Care Home: Cherry, Rowan and Aspen Villas Care Home

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What the care home does well The key principal of the service is that people who live there, or stay for a period of respite care, remain in control of their lives. The staff and the management team are fully committed to support people to lead purposeful and fulfilling lives. People spoken with confirmed that they make informed decisions and are supported to take risks in their daily lives. Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, in the home and the community and to enjoy all the rights and responsibilities of citizenship. The staff team understand the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. The service understands and actively promotes the importance of respecting the human rights of people using the service, with fairness, equality, dignity, respect and autonomy all being seen as central to the care and support being provided. The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who live there. The living environment is appropriate for people`s particular lifestyle and needs and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. The Expert by Experience reported as follows; "I feel the manager and the staff go out of their way to do everything they can to help the residents and treat them with total respect and care. I myself would love to live here as I feel that the staff go above and beyond their duty of care, which helps people live a long, happy and independent life." "I cannot say enough about how good this home is. It`s the best I have ever inspected." People living at the service told us "This is my home for good now. I am really happy here. "There is always someone there when I need them." "This is a very, very good place." What has improved since the last inspection? At the last inspection two requirements were made and these have both been met. A number of recommendations were made and have also been addressed. A third bungalow has been built providing accommodation for seven more people as well as office space. The service continues to develop in all areas and the management actively seek feedback from people to enable them to make any improvements possible. What the care home could do better: It would be very difficult to identify specific areas where this service could improve. However, there is always some scope to improve things and the manager has informed us of plans to create a sensory garden and to develop skills around supporting people who develop dementia. The bungalow used for respite care is to undergo some re-furbishment in the coming year. Key inspection report Care homes for adults (18-65 years) Name: Address: Cherry, Rowan and Aspen Villas Care Home Oakfield Lane Warsop Nottinghamshire NG20 0JE     The quality rating for this care home is:   three star excellent 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: Angela Starr     Date: 2 6 0 1 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: Cherry, Rowan and Aspen Villas Care Home Oakfield Lane Warsop Nottinghamshire NG20 0JE 01623842080 01623844034 cherryvilla@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Oaklands care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 20 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 Learning disability, Code LD Date of last inspection Brief description of the care home Cherry and Rowan Villas is a care home providing personal care and accommodation for 20 younger adults who have learning difficulties. The home provides 15 long-term beds and 5 respite beds and has dedicated beds for this purpose. The home is owned by Oaklands (formally known as Warsop and District Mentally Handicapped Association), which is a registered charity. The home is located in a residential area of Warsop and is close to shops, pubs, the post office and other amenities. The home was opened in 1986 and consists of 3 purpose built bungalows with a large community centre on the same grounds. All 20 of the homes bedrooms are single, and 10 of the bedrooms have en-suite facilities. The home is accessible for people with mobility difficulties. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 20 Brief description of the care home The home has extensive gardens with raised beds, sheds and greenhouses. There is a barbecue and garden furniture for people to enjoy in good weather. Most of the rooms overlook the garden area and some have direct access to the gardens and safe, enclosed patio areas. People may be assisted to care for pets, including guinea pigs, fish, a cockatoo and a dog. All outside areas are well maintained and easily accessible. There is ample car parking available. The home has its own accessible mini bus with hydraulic ramp as well as a car to enable people to travel for appointments and outings. The currrent fees range from £510.00 per week to £935.50 according to assessed needs. The current fees for respite care start at £560.00 per week. Care Homes for Adults (18-65 years) Page 5 of 30 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: three star excellent 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: The focus of Inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us about how well their service provides for the needs of the people who use it and how they intend to improve their service. We received this back from the manager within the required timescale and the form was completed in a satisfactory manner, providing us with information to assist in planning our visit and deciding what areas to look at. We also reviewed all the information we have received about the service since we last visited and we considered this in planning the visit and deciding what areas to look at. Care Homes for Adults (18-65 years) Page 6 of 30 The main method of Inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading their records and asking staff about their needs. An Expert by Experience assisted us with this inspection visit. This person looked around the accommodation, spent time with the people who live at the service and spoke with them, observing the interaction between staff and the people they are supporting. Their findings are included in this report. We spoke with three members of staff, four people who use the service and one relative to form an opinion about the quality of the service being provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who use the service. