the old laundry area to be turned into a bedroom. During our visit we saw that the refurbishment was under way and spoke with a person who uses the service who was keen to move into their new bedroom. The new bedroom opens onto the patio area. There is a sunken garden with a gazebo, decking and seating for people who live in the home to use. The main bathroom had also been recently refurbished and there is a dedicated sensory room and a computer room. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The AQAA told us that a new weekly cleaning schedule had been put in place and the premises looked clean at the time of our visit. The home had also recruited a cleaner. Infection control information in pictorial format was on the wall in the kitchen and we saw a manual on the safe handling of food was in use by staff. One of the people who live in the home also has his own manual and likes to keep his own checks and records. The home was awarded an excellent food hygiene rating at the last local authority inspection. Three of the people who use the service who took part in our survey said the home is always fresh and clean. One said it usually is. Care Homes for Adults (18-65 years) Page 22 of 29 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. People who use the service are supported by trained and qualified staff and are protected by the homes staff recruitment procedures. Evidence: A member of staff told us about the staffing rota in operation at the home. There are five staff on duty in the morning, one of who starts later and works into the afternoon when another four staff members come on duty. There are two waking night staff, apart from when one service user is away, when one of the night staff does a sleep-in duty. These numbers reflected the staffing levels at the time of our visit. We looked at the recruitment and training records for two members of staff who had started work in the home this year and a senior worker who had been employed since 2008. These showed that POVA First and Criminal Records Bureau checks had been carried out by the company prior to the person being employed. The manager told us how two of the people who live in the home have been involved in the staff recruitment process. We saw a set of questions in pictorial format, which are used as part of the interviews by one resident, while the other resident shows the interviewees around the home. This also gives an opportunity to see how candidates for the job interact with the people who use the service. The training records showed that training had been given in mandatory health and safety subjects, anti-discriminatory practice, Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: medication management, understanding and managing challenging behaviour. A recent addition to the training programme was care planning, the Mental Capacity Act and Deprivation of Liberty Safeguards. Out of seventeen permanent staff, six members of staff had completed a National Vocational Qualification in health and social care at level 2 and eight others have the NVQ at level 3. Records of staff induction, supervisions and meetings were also on file. The AQAA told us that the organisation had recently introduced a new structured induction and that all new staff at Cambria House are off rota for the first week to enable them to get to know the people who live there as well as undertake a range of training. A member of staff we spoke with told us that staff receive comprehensive training during their induction and this is followed by further training days and three yearly refresher courses in, for example, health and safety, autism and safeguarding. Six members of staff completed our survey questionnaire. Five indicated that there are usually enough staff to meet the individual needs of all the people who use the service. One person told us there sometimes are. All confirmed that their employer carried out checks and references before they started work in the home. Asked if their induction covered everything they needed to know to do the job when they started, five told us mostly and one said partly. All indicated that they are being given training which is relevant to their role, helps them understand and meet the needs of people who use the service and keeps them up to date with new ways of working. Two social and health care professionals who took part in our survey told us that the homes managers and staff always or usually have the right skills and experience to support peoples social and health care needs. Three of the staff who completed our questionnaire indicated that their manager gives them enough support and meets with them regularly to discuss how they are working. The other three staff members said that such meetings sometimes occur and one of these added when necessary. Each of the people who use the service who took part in our survey indicated that the staff and managers always treat them well and always listen and act on what they say. Care Homes for Adults (18-65 years) Page 24 of 29 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. People who use the service benefit from a well run home, which seeks their views about the quality of support they receive and promotes their safety and welfare. Evidence: The registered manager, Mr Andrew Key, has managed the home for three years. The manager sent us the completed AQAA when we asked for it and in this he stated he has completed NVQ level 4 and has started the Registered Manager Award. During this inspection visit the manager demonstrated that the three requirements from the last inspection had been met and that the service was responding to the requirements of new legislation. Staff at the home who we spoke with told us the manager is approachable and supportive. During our visit we saw that staff and people who use the service came into the office and talked with the manager in a relaxed and open way. The AQAA told us there is an annual development plan in response to the organisations quality assurance questionnaires, which are sent to people who use the service, their next-of-kin, staff and care managers. We saw there was a development Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: plan for the previous year and the manager said that this years plan was due later in the month, following an analysis of the questionnaire results. There are annual individual care reviews and the home also has less formal ways of obtaining the views of people who use the service, such as monthly key worker meetings. The manager said he has started informal meetings with the families of people who live in the home. We saw records are kept of monthly regulation 26 visits by the operations manager, who was present at the end of our visit, and of actions taken by the manager to address any issues identified. We looked at the fire safety logbook and saw that the last drill had been carried out on 17/07/09 and on a three monthly basis before then. The records showed each of the day or night staff attending the drill. This meets a previous requirement. Staff members had completed fire safety questionnaires in April and May and an up to date fire risk assessment was in place. Records of weekly checks on fire safety equipment were also on file. We saw further evidence that safe working practices are upheld in the home. There are weekly health and safety checks in which people who use the service participate. Certificates of gas and electrical safety checks carried out this year were available and the home carries out procedures to protect people from the risk of Legionella. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 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 29 of 29 - 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!