Care Home: Cavendish Lodge

Similar services:

• The Lodge Nursing Home
• Bracken House
• Sunnycroft
• Field Farm House
• Edgeview Nursing Home
• Church Terrace Nursing & Residential Home
• The Forbury

What the care home does well Peoples` needs are thoroughly assessed and they are encouraged to visit and see what the home has to offer before they make a decision to live there. Peoples` support plans are detailed and informative, ensuring that staff are able to meet individuals` assessed needs. Risk assessments enable people to take meaningful risks in a safe manner. People are actively supported to make decisions about their lives both on a daily and more long term basis as they progress through their recovery journey. The home supports people to be at the centre of their recovery, working within them at their own speed and ability. Activities are offered to people on a weekly basis, and people are able to choose whether to participate or not. A healthy, balanced diet is available for people. Personal support is provided sensitively and discreetly where necessary, in line with individually assessed needs. The health and wellbeing of people is promoted via attendance at routine and more specialised healthcare appointments as necessary. Medication is managed safely on peoples` behalf. The home has both a complaints policy, confidential compliments and complaints box and an adult protection policy in place. Records indicated that seven complaints have been received by the service, all of which were investigated in line with the homes procedures. We have not received any complaints about the home since the previous inspection in January 2009. Staff were aware of their responsibilities regarding adult abuse. No allegations or suspicions of abuse have been received by us. The home is nicely decorated and furnished with good quality furniture and soft furnishings. The opportunity to personalise individual space is available for people. The home employs satisfactory staff numbers on a permanent or bank basis to meet peoples` ongoing and changing needs. The staff team demonstrate a commitment to supporting the people resident with their ongoing rehabilitation. The homes training programme ensures that people are supported by a competent and sufficiently knowledgeable team. The home has a quality monitoring system in place that ensures that peoples` views are at the forefront of service development. Health and safety is managed effectively within the home. What has improved since the last inspection? Since the last inspection the home has worked to meet the requirement made regarding medication, which means that clear records of any returned medications are now maintained. In addition the home has also implemented the following good practice recommendations: Peoples` needs are thoroughly assessed during the six week assessment period potential new residents undertake. All non blistered tablet medication is now stored in it`s original packaging. Clear records are available to confirm that all staff working in the home have had Criminal Records Bureau disclosures. All required health and safety tests and checks are maintained within the required timescales. What the care home could do better: The following requirement has been made against the Care Standards Act 2000 as a result of this key inspection visit: The person managing the home must apply to register with the Care Quality Commission to manage a registered service as without being registered is a breach of the Care Standards Act 2000. In addition to the above requirement the following good practice recommendations have been made: The statement of purpose should contain accurate and current information about the service so that prospective residents are correctly informed. All staff should undertake training in safeguarding vulnerable adults from abuse so that people who use the service are safeguarded. The provider should consider whether it is necessary to render certain parts of the home inaccessible to people, and consider the impact of this on individuals where these areas do not pose any risk. Key inspection report Care homes for adults (18-65 years) Name: Address: Cavendish Lodge 41 Leam Terrace Leamington Spa Warwickshire CV31 1BQ     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: Justine Poulton     Date: 0 9 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: Cavendish Lodge 41 Leam Terrace Leamington Spa Warwickshire CV31 1BQ 01926427584 F/P01926427584 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.rethink.org Rethink care home 8 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 can be accommodated is: 8 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 (MD) 8 Date of last inspection Brief description of the care home Cavendish Lodge is a nursing home for eight people with mental ilness, which is part of the Rethink Organisation (formerly NSF). The Home is situated within walking distance of the town centre and local parks. The home aims to provide a supportive residence in which eight people with enduring mental health disorders can have a sense of belonging, be treated with respect and exercise choice in their daily lives. Each individual is encouraged to participate in activities suited to their own needs and wishes, to access local resources and facilities and to manage social and family relationships beyond the home. Through the long term development of trust between Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 1 6 0 1 2 0 0 9 Brief description of the care home individual people and staff, the fostering of hope and focus upon strengths, the home endeavours to enable people to approach their potential and to achieve some recovery in the quality of their lives. The range of fees for this service were not made available on this visit. The reader may wish to contact the home directly for this information. 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: This inspection was a key inspection. A key inspection addresses the essential aspects of operating a care home. This type of inspection seeks to establish evidence of safety and positive outcomes for the people using the service. The inspection focused on assessing the main Key Standards as defined under the Care Homes Regulations 2001. As part of the inspection process we reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents and complaints. We also sent an Annual Quality Assurance Assessment (AQAA) to the manager to complete. The deputy manager completed and returned the annual quality assurance assessment (AQAA), containing helpful information about the home in time for the inspection. The inspection included meeting all of people currently resident in the homeand case Care Homes for Adults (18-65 years) Page 6 of 29 tracking the needs of two people. This involves looking at peoples care plans and health records and checking how their needs are met in practice. Other peoples files were also looked at, in part. Discussions were held with the deputy manager, as well as with all of the people currently resident and four staff members. A number of records, such as support plans, complaints records, staff training information and health and safety records were also sampled for information as part of this inspection. We asked an expert by experience to meet with people who use the service. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a home with an inspector to help them get a picture of what it is like to live in or use the service. Their findings are also included in this report and used as evidence when assessing the quality of service provided at the home. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? Since the last inspection the home has worked to meet the requirement made regarding medication, which means that clear records of any returned medications are now maintained. Care Homes for Adults (18-65 years) Page 8 of 29 In addition the home has also implemented the following good practice recommendations: Peoples needs are thoroughly assessed during the six week assessment period potential new residents undertake. All non blistered tablet medication is now stored in its original packaging. Clear records are available to confirm that all staff working in the home have had Criminal Records Bureau disclosures. All required health and safety tests and checks are maintained within the required timescales. 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 9 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 10 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 considering moving into this home can be confident that their assessed needs will be met. Evidence: The home has a statement of purpose in place which informs prospective new residents about the services that the home offers and can provide. This may be misleading to prospective new residents however as reference was made within it to one of the organisations other homes. Similarly, reference is still made to the Commission for Social Care Inspection based in Leamington Spa. These were discussed with the deputy manager who undertook to update the statement of purpose so that the information it contained was current and accurate. The home has a thorough admission process in place that includes a flexible six week assessment period. Records were seen within peoples files looked at of referal application documentation completed by appropriate healthcare professionals, alongside the homes own assessment documentation. Records of prospective new residents visits to the home inline with the six week assessment period were also Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: available within the files looked at. Care Homes for Adults (18-65 years) Page 12 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 living in this home can be sure that their assessed needs willl be met via a support mechanism that encourages individual recovery. Evidence: This home makes use of the Mental Health Recovery Star programme with the people that live there. This is a programme which sits at the centre of the homes ethos of ensuring the person is at the centre of their own recovery by nurturing a safe and secure environment whereby people can feel supported and thus aid their own recovery at their own speed and level. Two people were chosen for case tracking purposes to inform this inspection visit. Both of these people had completed star recovery paperwork pertaining to their individual assessed needs in place. This clearly detailed where each person was at in their recovery journey, and the levels of care and support required from the staff. In addition to the care plans within the recovery programme, risk assessments were Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: also available. These pertained to each identified area of need and were written in such a way as to enable the person concerned to take meaningful risks within a safe framework. They also detailed where neccesary any risk to a persons health based on particular behaviours that were being displayed. It was apparent from reading the recovery plans of the people case tracked, and by talking to staff within the home that the empasis on recovery is very much the individuals. Staff are clearly working towards encouraging them to reclaim control over their lives by encouraging independance where possible, whilst providing a safety net of support to underpin the ethos of recovery within the home. As such people were observed to make decisions for themselves within their recovery journey as much or as little as they either wished or were able. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in this home continue to benefit from improved opportunities to take part in social activities. People are offered nutritious healthy meals, and are able to participate in food preparation if they wish. Evidence: It is recorded in the AQAA that individual activity and lifestyle requirements of service users are identified in many different ways. Some of these are through residents meetings, one to ones and spending time with service users listening and taking forward their opinions. In conversation with people living in the home one person said that she enjoys going to art club, walking the dog and going out to the local shop when she wishes. This person also said that they enjoyed regular visits from their relatives, and was looking forward to a visit soon. Another said that he enjoyed doing what he wanted when he wanted with no pressure Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The expert by experience who participated in this inspection spent time talking to the people currently living in the home. She recorded that one person she spoke with said he visits a centre called The Bank twice a week, and would like to go to an Elton John lookalike concert locally, whilst another said he goes out but not very often. It was her impression from observing people and talking to them that people living in the home have very little motivation and they were on the whole just existing there. This was discussed with the deputy manager on the second day of the inspection where she advised that she could understand this impression from a short observational visit to the home as each person currently resident has been using services for a considerable amount of time and have become to a certain extent institutionalised. She advised that this is one of the areas that is worked on via the recovery star programme. It was apparent from loooking at the files of the people chosen for case tracking that they are at the centre of their daily acitivity choices, and decide what they wish to do dependant on how they feel. Staff spoken with said that the best they can do is offer appropriate activites to people on a regular basis so that they are able to make the choice. The AQAA records that people are offered a variety of activities