Care Home: Care Approach Canonbie Recovery Centre

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What the care home does well The home is evidenced to be providing a generally good level of support to service users. Staff present as caring and attentive to individual needs. The home provides a pleasant and homely environment, with clients presenting as settled and satisfied with the personal and community facilities offered. What has improved since the last inspection? The manager has been developing a good relationship with both staff and service users. She is applying to become the home`s registered manager, a process which needs to be completed. The home has been developing its quality assurance processes, but needs to evidence the outcome of any surveys in a QA audit report. What the care home could do better: There is a need for a wider range of leisure, social, educational and/or training opportunities to be developed. The home needs to develop individualised activity programmes for each resident. Key inspection report Care homes for adults (18-65 years) Name: Address: Care Approach Canonbie Recovery Centre 118 Canonbie Road Forest Hill London SE23 3AG     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Peter stanley     Date: 1 1 1 1 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: Care Approach Canonbie Recovery Centre 118 Canonbie Road Forest Hill London SE23 3AG 02082911492 08452269904 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Jonathan Davids Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who may be accommodated is: 6 The Registered Person may provide the following categories of service only: Care home with Personal Care - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder - Code MD Date of last inspection Brief description of the care home Canonbie Recovery Centre was registered on 30 April 2008, to provides support and rehabilitation for up to 6 adults with a diagnosis of mental disorder. Since this date, the home has been owned by Jonathan Davids Ltd, the responsible individual being Mr Ade-Odunlade. Since the departure of the previous (registered) manager, Ms Adenike Ogunleye, in June 2009, the home has been managed by an acting manager, Ms Adeola Fapohundra. The home is situated in a converted house in a quiet residential road in Forest Hill, and provides accomodation for up to 6 service users. The home is close to local bus routes, Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 2 4 0 8 2 0 0 9 Brief description of the care home and is within a mile of both Honor Oak and Forest Hill railway stations. Service users have sufficient bathroom and toilet facilities, and have access to a communal lounge and kitchen. There is a garden at the rear. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home over one day for a key inspection. We also previously visited (on 12 August) for a random inspection. Over the two visits, we have talked to the manager and met with staff, and residents. We have examined records of both staff and service users, and looked at medication charts, assessments, care plans and reviews. Staff recruitment records and staff rotas were inspected on both visits. No AQAA had been received from the home at the time of writing this report, hence it was not possible to include any self-assessment information from this service. . 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 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 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 8 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. 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. Prospective clients are being provided with all the information they require, and the opportunity to visit, and stay overnight if they wish, before deciding whether the home is likely to meet their needs. The home is able to demonstrate that the range of needs presented by clients are being properly assessed. Each client is being provided with a contract that details the terms and conditions that apply to their residency at the home. Evidence: The home has a Statement of Purpose which sets out the aims, objectives and philosophy of the home, its services and facilities, and the terms and conditions that apply. It includes all the information detailed in Schedule 1 of the Care Homes Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: Regulations. There is also a Service User Guide, which includes information required by Regulation 5 and the National Minimum Standards. This is given to prospective residents, the Homes residents or clients (this being the Homes preferred terminology), their relatives or friends and to care managers/ professionals. The Guide includes comprehensive information relating to the home, and the services, support and facilities provided. The Statement of Purpose and Service User Guide have been reviewed and updated, and include contact details for the Care Quality Commission. The Home accepts referrals following a CPA assessment (Care Programme Approach) by the CMHT (Community Mental Health Team) or relevant health care agency. Together with any other information relating to the individuals social background, their health history and their present circumstances. The Home involves the potential client in the initial assessment. This includes a trial visit and overnight stay. Visits provide the opportunity for potential clients to ask questions, view the home, and to meet clients and staff. The Home has developed its assessment processes to include comprehensive written assessment and risk assessment formats. The Home also involves the services of an advocate where required, and provides access to advocacy services where these are requested. One client, from a minority ethnic background, has access to an advocate from his own community. The Home currently has four clients. The files include all the the relevant assessment documentation and care plans. Referral information, CPAs, CPA reviews, assessments and risk assessments were evidenced, together with daily logs and keyworker summaries. However minutes of reviews held for two clients had not, as yet, been received., and could not, therefore, be referred to for the purposes of this inspection. The home has a contract that is agreed and signed by the client following their admission to the home. Care Homes for Adults (18-65 years) Page 10 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. 