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: It would be very difficult to identify specific areas where this service could improve. However, there is always some scope to improve things and the manager has informed Care Homes for Adults (18-65 years) Page 8 of 30 us of plans to create a sensory garden and to develop skills around supporting people who develop dementia. The bungalow used for respite care is to undergo some re-furbishment in the coming year. 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 30 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 30 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 who want to live at the service have their needs fully assessed over an extended period to ensure that these needs can be met. People are given up to date and accurate information about the service that is provided. Evidence: The written information provided to us by the manager tells us We provide all the information about our home to prospective residents. We encourage tea/lunch visits, then an overnight visit. When we spoke with the manager about the information provided to people to inform their decision about living at the service we were told that anyone considering moving to the service has an extended community care assessment completed by a social worker. The person is then assessed by staff from the service to ensure that their needs and wishes can be met. Following the assessment, people are invited to visit the service and spend time getting to know the staff and the other people who live there. Family members are closely included in this process where appropriate. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: People are provided with opportunities to have meals and stay at Cherry, Rowan and Aspen Villas as part of a getting to know you process. People we spoke with who live at the service told us that they had visited several times before moving there. A relative told us that they had been included in this process and had felt that they had got to know the staff before their relative moved in. As part of our case tracking process we looked at the care files for three people who live at the service including the last person to move there. All three files contained thorough assessments of need as well as detailed person centred support plans which provided personal history, goals and aspirations. The files also contained copies of the service user guide and statement of purpose as well as contracts of residency. The manager told us that a new brochure is currently being developed to include the third bungalow Aspen, which has been built since the last Key Inspection took place. The manager and staff members that we spoke with were very knowledgable about each persons individual preferences. People we spoke with who live at the service told us I love living here. There is a friendly atmosphere and we all get on well. A relative we spoke with told us that they were given a lot of information about the service and felt it Exceeded my expectations. This is the best place for my relative. They had been in a few places before and had not been happy. Care Homes for Adults (18-65 years) Page 12 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in regular reviews of their needs and participate in the development of their support plans. People are supported to make decisions and take risks as part of a chosen independent lifestyle. Evidence: The manager provided us with written information which tells us All staff are trained in the need to allow our residents to make all their choices in all aspects of their life and care. We looked at care plans for three people chosen for case tracking and found them to be appropriately detailed providing staff with all the information they need to provide a high level of person centred support. All contained clear evidence of people being involved in the development and people we spoke with were aware of their support plans and what was in them. People told us that they make choices about how they are supported and they decide Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: what they want. All three files contained individual risk assessments as well as generic ones. People told us they do want to do things that may have an element of risk but that is their choice. Examples given were taking holidays abroad and getting involved in activities at the adjacent community centre. One person told us I help with the Charity shop and sell things. Each care plan had been developed in a format suitable for the individual person. Some contained a lot of pictorial information whilst others had more written down. Peoples personal goals are clearly recorded and as goals are achieved, new ones are identified. These vary in degree from person to person and include such things as caring for pets, attending exercise classes, swimming and a number of other activities in the local community as well as in the home. People told us I love to go out for a walk on my own. I like to go into town with staff, horseriding and swimming. All the support plans we saw had evidence of regular reviews taking place with the person and where appropriate, their relatives. Staff we spoke with were all aware of each persons individual likes and dislikes as well the necessary support required for them to achieve their goals and enjoy