Care Home: Care@Rainbow's End

What the care home does well People living in the home have lots of things to do and there are plans to help them to go to college and to find work. They get involvedwith shopping and cooking meals.The home has a choice of areas for people to use and it is very homely with good facilities. The home has a cat and the managers dogs spend lots of time in the home. The manager also has some horses and people living in the home can go and see them. There are lots of staff on duty and they are having training to help them to understand peoples needs better. There is lots of information for people to see before they decide to move into the home and it is written so that it is easy to understand.People get plenty of time to visit before they move in. What has improved since the last inspection? This is the first inspection at the home as it did not open until August 2009 and people have only just moved in. This will be assessed at the next inspection. What the care home could do better: Medicine procedures could be better but the manager is already addressing this.Staff records could be better.The home is still developing and improving and the manager has told us that soon there will be better care plans and people will be able to read and get involved in their care plan. There will also be meetings for people living in the home and they will be given a survey at least every year and this will make sure they have a say in how the home is doing and if they are happy. Key inspection report Care homes for adults (18-65 years) Name: Address: Care@Rainbows End Bosworth Farm Main Street Shelford Nottinghamshire NG12 1EE 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: Lynda Dyer Date: 0 8 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 34 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 34 Information about the care home Name of care home: Address: Care@Rainbows End Bosworth Farm Main Street Shelford Nottinghamshire NG12 1EE 01159332878 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care@Rainbows End Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is 5 The registered person may provide the following category of service only Care Home only PC To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Learning Disability Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Care @ Rainbows End used to be a farm house called Bosworth farm. There are views looking out over fields and wooded areas. The home has five large single bedrooms and some of them have their own toilet. One of the bedrooms can be for people with a mobility impairment. There are two lounges and a large games room so people can choose where to spend their time. Care Homes for Adults (18-65 years) Page 5 of 34 There are large modern bathrooms and shower rooms with a shower that people with a mobility impairment can use. There are lovely spacious gardens around the property and there are plans for a vegetable patch, chickens and a sensory garden. There is a patio and a BBQ area and also a Jacuzzi. It costs £ 1,250 per week to live in the home with extra charges for 1-2-1 and 2-1 care from staff. Care Homes for Adults (18-65 years) Page 6 of 34 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 7 of 34 How we did our inspection: This is what the inspector did when they were at the care home The manager and her assistant were there when we visited and they were very helpful and friendly. We had asked the manager to fill out a form for us. We call this an Annual Quality Assurance Assessment (AQAA). We had sent out a survey to people that live in the home, staff that work there and people that visit. 6 people filled in the surveys and sent them back to us. All of this helped us to plan what we needed to look at when we inspected the home. Care Homes for Adults (18-65 years) Page 8 of 34 We looked at the care plans of two people who live in the home. We looked at records that were kept in the home, which included staff records and health and safety records. We spoke with one person living in the home. We also spoke with three relatives of people that live in the home and two staff that work there. What the care home does well People living in the home have lots of things to do and there are plans to help them to go to college and to find work. They get involved Care Homes for Adults (18-65 years) Page 9 of 34 with shopping and cooking meals. The home has a choice of areas for people to use and it is very homely with good facilities. The home has a cat and the managers dogs spend lots of time in the home. The manager also has some horses and people living in the home can go and see them. There are lots of staff on duty and they are having training to help them to understand peoples needs better. There is lots of information for people to see before they decide to move into the home and it is written so that it is easy to understand. Care Homes for Adults (18-65 years) Page 10 of 34 People get plenty of time to visit before they move in. What has got better from the last inspection What the care home could do better Medicine procedures could be better but the manager is already addressing this. Care Homes for Adults (18-65 years) Page 11 of 34 Staff records could be better. The home is still developing and improving and the manager has told us that soon there will be better care plans and people will be able to read and get involved in their care plan. There will also be meetings for people living in the home and they will be given a survey at least every year and this will make sure they have a say in how the home is doing and if they are happy. Care Homes for Adults (18-65 years) Page 12 of 34 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 Lynda Dyer Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000 616161 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 13 of 34 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 14 of 34 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s needs are properly assessed before admission to ensure that peoples needs can be met in the home. People have given the right information so they can decide if the home is right for them. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that admission to the home is carefully planned, gathering information from a variety of sources to enable them to have a clear understanding of the individual and how best to meet their needs. They said that they have an information booklet which is available in two different formats with an easy to read version with photographs and Makaton signs and symbols to help understanding and a more detailed booklet, designed to provide information appropriate for parents and carers. One person living in the home told us in a survey that they were asked if they wanted to move into the home and were given enough information before making the decision to move in. We looked at the care plan of one person living in the home and it held an assessment of Care Homes for Adults (18-65 years) Page 15 of 34 Evidence: their needs, which was completed prior to admission. There was also a booklet which was in an easy read format and included pictures and photographs which had been written so that staff knew what needs the person had and what was important to them. We spoke with the relatives of one person living in the home and they told us that the assessment process had been very thorough and included several assessments taking place in both the person’s home and educational environments. They said that their relative had then visited the home and over a period of time had stayed overnight for short periods of time before the decision was made that the placement was the right one. During this time the relatives told us that the manager had been flexible and supportive and that their relative had been able to chose their preferred bedroom. The relative also told us that the speech and language team had been involved in the assessment and admission process and had met with staff to deliver training centred on the individuals communication needs. We looked at the information that the home gives to people before they decide to live there and it is written in a clear easy read format with pictures to assist the service user group it is aimed at. Care Homes for Adults (18-65 years) Page 16 of 34 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 living in the home are supported to make decisions and to take responsible risks to ensure they have control over their daily lives. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they have a positive attitude and support the individual to make decisions about their lives. They also told us that the care plan is person centred and concentrates on the individual’s strengths and interests, includes important information and essential details. They also told us that reviews are frequent and take the form of asking questions, what has worked, what could be better, what progress has been achieved, any concerns and plans for the future. We received surveys back from people living in the home and told us that they always made decisions about what they did each day and that they could do what they liked with their time. A survey received from a relative told us that home always supports people to live the way they choose. Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: We looked at the care plan of two people living in the home and they had been developed with the information from assessments, which were person centred and concentrated on what was important to the person it was written for. The people living in the home have only been there for a short period of time and so the care plans are still under development with evidence of input from external health professionals. Informal reviews are taking place with the manager and staff reviewing and changing the plans on a daily basis as they get to know the people living in the home. Formal reviews have not yet taken place as the people living in the home have only been there for a short period of time. There was no written evidence in the care plans that the person it was written for or their representative were involved in them. However we spoke with relatives and the manager and they told us that the care plans were discussed and agreed. There was evidence that the manager and staff are being creative in finding ways of managing risks and behavior without having to use physical restraint and this is being developed around the individual and is detailed in the care plan. We observed positive interaction throughout the inspection of people being supported to make their own decisions. The relative of the person living in the home told us, Programmes are very individualised. This is not just paying lip service to person centred planning. My relatives wants, needs and pleasures are well managed and Communication development is planned and is crucial. Care Homes for Adults (18-65 years) Page 18 of 34 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are actively encouraged to develop and maintain social, emotional, educational and independent living skills. People are supported to make informed choices and maintain family and personal relationships. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they respond well to the interests of residents, promote choice and variety in activities, and pursue interests and community involvement and integration. They also told us that responsibility is attempted by involvement in meal planning, shopping and food preparation. The manager said that mealtimes should be relaxed and taken as a family with staff being able to offer discreet support if needed and that consideration has been made in promoting healthy choices. We looked at the care plan of the person we had chosen to case track and there was evidence that activities were being tailored around their wishes and needs. Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: The care plan contained evidence of what activities were important to and important for this person and we observed this being put into practice on the day of the inspection. One of the things that the assessment process had highlighted as important to this person was being involved with animals and this had not been possible prior to moving into this home. Since moving into the home they had been supported to visit the local animal shelter and had chosen a cat for the home. The manager also brings her dogs into the home regularly and she has horses that the people living in the home are encouraged to visit with possible plans for riding lessons in the future. The staff told us how this interaction with animals was having a positive affect on the person’s wellbeing. Music had also been identified as an important part of this person’s life and there was evidence that staff were supporting them to follow this interest and there are plans for them to attend college to have music lessons. We saw relatives visiting the home freely and they told us that they always felt welcome and that they regularly stayed and ate with the people living in the home and the staff. The manager told us that they were looking for local groups in the area for the person we were case tracking to attend so that they could meet new people and form new relationships in the community. Lunch was prepared by one of the people living in the home with support from staff and we observed that people living in the home, staff, visitors and the manager all sit around a huge dining table and eat together. There was a family-like atmosphere and the meal was relaxed and an enjoyable occasion. We saw evidence that people living in the home are being supported to eat a healthy balanced diet. A relative of a person living in the home told us, Rainbows End has a real family feel and ensures my relative has a varied programme of activities with a balance between personal development and fun/leisure activities. One member of staff working in the home told us, The amount of activities offered is superb another said, There are plenty of activities such as swimming, bowling, walking in the countryside, trips to the coast and living skills such as cooking and baking. Care Homes for Adults (18-65 years) Page 20 of 34 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 living in the home have their health care needs met and they receive personal support in the way that they prefer. Medication procedures are generally safe. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that personal and health care support is carried out and is outlined in Person centred planning to provide personal, sensitive care, treating the resident with respect and dignity, being aware of confidentiality, privacy, medical and health issues. They also told us that medication and first aid training is carried out. We received a survey from a relative of a person living in the home and they said that the home gave their relative the support and care that they had expected and that they usually met their needs. The relative of the person living in the home said, They are developing very well. We received surveys back from staff working in the home and they told us that they had received training that gave them enough knowledge about health care and medication. We saw records of external health care appointments and evidence that external specialists were being involved where needed. The care plans are still being developed to Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: include health plans. We viewed the care plans of two people living in the home and they showed some information on how they liked to spend their days and how much support they needed with their care. The plans are still being developed with the input of external health professionals. One member of staff working in the home told us, The care for service users is excellent and so is the support for staff. We spoke with relatives of people living in the home and one of them said, “My relative has only been here for a week and yet already I can see the improvements in them. They look healthier and more relaxed”. We looked at the homes medication procedures and found that the medication was being administered to people as prescribed and we saw evidence that staff were trained in the safe administration of medication. We found some minor shortfalls in the medication storage and procedures but the manager told us that they were in the process of registering with a pharmacy and they were going to ask for advice on improving the storage and procedures. The manager has provided us with an action plan detailing how this will be managed. Care Homes for Adults (18-65 years) Page 22 of 34 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 living in the home are safeguarded from abuse and people know how to make a complaint. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they respond to any concerns in a positive and caring manner and that the ethos of the home welcomes complaints and suggestions about the service and responds positively to them. The manager said that a complaints procedure is given to residents and their parents or advocate. They also told us that they support whistle blowing and that all staff will receive training in safeguarding. We received a survey from one person living in the home and they told us that they knew who to speak to if they were not happy and their relative told us that they knew how to make a complaint. Staff told us that they knew what to do if someone raised a concern with them about the home. The complaints procedure is written in a clear easy read format with pictures to assist the service user group it is aimed at and it forms part of the information given to people prior to admission to the home. On the day of the inspection the procedure was not displayed in the home for people to refer to. Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: The Commission has not received any complaints since the service registered with us and the manager told us that they had not received any complaints since they had become a registered service. The home has the local current safeguarding referral procedures in place and the manager told us that they were familiar with them but had not yet needed to make any referrals. We spoke with staff about safeguarding adults procedures and they had a good understanding of them and we saw evidence that staff are booked to attend training on this very shortly. Care Homes for Adults (18-65 years) Page 24 of 34 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. People live in a safe, comfortable and homely environment with facilities which reflect the interests and needs of people living in the home. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they have created an environment which is homely, well maintained, attractive, spacious and restful, providing facilities which are suitable to the residents and reflect their interests and needs. They also told us that all bedrooms and communal areas are spacious and well equipped and that residents are encouraged to personalise their space and to make it theirs with the general ambiance being relaxed, homely, clean and well cared for. On the day of the inspection we found the atmosphere of the home to be relaxed, friendly with a family-like environment. The home was very clean and well maintained. All areas are furnished to a high standard and the communal areas are spacious and set out to provide people living in the home a choice of where spend their time. These include two lounges and a large games/activities room as well as the farm house kitchen which forms the heart of the house. The bedrooms are large and well furnished with double beds in each room. Some bedrooms have an en-suite while others have nearby access to renovated, modern and Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: spacious bathrooms. People living in the home are encouraged to personalise their bedroom with their own possessions. There are extensive gardens around the property and there are plans for different areas to be transformed into places of interest for people living in the home. These are to include a vegetable plot, an area to keep chickens and a sensory garden. There is also a large patio area with seating, a BBQ area and a Jacuzzi for people to use. The home has health and safety practices and procedures in place. There are infection control systems in place to prevent the spread of infection and staff are trained to maintain the systems. Hand towels that are frequently laundered are provided in all areas of the home. People living in the home told us in a survey that the home was always fresh and clean. Care Homes for Adults (18-65 years) Page 26 of 34 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. Care delivered to people living in the home is person centred and there are enough staff members with the training and skills to be able to care for people properly. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the staff team is carefully selected to be diverse and to cater for the needs of residents and potential residents, having a range of skills and expertise from a variety of backgrounds so able to provide holistic care for the residents. They told us that training needs are identified and training is planned through a mixture of in-house and externally provided sources. The manager told us that staffing levels are high to reflect the level of needs of the residents but also allows for flexibility, creativity and choice in activities. We received a survey from one person living in the home and they told us that the staff treated them well and that they listened and acted on what they said. We received surveys back from staff working in the home and they told us that the home carried out the required checks on them before they commenced working there. We looked at the files of three members of staff and two of them contained evidence that the home had made the required safety checks prior to these two members of staff Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: commencing employment. The third had some gaps in the required safety checks and the manager addressed this the day after the inspection and has provided us with an action plan to show how they will manage this in the future. The manager told us how the staff were being employed to match the needs of the people living in the home and we saw evidence of this on the day of the inspection. One person living in the home has been involved in the recruitment process of two members of staff and has been supported to ask questions and have a say about the suitability of these applicants. When we asked staff what the home did well one member of staff told us, Very homely with caring staff that have been well chosen for their different skills and experience. Staff told us in surveys that they were receiving an induction that was covering everything they needed to know about the job and that they had received training that was relevant to their role, kept them up to date with new ways of working and helped them to understand the needs of people they were caring for. One member of staff told us, The training we have is very good and is always ongoing and another said All staff are committed to their jobs and to caring for the clients. Staff have received training in some areas of health and safety and health care and we saw evidence of further training booked over the next two months. Staff are enrolled on a recognised induction programme and are also in the process of being registered to complete a recognised qualification in caring for people with autism and learning disabilities. We received a survey from a relative of a person living in the home and they said that the staff usually had the right skills and experience to look after people properly. A relative of a person living in the home told us, All staff are being further developed in communications skills and as this progresses my relative will be more able to express their choices, needs and wants. On the day of the inspection there were ample staff on duty to meet the needs of the people living there and staff told us that there were always two waking staff on duty at night and that they felt there was always enough staff on duty. Care Homes for Adults (18-65 years) Page 28 of 34 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 run in the best interests of the people living there. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that she has a clear vision and ethos of care, committed to the principles of person centred planning and approaches to care. She also told us that she has passion and commitment to providing care which is high quality, caring, creative, stimulating and holistic. She said that policies and procedures are in place for health and safety and that staff are encouraged to access training in this. We saw evidence that the manager has completed training in areas of social care management and that she has registered to undertake a recognised qualification. We spoke with the manager and her assistant at length and their passion and excitement for providing person centred care and for the creation and development of the home was clearly evident. A relative of a person living in the home told us, A brilliant start has been made and the Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: ongoing development is aimed at making Rainbows End a centre of excellence for those on the autistic spectrum. We received surveys back from staff working in the home and they told us that the manager met with them regularly to discuss how they were working and to give them support. The home has only been registered with us for four months and the two people living there have only been there for a very short time. However, the manager has already shown that she is going to work well with us and is putting systems in place and developing the home to meet standards of quality and safety. There is not yet a system in place for the manager to seek the views of people living there or their representatives in order to measure the quality of the service being provided. However the people living in the home have only been there a very short time and the manager told us that there were future plans for people living in the home to have regular meetings and for surveys to be given to all people involved with the home to gain their views on the service at least annually. We saw evidence that equipment in the home is regularly maintained and that staff are trained in areas of health and safety. There was no evidence of staff having received training in safe moving and handling procedures, although there are not currently any people living in the home who require help to move around and the home has written procedures on the safe handling of people. One member of staff said to us, I feel that this is a lovely place to work, it feels just like home. We have regular meetings to discuss any problems and to discuss what we could do better and to listen to any ideas. Care Homes for Adults (18-65 years) Page 30 of 34 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 31 of 34 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 1 20 13 The home must have in place 14/07/2010 a metal storage facility for controlled drugs, which meets the requirements of the misuse of drugs regulations 1973. This will safeguard the health and welfare of people living in the home. 2 34 19 Where the registered person 24/02/2010 has accepted a criminal records check that has not been not been obtained by the home, they must undertake a risk assessment of this and a record of the assessment must be kept. This will make sure people living in the home are protected. 3 34 19 All staff must have the required documentation 24/02/2010 Care Homes for Adults (18-65 years) Page 32 of 34 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 around recruitment in place before commencing working in the home. This will make sure people living in the home are protected. 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 6 There should be evidence in the care plans that the person it was written for and their representative, where appropriate, are involved in the preparation and review of the plan. The temperature of the area that medication is stored should be taken each day and a record made of this. The complaints procedure should be displayed prominently in the home. Paper towels should be provided in areas where staff wash their hands after delivering personal care and areas where food is prepared. Staff files should contain a recent photograph of the member of staff. Staff should be given training in safe moving and handling procedures. 2 3 4 20 22 30 5 6 34 42 Care Homes for Adults (18-65 years) Page 33 of 34 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. 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