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. Clients are having their health, personal and social care needs and goals set out in an individual plan of care, and are being involved in the care planning process. However, the home must aim to develop more person-centred care plans. The home must ensure that review minutes are obtained following CPA reviews, and that these fully inform the review of care plans. Generally, clients are being enabled to participate in daily routines and activities, and are being supported to make decisions that affect them and their day-to-day lives in the home. Clients are being assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The home has developed care planning processes, with clients service user plans being based on information available from both CPA and the Homes assessments. These identify clients needs and choices, and risks, and provide detailed information evidencing how residents needs are being addressed. Inspection of service user plans indicates that these are providing the necessary information regarding clients needs, choices and risks, and that they are being formally reviewed on at least a 6 monthly basis. Keyworkers are required to review service user plans with their clients from month to month. Service plans are being agreed and signed by residents and are accessible to them at all times. Whilst service user plans detail individual needs, these need to be developed so as to become more person centred in their structure and content. Whilst CPA reviews are taking place, minutes had not, as yet, yet been obtained for two recent client reviews. This must be followed up as a priority. Clients are being consulted in a variety of ways during their stay in the home. This includes service user meetings, and meetings with their key-workers. Questionnaires have also been designed for quality assurance purposes. Clients are encouraged to be as independent as possible in their day-to-day living and, with the support of their key workers, to be fully involved in making decisions relating to their daily recreation and activities. From the evidence available from this and the recent random inspection, the indication is that residents are being encouraged to be as independent as possible in their day-to-day living, and that, with the support of their key workers, are being consulted and involved in making decisions relating to their daily recreation and activities. The inspector has met with 3 residents, all of whom presented as settled and happy with the support being provided. One resident, from a minority etnic group, with a limited grasp of English, has had ongoing access to an advocate from his own community. This has assisted in resolving any misunderstandings regarding the clients wishes, and has improved communication of his needs to staff. From the evidence available, the indication is that residents are being encouraged to be as independent as possible in their day-to-day living and, with the support of their key workers, to be consulted and involved in making decisions relating to their daily recreation and activities. We spoke with a number of clients during the inspection. This indicated that clients Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: are generally feeling settled and well-supported living in the Home, and that they are being encouraged to pursue their interests and to develop their independent living skills. The Home has developed its links with the wider community, and is encouraging clients to access local leisure, occupational and educational resources. The inspector was advised that one client has recently been able to make the transition into supported accomodation following a period of residency at the Home. There is evidence that residents are supported to take risks in developing independent skills and abilities. The home aims to enable residents to take responsible risks wherever possible. Prior to their admission prospective residents are thoroughly assessed regarding potential risks relating to their day-to-day living inside and outside of the home. Inspection of clients service user plans and daily logs evidences that individuals are being encouraged and assisted to participate fully in daily routines and activities. This includes using public transport, and accessing local recreational and shopping facilities. Residents are also encouraged to look after their own monies and to collect their own benefits. Risk assessments are completed by the Home, with any specific areas of risk being identified, together with the actions required to address and minimise these. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is providing a limited range of opportunities for social and leisure engagement. These could, however, be developed so as to provide access to a wider range of activities. Generally, clients are being enabled to participate in daily routines and activities, and are being supported to make decisions that affect them and their day-to-day lives in the home. However, the home needs to evidence that it is addressing individual needs and preferences, and develop an individualised social, learning and activity programme for each client. Clients are being encouraged to maintain contact with their family and friends, and to develop their links and involvement with the local community. Care Homes for Adults (18-65 years) Page 14 of 29 Judgement: Clients rights and responsibilities are being respected and recognised in their daytoday lives. There is choice and flexibility with meal arrangements. Clients are being assessed regarding potential risks to their health and safety, and are enabled to take responsible risks wherever possible. Evidence: The ethos of the home is very much orientated towards promoting independence and maximising individual choice and opportunities. Staff at the home work with clients with the aim of increasing their motivation and confidence, and developing their independent living skills. One client has recently made the move into supported housing. Clients are encouraged to take responsibility for undertaking daily tasks such as tidying their rooms, and preparing drinks, food and snacks. Views expressed by clients has indicated that the daily routines of the home are flexible and accommodating of individual needs and preferences, and that clients feel able to exercise choice in their day to day activities. Clients are supported to develop their independence by obtaining freedom passes for public transport, and making use of local resources, and by encouraging clients to vote in local elections. The home has a weekly activity programme, and individual activities, a copy of which was available. Clients are assisted to access community resources such as the local library, leisure centre, cinema, Horniman museum and local shops and restaurants. Each client is provided with a key to their room, and are able to receive visits from friends and relatives. The Home organises an occasional barbeque to which friends and relatives are invited. Clients are able to access activities at the Speedwell Mental Health Day Centre in Deptford, with three clients currently attending. Care Homes for Adults (18-65 years) Page 15 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 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. Clients are receiving appropriate health care and personal support, and