the activities of daily living. We were assisted at this inspection by an expert by experience who asked people if they had been involved in the production of their care plan. All four people spoken with replied Yes. They were also asked about the quality of the care and support they receive and all said this is good. People also told us that they are involved with any decisions that are made affecting their lives. Care Homes for Adults (18-65 years) Page 14 of 30 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 at the service experience a fulfilling lifestyle. The staff team are committed to promoting peoples rights and maintaining peoples dignity. Individual goals are identified and achieved and people are enabled to make choices and exercise preference. Evidence: The written information provided by the manager tells us Our residents join in courses that are available, healthy lifestyles, skills for life etc. We support our residents to make their own choices and to be independent. The files we looked at, including the records of activities, showed us that people are pursuing activities of their choice on a daily basis. The activities are extremely varied and many people are supported on a one to one basis to ensure that their individual Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: requirements and wishes are met. A number of activities take place in the adjoining Community Centre including Bingo, Dances, Parties, Coffee mornings, Charity Shop and Exercise classes. People living at the service are supported to attend any of these events and told us I love playing Bingo. I like shopping in the Charity shop. I like the dances and things where we meet our friends. Further activities include playing games, doing puzzles, watching DVDs, videos, music and barbecues in the better weather. People are also supported to go swimming, bowling and a number of other activities outside the home. One person showed us photographs and told us about the holidays they have been on. People told us that they receive visits from family members who join in some of the activities. We spoke with one relative as part of this inspection and they confirmed that they feel very involved in the lives of their relative living at the service. This is a very, very good place. My relative is happy and keeps busy. Peoples rights and responsibilities are fully supported and evidence of this was seen in the care plans as well as observed at the time of the inspection. On the day of the inspection we saw one person choosing to go swimming with staff, another person spent the morning helping in the weekly Charity shop that takes place in the adjoining community centre and we observed other people shopping at the charity shop. We observed a person to be occupied doing puzzles on a one to one basis with a member of staff and a number of people who appeared to be happily occupied in their rooms listening to music, watching T.V. etc. We observed people to be happy and occupied throughout our visit. The dining rooms appear to be the favoured areas where people spend time interacting with each other and with the staff. The dining rooms are spacious and provide a comfortable area for people to enjoy their meals. The menu is varied and is produced in conjunction with the people living at the service. People told us I usually have what I want to eat. I am doing healthy eating because I want to lose some weight. People told us that the food is Great and there is plenty of it. People told our Expert by Experience that they have a choice about the food they eat. One person said I love it here. I have never been happier. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People told us they are included in the meal planning, preparation and they enjoy helping to clear away and wash up after meals. A number of people living at the service have been awarded cerificates for courses they have attended including Healthy hearts. Healthy eating. and Smile, no bullying. One person told us I enjoyed doing these and feel better with what I have learnt. Staff we spoke with told us This is a lovely community to be part of. We are always out and about, going swimming, to the pub and socialising. Care Homes for Adults (18-65 years) Page 17 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are receiving personal support in the way they prefer and require, and their health care needs are met. Evidence: The manager told us in the written information she provided, We produce person centred care plans which involve the residents and where appropriate, next of kin. We also devise a health action plan, using a traffic light system which indicates areas of importance. As part of our case tracking process we looked at support plans for three people and saw that they were developed in a person centred way and the person they related to had been involved. Support plans had been agreed and signed by the person or their representative. People we spoke with were very confident that their wishes had been recorded and were being met where possible. Evidence of health intervention was clear and there were records of involvement from other professionals. e.g. Doctors, specialist teams such as the speech and language therapy service, district nurse intervention, opticians, physiotherapists etc., Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: We saw evidence that peoples emotional needs are also addressed and where possible they are met. People told us that there are regular residents meetings and they feel confident to contribute to these and to raise anything of concern. The manager told us that day to day issues are always dealt with on an individual basis. People told us that if they want to see the Doctor, they ask the staff and an appointment is made. Staff do accompany people for appointments as necessary according to peoples wishes and needs. One person said I need