Care Home: Carranmore

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What the care home does well People living at the home experience a good quality of life through the support of an experienced, and stable staff team. People stated they receive support in a warm and caring way from the staff team. People told us: “I have been helped a lot, emotionally, with my illness but also with things like budgeting. It’s a strong base for me” “In my years of living at the home I have always found the staff here to be courteous, friendly, helpful and supportive”. People report that staff help them to make both everyday decisions and to have control over their life. The overall picture gained by us was that people living at the home are being supported in a way that suits them and helps them manage and maintain their mental well-being. Health and social care professionals were all positive in their comments and commended the staff team. One stating “Excellent provision of service for clients, only difficulty is that vacancy for clients do not arise there very often.CarranmoreDS0000022570.V378247.R01.S.docVersion 5.3 What has improved since the last inspection? People are being supported in more innovative ways to improve and maintain their mental health. The organisation has offered training in working in more person centred ways and using tools that are part of good practice in the mental health field. This has resulted in a new focus for the home, and people are now actively encouraged to view the support they receive as a stepping stone to moving onto a more independent lifestyle. This has been achieved by some people successfully moving onto their own homes, and for some people this has led to being more independent but still remaining at Carranmore. What the care home could do better: The manager has identified the areas for development, which are around staff using less institutionalised practices and this has begun to have positive outcomes for people in the home. Key inspection report CARE HOME ADULTS 18-65 Carranmore 218 Warwick Road Carlisle Cumbria CA1 1LH Lead Inspector Liz Kelley Key Unannounced Inspection 1st December 2009 11:00 Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 1 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. 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 home adults 18-65 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. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 2 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 Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Carranmore Address 218 Warwick Road Carlisle Cumbria CA1 1LH 01228 514180 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) carrranmore@croftland.plus.com The Croftlands Trust Mr Peter Cork Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - 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, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 6. 14th October 2008 Date of last inspection Brief Description of the Service: Carranmore is run by The Croftlands Trust, a non-profit making organisation, which runs a number of residential and community based services in the county for people with mental health problems. Carranmore accommodates up to 6 people who have, or who have had, difficulties in maintaining aspects of their mental health. The property is located on a busy road close to the centre of Carlisle, with good bus links and close to a wealth of local shops and facilities. The home is a large terraced, three-storey older property, which has been modernised and converted for its present use. On the ground floor there are two lounges, kitchen-dining room, office, utility room and toilet. On the first and second floors there are 6 bedrooms, and two bathrooms. At the rear is a small parking area and patio garden. All service users have individual bedrooms, each with a wash hand-basin. All referrals are made, and funded via the Integrated Health and Social Services Team. The current scale for charging is £423.64. A Handbook is available for prospective residents, which includes a summary of the latest Commission for Social Care Inspection report. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection visit took place over one day. We (Care Quality Commission, CQC)) spent time with people living in the home and talking to them about their experiences. We also met with the manager and the staff on duty and looked at records relating to the running of the home and how people like to be supported to live their lives. We also sent out surveys as part of this inspection to get feedback from people living in the home, their relatives and representatives and other professionals involved with the home. Before the visit the manager completed an Annual Quality Assurance Assessment, which provided information about all aspects of the running of the home. On the day of inspection five people were at home. They were seen making their own choices on how to spend their time. For example, one person was out with relatives, a couple of people watched TV and made cups of tea, one was tidying the kitchen, and another said they had decided to have a day at home due to bad weather. What the service does well: People living at the home experience a good quality of life through the support of an experienced, and stable staff team. People stated they receive support in a warm and caring way from the staff team. People told us: “I have been helped a lot, emotionally, with my illness but also with things like budgeting. It’s a strong base for me” “In my years of living at the home I have always found the staff here to be courteous, friendly, helpful and supportive”. People report that staff help them to make both everyday decisions and to have control over their life. The overall picture gained by us was that people living at the home are being supported in a way that suits them and helps them manage and maintain their mental well-being. Health and social care professionals were all positive in their comments and commended the staff team. One stating “Excellent provision of service for clients, only difficulty is that vacancy for clients do not arise there very often. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 6 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. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 People using the 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 receive information and support that helps them to make informed decisions on choice of a home. EVIDENCE: Good systems are in place to make sure the home have sufficient information about a persons care needs prior to agreeing for them to stay. There was evidence this system has been reviewed and improved with staff contacting Social Workers for the most up to date assessment of need. In addition they also ensure the person receives relevant information about the service to help them make an informed choice about using the service. Admissions are not made to the home until a full needs assessment has been undertaken, and these were seen in peoples files and included social work assessments and risk assessments. Admissions to the home, therefore only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. The manager considers the application together with the staff team, where all information is shared and views are listened to and fully debated, before agreement is given for the admission. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 9 The AQAA states: “When new service user is referred to home we check all information to make sure it is appropriate referral for both our project and client been referred, so that we can meet that persons needs and expectations. If someone is accepted we encourage gradual visits to home and then longer stays if this is appropriate to service user. We would be aware of various assessment needs of service user and develop relevant care plans and risk assessments, to go with additional information, which we have received from, care co-ordinator who did referral.” A Mental health professional said “They use their skills to make people feel welcome, supported, part of a family unit. This leads to successful placements where people are assisted to make the right choice for them and given support to settle. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 People using the 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 are being ably supported by a more skilled staff team which has seen much improved outcomes for people’s mental health. EVIDENCE: The individual needs and choice of people using the service have been greatly improved by the recent introduction of a more efficient and effective care planning system. This has included both making people who use the service more aware of what is expected of them during their stay, and being clearer on the support role of staff. Staff have had training in using different ways of working with people to ensure that people gain maximum benefit from their stay. The AQAA backs this up by stating: “We do care plans, risk assessments, individual needs assessments and weekly programmes with each individual service user and these are regularly reviewed at agreed intervals. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 11 We try to empower service users to be as independent as possible and to take agreed risks to achieve outcomes. We have been working with Outcome Starr and this as been success with most service users whom have worked with this.” Another recent development has been the introduction of a more in depth assessment carried out by the home in the first few days of a person’s placement. This has been a positive move as it allows people to make a connection with their keyworker early on in their stay, and to examine the issues of their mental health that led to their admission. Staff described the use of these tools to assist in this process, namely a “spider diagram” which visually charts a person’s progress in key areas that affect their mental health, graphically displaying this information at admission and then plotting progress throughout their stay in the home. There was evidence that these were being completed to good standards and involved face-to-face sessions with service users to ensure they were clear on the reasons for their admission and the outcome hoped for. The more person centred approach has led to care plans that have real meaning for individuals and that they were in control of. To support this work risk assessments had also been greatly improved and demonstrated clear steps to support people to achieve success. One person living at the home said “Gives me support in many ways both mentally and physically. I feel safe and warm here. I feel I have security with having staff and other people around me” A relative said “The home has been very responsive to issues discussed at the last review. The bottom line is my relative is happy and settled and has had no major mental episodes for some years”. A Mental health professional said of the team “They ensure that every person has an up-to-date care plan which is reviewed regularly, helping them to make informed choices, to support them to live like they choose, and to promote independence.” And another professional said of what the home does well: “They are able to care in a person-centred way using a holistic approach. The use of the outcome star for assessing need and planning care is very useful”. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12,13,15,16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lifestyle choices for people are becoming much more individual and this leads to increased community involvement. EVIDENCE: It was noted on this inspection that people are doing much more for themselves, instead of being looked after by staff. There was an increase in the use of public transport by people living in the home and staff where increasingly helping people to identify places and activities to individually take part in rather than going on group outings. A Mental health professional said “people are involved to take part in positive activities linking to day centres, voluntary work, and agencies such as MIND, Bridge Building, Age Concern and advocate services.” Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 13 A relative stated: “personal care of individual resident is a key factor- everyone seems to be given opportunities to develop skills. My relative is given freedom to do his own thing yet has security of excellent support staff.” The AQAA states: “We encourage Service Users to have active weekly programme of different interests of their choice. We ask service users what their interests are and what they would like to do, we give residents support if needed when trying new activities etc. Service Users use local amenities such as Swimming baths, Cinema, Sands Centre and Green Room Club, which have plays on, Restaurants and Cafe s for bar meals etc . Service Users are encouraged to eat healthy diet and cook for themselves, two Service Users at Carranmore cook and shops for themselves at present. Staff have been on training courses re Food Hygiene, healthy eating/diets etc.” Relatives feedback was overwhelmingly positive with only one person requesting more staff to “allow more one to one time to go out more”. A professional who was again very complimentary on the work of the home said “ Increase in staffing levels so a more extensive social and recreational programme could take place on an individual basis.” The organisation, The Croftlands Trust, was addressing these issues by developing an out reach team to be used by people living in the home for oneto-one personal development areas and this support can continue when the person has moved onto their own home. For one person this was working well. They described going out for lunch and getting on very well with the support worker. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A Mental health professional said of the team: “They work well with the mental health services in identifying concerns early , so a timely intervention can take place”. And “People with severe and enduring mental health problems, who often exhibit challenging behaviour, are treated as individuals”. A Care Manager states: “Excellent relationship with care co-ordinators and service users mental well being is paramount”. The comprehensive person centred care plans including the health action plans ensure staff have detailed information about all aspects of service users personal and health care needs. Specific strategies have been developed with the support of other professionals and specialist services that ensure that Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 15 peoples privacy, dignity, independence and control over their lives is respected. Contingency plans are in place for each person, and these identify triggers and warning signs to help people identify when they require additional support and strategies. This is good practice in this field and gives good support to people in times of potential crisis. Through the completion of health action plans health care needs are well documented and staff are aware of all relevant health related needs and making sure they are closely monitored. Staff explained how they liaise with a number of other professionals on an ongoing basis to ensure peoples needs are responded to in a timely and effective manner. Specific strategies have been developed to support staff in responding to individuals physical and emotional health care needs. These are reviewed regularly and updated as required. We examined the homes medication records and storage system. All medication was securely stored and a record of administration is completed when it is administered. There was now a clearer stock record being maintained of medication entering and leaving the home, meaning stock control can be effectively monitored and mishandling identified quickly. This was recommended at the last inspection, and the manager is also ensuring that two staff check medications in and out of the home. While medication handling has generally improved, the home continues to have a small number of medication errors, as identified by the regular reports sent into us by the homes Operations Manager. The manager should identify ways of reducing these and possibly addressing these in supervision and via additional training and displinanry action if necessary. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the 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 are safeguarded by the homes policies and practice, with staff aware of their role and responsibilities in reporting concerns and complaints. EVIDENCE: There has been no formal complaints received by the home since the last inspection visit. The home has a suitable complaints policy and procedure, which is made available to people living in the home and their relatives. Survey responses from people living in the home, their relatives and staff working their, confirmed they knew who to speak to regarding any concerns or complaints they may have. There was evidence appropriate referrals have been made on behalf of individuals to advocacy services and other professionals when best interest issues have arisen. Since the last inspection safeguarding training has been provided for the staff team. In addition the manager has attended specific training for managers of services to enable them to deliver further training to their staff. This is particularly around the deprivation of people’s liberty when restricting practices to keep them safe. The manager needs to ensure staff understand how this affects practice and to incorporate these into care plans for people. It was evident they are aware of their responsibilities in recognising and reporting any suspected or actual abuse. There was evidence of appropriate referrals being made to other agencies and the home working closely with Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 17 them to safeguard people. The most recent resulting in measures to safeguard people in the home. Action plans had also been developed to instruct staff via supervision sessions on less institutional practices.. The AQAA states: “We have regular meeting where residents can discuss any issues/concerns as a group. We encourage residents to approach staff with any complaints/issues etc, we look resolving complaints as quickly as possibly in line with Organisations complaints policy. Complaints will be logged in our complaints book when they arise and are followed through in line with complaint’s policy. Service users have been made aware that they can make complaint directly to social services or CQC, contract address is in service users handbook which each service users as copy of in their files. All staff have recently attended safe guarding of Vulnerable adults training course on 20.7.09 and gained certification. There is information on wall in hall of procedures to take if feel any concerns re any abuse as taken place. Manager attended Deprivation of liberty training workshop.” Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Carranmore is a safe and comfortable living environment that is suitable for the needs and lifestyles of the people living there. EVIDENCE: All areas of the home are decorated and furnished to a good standard suitable for a domestic setting. There is an ongoing programme of maintenance and repairs that ensures the home is safe and well maintained. The AQAA states: “We do regular fire alarm checks and fire equipment checks, which are recorded in fire, log book according to organisations policies and procedures etc. Manager continues to update 6 monthly fire risk assessments. We have cleaning rota in place which all staff are aware of and sign sheet when completed cleaning tasks. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 19 We have a window cleaner who does windows on regular basis. Environmental Health Officer visits premises roughly once a year. All residents have their own rooms for privacy. All areas of home are regularly monitored by Manager /staff for any decoration or improvements that maybe needed. Freezer and fridge temperatures are carried out daily by staff. Smoking Shelter was built outside for service users who smoke. We have regular Gas appliance checks, which are organised by Impact Housing. There is a Laundry room and also washing line outside. Member of staff is trained fire warden who goes on yearly refresher courses. Staff on duty on evening check that all doors at front and back are locked. Service users are given front door key and key for bedroom door. Water Temperature checks are done re Legionella in line with guidelines and external contractors visit every 3 months to do agreed checks which were organised by Impact, all information is recorded in file in office. Portable appliance tests are done on yearly basis.” All the bedrooms are personalised in the way they are decorated with individuals able to put their own stamp on their rooms. People are able to choose the furniture and fittings that are suitable to meet their individual needs and lifestyles. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People using the 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 are supported by an increasingly well-trained staff team who have specialist knowledge of working with people with mental health problems. EVIDENCE: The service has robust recruitment procedures that include all staff having enhanced level CRB disclosure checks. Upon appointment staff are issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. The Croftlands Trust has a code of conduct and all members of staff have a statement of terms and conditions. A new member of staff interviewed confirmed these practices and had felt well equipped by the induction programme. The AQAA tells us: “We feel staff are trained to high standard and are encouraged to go on any training courses, which will develop their knowledge and skills. Staffs receive regular supervision and appraisals from Manager of the home. All staff have got at least NVQ Level 2 in care or higher. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 21 We also send staff on refresher training courses such as first aid, food and hygiene and fire training. All staff have worked at project a number of years and are experienced in all aspects of their work duties. Before staffs are allowed to work in project relevant CRB and POVA Checks etc are carried out by organisation. At point of recruitment applicants are given detailed job descriptions and person specifications. New staff are given statement of terms and conditions, key personnel policies and copy of code of conduct. After which 3 month probationary period is completed and then this is followed by 6 monthly appraisals. This would give project Manager indication if person would be suitable to work in project and provide good service for the service users and project and also work to standard expected by organisation.” And “All staff have a staff training matrix in their files which highlights training done and training which as been discussed with themselves and Manager in supervision/appraisals. The Manager has NVQ Level 4 award in care and also registered Managers award, is also NVQ Assessor. All staff have obtained AT LEAST NVQ LEVEL 2 award in care. All staff have completed Aset level 2 certificate in Managing and safe storage of medicines.” These facts where checked on inspection and this makes for a well trained and qualified workforce. Appropriate staff training is also being provided that gives staff the skills and knowledge they require. In addition to this supervisions and appraisals are now part of a Quality Assurance monitoring system for manager, and monthly returns are sent into the organisations HQ for monitoring. Staff reported they were having more regular supervision and felt well supported by the manager. All these measures are creating a more professional and skilled work force that are better able to support and promote peoples well- being. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People using the 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 manager is providing clear leadership and is making sure peoples rights and best interests are promoted and protected. EVIDENCE: The homes AQAA tells us: “Staff have been trained in various aspects of health and safety. Staff are encouraged to attend any health and safety training which would improve their knowledge and skills. We have our own Quality Assurance System in place which takes note of views of residents, family members, social workers, staff and care co-ordinators.” The AQAA recorded how the service is consulting with people in a number of ways to make sure their opinions and views are taken on board and Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 23 improvements made if required. We received overwhelmingly positive feedback from people who have used this service. The home had recently undergone a review of its service provision by social services contracts team, and had been complimented on very good progress to meet some outstanding requirements, and they now fully met the contract. The records we examined during this inspection visit were all securely stored in line with good practice and on the whole were well maintained and accurate. There was a good range of risk assessments in place that keep both people living in the home and the staff working there safe from identified hazards. Routine servicing and maintenance of equipment and services is taking place making sure both service users and staff are kept safe. Routine health and safety checks are being completed and recorded as required. Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.3 Page 25 Carranmore DS0000022570.V378247.R01.S.doc no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carranmore DS0000022570.V378247.R01.S.doc Version 5.3 Page 26 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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