monitoring of their mental, emotional and physical well-being. Clients are being protected by the homes medication policy, procedures and training. Accredited medication training is being rolled out to all staff. Evidence: The Home has developed good links with a GP practice and clients are supported in attending their appointments. There are also good links with the local CMHT based at the Speedwell Centre in Deptford. Support is provided by a team of CPNs, care coordinators and psychiatric consultants. Clients are rerminded to attend appointments and receive visits as and when these are required. The inspection of clients files indicates that there has been regular contact with health care professionals, and that clients healthcare needs are being addressed. These are Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: monitored in daily logs and in keyworkers summaries. The home has a medication policy and procedures in place, with training being provided both internally, and by Boots Pharmacy. The manager confirmed that all support staff are required to undertake accredited medication training. Medication storage arrangements were inspected. This confirmed that safe and secure storage arrangements are in place, with a separate locked cabinet for each client Medication storage arrangements were inspected. This confirmed that safe and secure storage arrangements are in place, with a separate locked medication cabinet for each client. A sample of medication records was inspected. These confirmed that appropriate recording of medication is taking place. Views expressed by clients indicate that they feel that their support and health care needs are being met. Feedback received from care managers indicates that the home is providing a generally good level of health care support and monitoring, and that clients mental health needs are being appropiately monitored, with good communication of any concerns that arise. Care Homes for Adults (18-65 years) Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information for raising complaints is made available, and clients, and their relatives and friends, are encouraged to raise any concerns they may have. The Homes safeguarding policies, procedures and practice indicate that clients are being protected from abuse, and that they are living in a safe environment. Evidence: The Home has an appropriate Complaints Policy and Procedure in place. The contact details for the Commission have been updated to those for the CQC. The Home maintains a record of complaints. No complaints have been recorded or notified to the Commission. The service has a policy and procedures on adult protection, which is based on statutory guidelines. This is complemented by a copy of Lewisham multi-agency POVA (Protection of Vulnerable Adults) policy and procedures. All staff are familiarised with these procedures, and receive POVA training from a qualified trainer. The training is Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: based on Lewishams statutory policy and guidelines. A number of clients were present during the recent random inspection. Views expressed indicated that clients feel safe and secure living in the Home. No concerns were expressed. No allegations of abuse have been recorded or notified. Care Homes for Adults (18-65 years) Page 19 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 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. Generally, clients are living in a safe, hygienic and well-maintained environment with access to appropriate communal facilities. The home must, however, ensure that clients refrain from smoking in their own rooms. Clients rooms are reasonably furnished and decorated, and are suited to individual needs. The home has sufficient bathing and toilet facilities, which are generally meeting clients needs. Evidence: Canonbie Recovery Unit is situated in a quiet residential road in Forest Hill, close to bus and rail connections. The Home provides accomodation for up to six clients over 3 floors of an old Victorian house.There is a communal lounge (with widescreen television), dining area, and kitchen. There is a garden at the front and rear of the property. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Each client has their own room, with access to bathroom and toilet facilities on each floor. Each client is provided with a key to his/her room, and has lockable storage for money and valuables. The home is housed in an old, spacious building which is not ideally suited to its present use. The owner has previously indicated that he plans to move to another property which he feels will provide a more user friendly and modern environment. Inspection of the premises indicated that the Home is reasonably well furnished, carpeted and decorated throughout. A programme of maintenance and repair is in place, and the property presents as being reasonably well maintained. Views expressed by clients on the recent random inspection indicate that the Home is meeting their individual needs and that it provides the necessary communal facilities. Laundry facilities are provided in a separate laundry room. Clients rooms present as reasonably well furnished and decorated, and are personalised with personal possessions and photographs. Generally, the Home presents as a reasonably safe environment. Cleaning agents and chemicals are securely stored, and a Health and Safety policy is in place. The home presents as being clean, hygienic and free from any offensive odours. Staff receive training in food hygiene, and health and safety. A new emergency fire alarm system has recently been installed. Health and safety checks on gas, electricity and electrical appliances are undertaken as required. A legionella check is not required as the home does not have a water tank. The home has a no smoking policy, with a small room being set aside for smokers on the ground floor. Evidence was discovered in one room of cigarette stubs. The manager gave an assurance that clients are regularly reminded not to smoke in their rooms and no smoking notices are put up at various points throughout the home. Checks are also made to try to ensure that clients are not smoking in their rooms. Care Homes for Adults (18-65 years) Page 21 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 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 best interests of clients are being protected through the maintenance of appropriate staffing levels, and by clearly defined staff roles and responsibilities. The needs of clients are being met by appropriately trained staff. Clients are being protected by the Homes recruitment practices and procedures. Evidence: Following a concern expressed regarding staff recruitment checks, a random inspection of the home on 12 August 2009 found that there were no staff records to view, these being held at their Head Office. On a return visit, on 24 August, staff records had been transferred, being securely stored in lockable filing cabinets. Inspection of recruitment records for 5 new staff indicated that, apart from one outstanding CRB check, awaited for one staff member, recruitment checks were being satisfactorily completed. The CRB check was completed shortly after this visit. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Staff rotas were examined, indicating that 2 staff members are on duty at all times. Management cover was discussed, the existing arrangements at the time of the random inspection not being felt to be sufficiently full proof, with on call management cover being provided at weekends. With the appointment of a new Deputy Manager, there is now on site management cover for 7 days a week. Since the last visit, there has been one further staff appointment. The necessary CRB and other employment checks have been completed. There is a keyworker system in the home, with each client being allocated their own keyworker. There are regular monthly staff meetings which are attended by the acting manager and deputy manager. Supervision sessions are being held with staff on a 6 to 8 weekly basis. Care Approach has a qualified training and quality assurance manager, who organises the induction programme for new support staff. This includes an initial 3 days mandatory training and a Skills For Care learning pack which is completed over the first six months of employment. There is an ongoing training programme for staff which includes training in mental health, challenging behaviour, POVA, medication, First Aid and Food Hygiene. Training for each staff member is monitored, and recorded, and contributes to the appraisal process. Staff are encouraged to study for NVQ qualifications, 8 staff currently possessing NVQ Level 2 or above and 5 staff working towards this qualification. The Home also accesses training from external training providers, and utilises a number of training resources and materials to enhance staff learning. Views were elicited from a new staff member. She confirmed that she had received her induction and that she is due to register for study for an NVQ qualification. She indicated that she feels well supported in carrying out her duties. The Home has previously confirmed that it plans to involve clients more fully in the recruitment process (i.e in interviewing) and to develop a more in-depth induction and foundation training which meets with Skills For Care specification. Care Homes for Adults (18-65 years) Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. While clients are living in a home that is being generally well managed, it needs to be demonstrated that the home is being run in their best interests. To this end, an up to date quality assurance audit report, needs to be published and made available. Clients rights and best interests are being safeguarded by the homes record keeping policies and procedures. The health, safety and welfare of residents and staff are being appropriately protected. Evidence: The day to day management of the home is the responsibility of the manager, Ms Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: Adeola Fapohunda. Ms Fapohunda has an RMN nursing qualification, a degree in Social Policy and an MA in Resource Management. She has over three years experience of working with people with mental health problems. Ms Fapohunda has confirmed that she is studying for an NVQ Level 4 management qualification, and that she has applied to the CQC to become the homes registered manager. Ms Fapohunda is being assisted by a recently appointed deputy manager, who has substantial experience of working with this client group. Ms Fapohund confirmed that on site management cover is now being provided 7 days a week. The provider organisation (Care Approach) employs a manager with responsibility for quality assurance and training. The organisation has been gradually developing its quality assurance processes with view to canvassing the views of clients, relatives and professionals regarding the quality of services that the organisation provides. There is, however, a need for the organisation to produce a quality assurance audit report detailing those areas where the aims and objectives of the home are being met, and those areas where improvements need to be made. All records examined on this inspection were found to be kept in good order, and kept securely in locakable filing cabinets. The Home has policies and procedures in place for Health and Safety, Fire Safety, Food Hygiene, Infection Control and COSSH. Inspection of health and safety records indicates that the home is complying with health and safety requirements, and that there is up to date certification in place. A new emergency fire alarm system has recently been installed. Health and safety checks on gas, electricity and electrical appliances are undertaken as required. A legionella check is not required as the home does not have a water tank. Following a requirement from the last key inspection, it was evidenced that a record of fire drills is being maintained, and that these are being held on a regular basis. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 11 12 The home needs to develop an individualised social, learning and activity programme for each client. To evidence that the home is enabling clients to develop their skills and potential, and that clients social needs and preferences are being addressed. 31/12/2009 2 24 13 The home must ensure that 31/12/2009 service users refrain from smoking in their rooms, oi in any of the communal areas apart from the area set aside for this purpose. To ensure the safety of service users within the home. 3 37 9 The home must complete the registration of the manager with the CQC. To assure users, and other stakeholders, that the Home 31/01/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 is being managed by a person who has proved their fitness to manage. 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 2 3 6 Minutes of all CPA review meetings must be obtained and evidenced on client files. Service user plans need to become more person-centred, reflecting more fully individuals preferences and wishes regarding their support and daily activities. So as to ensure that clients mental health and social needs are being met, and that their care plans are being appropriately updated, CPA review minutes must be obtained, and acted upon. The range of opportunities for access to leisure, educational and social activities should be widened to take more account of individual needs and interests. There is a need for the organisation to produce a quality assurance audit report detailing those areas where the aims and objectives of the home are being met, and those areas where improvements need to be made. 3 6 4 12 5 39 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. 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