the staff there to explain things to me and help me remember. The manager told us that if a person is admitted to hospital a member of staff stays with them throughout their waking hours to alleviate any unnecessary anxiety. During the course of this visit to the service we spoke with a nurse who is currently involved in a persons care whilst in hospital. She told us The staff from the home are excellent. They really work hard with the person to make sure they are happy and occupied whilst they are in hospital. People get better quicker that way because they dont get as anxious. A relative told us They always go over and above what we would expect to make peoples lives better. As part of our case tracking process we looked at the medication administration records for the people chosen. All the records were accurately completed and signed. We also looked at the risk assessments for people to manage their own medications and found that there is currently no-one at the service who is assessed as being able to do this. The storage, ordering and disposal of medication was checked and found to be in order. There are currently no controlled drugs being prescribed for people but there is a suitable storage facility and record book if this changes. Training records showed us that staff have undergone medication training. Staff we spoke with were knowledgable about the medication policies and practices and the importance of clear and accurate record keeping. Care Homes for Adults (18-65 years) Page 19 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service are protected from potential abuse and harm and their views are actively sought, listened to and acted on. Policies and procedures are understood and are followed correctly by the staff team. Evidence: The manager told us in the written information she provided Everyone is trained in Safeguarding of Adults. We have a complaints procedure in place with picture format for all our residents and they are aware of this. New residents and people who stay for respite care are informed of this. We saw the complaints procedure clearly displayed in a suitable format for the people who use the service. People we spoke with told us that they know how to make a complaint and would always tell someone if they werent happy about anything. We were assisted with our inspection by an expert by experience who told us that the complaints format was good and easy to understand and follow. Staff we spoke with were all knowledgable about the services complaints procedures as well as the Nottinghamshire County Councils Safeguarding Adults and Whistle Blowing policies. As part of our case tracking process we looked at files for three members of staff and Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: also at training records. We saw that all staff have undertaken training in safeguarding. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk. Whistle Blowing is a means for staff to feel supported to report anything of concern that they may witness. Staff were very confident that they would always report anything of concern and would always listen to anyone who was unhappy. Staff we spoke with told us If I ever have any problems or concerns about anything the office is always open. The manager is very good. Relatives we spoke with said they had never had to complain but would if they thought something was wrong. Regular residents meetings take place to ensure that people have a forum to discuss anything of concern. Advocacy services are made available to anyone who requires this support. People spoken with confirmed this. We looked at the records of complaints and saw that none had been recorded. The manager assured us that this is because anything that is raised as a concern is dealt with immediately, therefore people do not feel they need to complain. The Key worker system also supports people to make any concerns known and enables staff to deal with things as and when they may occur. People spoken with all know who their key workers are and told us that they feel supported with their communication. I have never had to complain. They talk about everything with me. Care Homes for Adults (18-65 years) Page 21 of 30 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. The home provides a physical environment that is appropriate to the needs of the people living there and is well maintained. Evidence: The written information provided to us by the manager tells us Our bungalows are furnished to a high standard and the bedrooms are individual with everything chosen by the residents. We have a games room, conservatories, and a large garden which is accessible to everyone. We have up to date baths with chair hoists, some walk in shower rooms and some bedrooms have ceiling hoists. Ten of the twenty bedrooms have en-suite facilities. We undertook a partial tour of the service and looked at all communal areas and some peoples bedrooms. All areas of each bungalow were clean, comfortable and welcoming. Peoples bedrooms were furnished and decorated with colours and items of their choice making each one individual and personal to the person. A number of rooms have direct access to the garden, enhancing peoples independence. The expert by experience who assisted us with our inspection stated that his first impression was that the bungalows reminded him of a day centre because the communal areas did not have photographs and were less personal than peoples Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: rooms. We discussed this with the manager and she told us that she would raise this with the people who live at the service and would address this in accordance with their wishes. However, he also reported that All three of the bungalows are of a very high standard There are thick carpets and the decoration looked new and fresh. Each bungalow has a lounge and kitchen/dining area. The rooms are