based on their lifestyles and interests which include meals out, making use of the local community, organised daytrips or holidays and tending to the homes allotment. The deputy manager records in the AQAA that the maintenance of the increase in staffing levels since the last inspection continues to allow more activites to be offered to people, but she recognises that this still needs to improve in order to be able to increase the number of new experiences that service users are able to sample whilst supporting people to move towards greater independence in pursuing their chosen activities with minimal staff support. A number of people living in the home have plans in place via the recovery star in relation to nutrition and meal preparaton. During this inspection visit people were preparing their breakfast and lunch in line with these plans. Main meals are planned with people on a weekly basis and a menu is available for people to choose from. Meals provided are nutritious and follow healthy eating guidelines, however people are able to choose an alternative, go out to eat or phone in a takeaway if they so choose. All of the people spoken with commented that the food provided by the home is good the food is really nice, excellent food, particularly the cauliflower. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with personal support sensitively and discreetly where necessary, in line with individually assessed needs. Peoples health and wellbeing are promoted via attendance at routine and more specialised healthcare appointments as necessary. People can be confident that their medication is managed safely. Evidence: Two peoples recovery plans were looked at for case tracking purposes in relation to their personal and health care needs. Information was available within both plans looked at regarding personal care needs, and clearly detailed how support is to be provided. These were signed by the individuals concerned. As at the previous inspection of the home, staffing is still arranged to ensure that both genders are catered for, with a male and a female staff member on duty. The staff on duty during the inspection visit were clearly sensitive to peoples individual needs and were seen to interact with individuals in a manner that was clearly acceptable to them. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: As a mental health nursing home the home has a qualified RMN nurse on duty each shift. This ensures that there is always a professional element to monitoring and guaging the current state of peoples mental health available so that intervention can be provided if it becomes necessary. Records were available to confirm that people are supported with maintaining their health both via attendance at routine appointments such as the dentist or opticians, and with other associated healthcare professionals namely, psycology and psychiatry services, district nurses and community mental health nurses. Medication is supplied to the service by a local pharmacy utilising a multi dispensing system (MDS). This is accompanied by medication administration record charts (MARs). Any medication that is not suitable for the MDS is accounted for via daily stock control measures on a separate chart that is signed by staff to confirm the number of tablets received and administered against the number that are left. All of the medication is stored within a wall mounted lockable cabinet. Each persons name was clearly labled on a shelf within this cabinet for the storage of medications that were not in the MDS. A photograph of each person was at the front of their MAR chart to aid with ensuring that medication is given to the correct person. The qualified nurses employed by the home are responsible for administering medication to people. It was noted and observed that where identified in the recovery plan, people were given the responsibility of asking for their medication as a means of giving them some ownership of their care and treatment. Consent to receiving medication sheets were available within the files looked at. These were signed by the individuals concerned. The MAR charts looked at were completed accurately and codes for non administration were used appropriately. The requirement for ensuring that all medications returned to the pharmacy are accurately recorded has been addressed. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that their views are listened to and acted upon, and that they are protected from abuse, neglect and self-harm. Evidence: The home has a compliments and complaints policy in place. This is displayed in the home and is accompanied by a confidential compliments and complaints box for people to use. Two people were asked if they know how to make a complaint or raise a concern. Both said they did, and that they would speak to the staff or manager. One person said I dont have any grumbles but I know what to do if I did. The AQAA records that service users are... encouraged to raise any concerns or make complaints at residents meetings...one to one meetings or in service user satisfaction surveys. As well as a complaints policy the home also has policies and procedures on safeguarding vulnerable adults from abuse. Records indicate that this was updated in October 2009. It is recorded in the AQAA that all staff have attended POVA training. Training records of one person show that they have not done any training in this area during the last three years. This staff member was spoken to about safeguarding vulnerable adults was knowledgeable about what would consitute abuse, and what she would do if she suspected, witnessed or had an allegation of abuse disclosed to her. Each person has a financial profile and plan in place. These range from the home Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: having no involvement with peoples monies, to providing varying degrees of financial support. The AQAA records that the system now in place is a more robust recording system that allows people more financial independence. Staff spoken with confirmed this and said that it has helped certain individuals maintain their mental health equilibrium as they are now aware of their finances and feel in control of them. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from uncluttered and spacious communal and personal areas, which are kept clean and tidy. Peoples rights may be impinged upon through the inaccessibility of some areas within the home. Evidence: The home is a large three storey victorian building in a leafy residential area of Leamington Spa. It is not easily recognised as a nursing home as it blends well with neighbouring surroundings. The home comprises a large lounge and a large smoking room, bathroom, laundry, kitchen and office with clinic on the groundfloor, with the bedrooms and additional bathrooms and toilets on the first and second floors. The communal rooms were nicely furnished and decorated. Two poeple showed us their bedrooms. These were both personalised to individual tastes, and both people commented on how much they valued their personal space. Since the previous inspection the downstairs bathroom has been refurbished and redecorated. The deputy manager said that maintenance work within the home is Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: ongoing as necessary. The expert by experience commented in her report that she found the laundry room and various cupboards in the kitchen to be locked, which indicated a lack of trust in the residents ability to look after themselves. We didnt see any records to indicate why these were locked and as such unaccessible to the people living in the home. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home can be confident that their immediate and ongoing mental health needs can be met by appropriately trained and qualifed staff. Recruitment procedures in place ensure that people are protected from potential harm. Evidence: The home employs seven permanent staff plus a deputy manager. In addition eight further staff are employed as bank staff. This enables the home to be staffed by two people per shift and one over night. The staff team is made up of one qualified nurse and one Mental Health Recovery Worker (MHRW). The night staff is either a qualified nurse or a MHRW. Staff spoken with said that they felt that this was acceptable given peoples individual abilities, but additional staff would be nice to enable more activities to be offered. In addition to the two staff on duty, the deputy manager works two ten hour shifts in the home and is available during this time should additional hands on support be required. The home also offers placements to student nurses via Coventry University. During this inspection, there were two staff on duty for both day shifts plus a student nurse on the first day. On the second day of the visit the deputy manager was also available. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The administrator for the home advised that there have not been any new staff recruited since the last inspection visit in January 2009. Three staff recruitment files were looked at to confirm that the home operates a robust recruitment procedure that protects people from potential harm. These all included the necessary documentation of a Criminal Records Bureau disclosure, proof of identity, full employment history, confirmation of registration with the Nursing and Midwifery Council for the qualified nurses, and in two files, two written references. The third file only contained one written reference, but the staff member concerned had commenced work at the home some considerable number of years ago. The deputy manager was reminded of the importance of ensuring that two written references are obtained for all newly appointed staff members. The homes administrator has produced a training matrix for all staff since the last inspection that shows exactly what training has been undertaken by staff and what refereshers are due when. This indicated that staff have up to date training in the mandatory areas such as basic food hygiene, first aid and fire safety. in addition staff have received training in medication awareness and administration, infection contol, wellness recovery action planning, mental health awareness, recording skills for care workers and core communication skills. Information in the AQAA states that all of the permanent staff have achieved NVQ II or above in Care or Health and Social Care. this was confirmed by the deputy manager and staff spoken with. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home do not benefit from having a registered manager in post therefore they cannot be confident that the service is managed in their best interests. An effective quality monitoring system ensures that peoples views are at the forefront of service development. Evidence: The home has not had a registered manager for at least two years. The acting manager in post at the last inspection of the home has been replaced by a deputy manager. The person managing the home must apply to register with the Care Quality Commission so that people can be confident that the service is being managed by someone who is appropriately qualified and experienced, and in accordance with section 11 of the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Staff spoken with during the inspection spoke highly of the deputy manager saying that they felt she had brought a period of stability and improvement to the service. Positive relationships and interactions were observed between the deputy manager and both the people living in the home and the staff team. The home routinely undertakes an annual quality review that looks at all aspects of the service provided. This takes into account the views of the current residents, staff and other key stakeholders to ensure that they are at the forefront of service development. Questionnaires sent to people living in the home in March of this year indicate a genaral satisfaction with the service they receive, however four people did indicate that they would like more in house activities to be offered. Records of discussions with the four people concerned were available along with how the home could imporve in this area. Surveys were sent to other interested parties in August of this year. At the time of the inspection visit the return of these was still awaited. In addition to the surveys, the home measures the quality of the service it provides through one to one consultations with the people who live in the home as part of their ongoing recovery programme, more formal minuted meetings for the people who live in the home on a regular basis, minuted regular staff meetings and unannounced, recorded visits by senior managers of the organisaiton in line with regulation 26 of the Care Homes Regulations 2001 which requires providers to monitor the service they provide on a regular monthly basis. Health and safety is maintained within the home. Dates of when the most recent maintenance checks were undertaken were provided in the annual quality assurance assessment (AQAA). A sample selection of health and safety records which included fire alarm tests, portable appliance testing, the gas safety certificate and water temperatures all confirmed that they were in place and up to date. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The statement of purpose should contain accurate and current information about the service so that prospective residents are correctly informed. All staff should undertake training in safeguarding vulnerable adults from abuse. The deputy manager should consider whether it is necessary to render certain parts of the home inaccessible to people, and consider the impact of this on individuals where these areas do not pose any risk. 2 3 23 24 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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