spacious, light and airy with modern and comfortable furniture. On the day of this inspection visit we observed that people gather in the kitchen where they socialise with each other, staff and visitors. People told us that they enjoy being outside when the weather permits. The gardens are extensive and are very well cared for. There are patio areas and a variety of garden furniture. People told us that they often have barbecues and eat outside in the summer. Our Expert by Experience commented The garden area is very nice and pretty. Staff help people grow their own fruit and vegetables and the residents really enjoy their home grown tomatoes. The adjacent community centre is a very popular venue for the people we spoke with. They told us that they enjoy going to the many functions and activities that take place there. Because of its proximity to the service, some people are able to go there independently and feel very involved with the local community. Care Homes for Adults (18-65 years) Page 23 of 30 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. Recruitment practices, training and support for staff are well managed providing good outcomes for people living at the service. The home is run in the best interests of the people living there. Evidence: The written information provided to us by the manager tells us All staff have Criminal Record Bureau and Protection of Vulnerable Adults checks before they commence employment. Two written References are obtained for all new staff. As part of our case tracking process we looked at files for three mebers of staff and observed that all relevant and necessary documents were in place. These incude an enhanced Criminal Record Bureau and Protection of Vulnerable Adults check, a minimum of two written references and proof of identity. Staff we spoke with confirmed that these had been in place before their employment commenced. We were also told by the staff we spoke with that they had a period of induction where all mandatory training was delivered. They worked alongside an experienced member of the staff team until they were competent to work independently. Staff told us that training is always available to cover anything relevant to their work and the records we saw confirmed this. All staff have had mandatory training such as moving and Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: handling, food hygiene, fire safety and Health and Safety. Other training that has been provided has included; Equality and Diversity, Medication training, Mental Capacity Act as well as some training to enable staff to gain a better understanding of specific health conditions. Staff spoken with told us that they receive regular supervision which they find useful and it provides an opportunity for them to identify any training they wish to undertake. We were told This is a brilliant place to work. Its lovely working here. People living here are very happy. Our Expert by Experience reported The manager and the staff go out of their way to do eveything they can to help the residents and treat them with total respect and dignity. Care Homes for Adults (18-65 years) Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openess and respect. There is an effective quality assurance system to ensure the service runs in the best interests of the people living there. Evidence: The written information provided to us by the manager tells us The registered manager has 20 years experience. She has achieved the Registered Managers Award, National Vocational Qualification level 4 and has just completed level 5. The two Deputy Managers have NVQ 4, and the Funding/Office Manager has a Diploma in Business Practices, NVQ 3 in Business Administration and Customer Service. The manager has worked at the service since it opened and she has been the registered manager for the last ten years. We found the manager to be very knowledgable about all the people who live at the service and about the staff. She has established good working relationships with social services, health practioners and specialist service providers as well as with the local Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: community and the extensive list of volunteers who help with fund raising and social activities. Weekly meetings are held with staff and residents and every two months this is extended to family and friends of the residents. These meetings are structured to ensure that all feedback is captured and any necessary actions are then implemented as soon as possible. The quality assurance system is based on the Quality Tree and the people we spoke with were familiar with this and understood that it is a mechanism for them to record their views and opinions of the service. People spoken with were confident that their views are listened to and acted upon and they feel part of any decision making. The buildings each have a maintenance programme in place and the maintenance person works full time to undertake all the work. Decorating and improvements are on-going. The service is non-profit making and therefore any income is used to make improvements in any area identified. The manager told us that the plans for the coming year are focussed around the bungalow that is used for respite. People we spoke with told us Top marks for Brenda. She is a wonderful manager Staff told us that the office is always open to them and they feel valued and supported by all the management team. We saw the records of accidents and incidents and five had been recorded since the last Key Inspection. The actions recorded in response to each of the entries were appropriate. All the evidence that we saw indicated to us that the home is run in the best interests of the people who live there. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 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). 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