Care Home: Cherrycroft

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What the care home does well Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Each person`s needs are assessed in detail before they are offered a place in the home. When a person moves into the home staff develop a care plan with them. Care plans describe how they person was to be supported and includes details of what the individual likes, disliked and what makes them happy or unhappy. Residents are well cared for. They receive the medical treatment they need as part of their ongoing care and see a doctor promptly if they are unwell. Residents have opportunities to participate in a wide range of activities and to spend their free time doing the things they like to do. Residents receive a healthy and balanced diet, which includes meals and food that individuals choose. Staff treat residents well and listen to what they say. Complaints and concerns are taken seriously and staff are trained to recognise and report any poor practices or ill treatment of people living in the home. Staff are recruited thoroughly and trained so that they can meet the needs of residents. The home is clean and safe. The home is well managed and resident`s views are obtained so that the service they receive can be improved. What has improved since the last inspection? Staff have received training and understand the home`s and local safeguarding policies and procedures for safeguarding residents from harm. What the care home could do better: The homes complaints policy and procedure could be made available in a more user friendly version. When the home uses temporary agency staff they should check whether these staff have received training in supporting people who have a learning disability. Key inspection report CARE HOME ADULTS 18-65 Cherrycroft 59 Crowstone Road Westcliff On Sea Essex SS0 8BG Lead Inspector Carolyn Delaney Key Unannounced Inspection 15th June 2009 10:30 Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherrycroft Address 59 Crowstone Road Westcliff On Sea Essex SS0 8BG 01702 343654 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) s.gontsi@precisioncare.co.uk ACH of London LLP Sarah Louise Gontsi Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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: Learning disability - Code LD Physical disability - Code PD The maximum number of service users who can be accommodated is: 10 12 April 2007 2. Date of last inspection Brief Description of the Service: Cherrycroft is a detached home just off the main London Road area in central Westcliff on Sea. The home provides accommodation in 10 single bedrooms all of which have an ensuite facility. There is a communal lounge/conservatory, a lounge/dining area and an activities room. There are other utility/communal facilities. The home is decorated and furnished to an excellent standard. The home has easy access to public transport and local community facilities. The current range of range from £1200.00 to £1610.00 per week. Additional charges are specified with the Statement of Purpose. Fees are assessed on an individual basis according to care needs and requirements. Copies of the home’s Statement of Purpose/Service User’s Guide are available from the home upon request. These documents are in a ‘user-friendly style. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. This was a routine unannounced inspection, which included a visit made to the home between the hours of 10.30 and 18.00 on 15th June 2009. The last inspection was carried out on 12th April 2007. As part of the inspection process we reviewed information we had received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they do well, how they evidence this and the improvements made within the previous twelve months. When we visited the home we looked at residents care plans and information available to staff to help them support residents. We looked at how staff were recruited to work in the home and how they were trained to support residents. During the inspection we spoke with three residents, three members of staff, and the manger and deputy manager of the home. We looked at how the home was managed and how residents were involved in this. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the service does well: Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 6 Each person’s needs are assessed in detail before they are offered a place in the home. When a person moves into the home staff develop a care plan with them. Care plans describe how they person was to be supported and includes details of what the individual likes, disliked and what makes them happy or unhappy. Residents are well cared for. They receive the medical treatment they need as part of their ongoing care and see a doctor promptly if they are unwell. Residents have opportunities to participate in a wide range of activities and to spend their free time doing the things they like to do. Residents receive a healthy and balanced diet, which includes meals and food that individuals choose. Staff treat residents well and listen to what they say. Complaints and concerns are taken seriously and staff are trained to recognise and report any poor practices or ill treatment of people living in the home. Staff are recruited thoroughly and trained so that they can meet the needs of residents. The home is clean and safe. The home is well managed and resident’s views are obtained so that the service they receive can be improved. 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. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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, 4 & 5 People using the 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 who move into the home know that their assessed needs will be met in the way they chose. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that information about the home, the surrounding area and the organisation was available in a suitable format for residents to understand. They also told us that each person’s needs would be assessed and there was a transition process for people to move into the home, which included visits and overnight stays. When we visited we looked at the information, which was available about the home and the arrangements for assessing a person’s needs. We spoke with staff and residents and we looked at the home’s service user’s guide. Each person had a copy of this document in their care plan. There was detailed information about the home’s layout and facilities including photographs of communal areas. There was information about staff who worked in the home, including a photograph of the manager. The information was supplemented with picture references to help people understand. The document contained Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 9 information about the local area including photographs of the seafront, the high street and other areas of interest. The document also had information about advocacy services and how a person could complain if they were unhappy. We looked at the assessments, which had been carried out for two people before they moved into the home. The needs of both people had been assessed in detail by the manager. Information provided by others such as family and health and social care professionals involved in the care of both individuals was used to help determine that the home would suit the person’s needs. There was comprehensive information about each individual’s needs and the assistance they needed to carry out activities of daily living such as washing and dressing, eating and drinking and mobility. There was information about the person’s health and medical conditions and the treatment and support the individual needed to manage these. There was an assessment of the person’s ability and method of communicating with others. The manager looked at how each person formed relationships with others to help determine if they would be compatible with the people already living in the home. Following the assessment the manager made the decision as to whether the person’s needs could be met at Cherrycroft. We spoke with staff and they told us that they develop support plans for people when they visit the home as part of the transition period. We spoke with three residents. While they could not tell us about their experiences of moving into the home, they said that they were happy and liked living there. One resident said ‘I like it better here (than their previous home) it is quieter, I don’t like noise and I like the staff and people who live here’. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 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. Resident’s needs are met well and they make choices about how they live their lives. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that each resident has a care plan, which was developed with them and reflects their choices. They told us that residents were involved in planning support and making choices about their lives. When we visited the home we looked at how staff supported residents in making decisions and choices about their lives. We looked at the care plans for two people. Each person had an ‘about me’ section of their care plan. We saw that there was detailed information, which described each person’s likes, dislikes, interests and aspirations. Staff recorded what made residents happy, unhappy or angry and information was recorded so that it reflected how each individual and was supported. There were photographs Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 11 and pictures to help the person understand their care plans. Information was reviewed regularly and amended where there were changes to the person’s needs. We saw from reviews of care, which had been carried out that residents had settled well in the home, were making improvements, achieving their personal goals and they were happy living in the home. We saw that one person’s mobility had improved so much since moving in that they could now access pursuits within the community which they would previously not been capable of doing. We looked at how risks to each individual were assessed and managed, while allowing people to live their lives as independently a possible. Risks to resident’s health, welfare and safety were assessed and they were supported to go out, manage money and to participate in activities such as cooking. Residents made choices about the holidays and activities they wished to participate in and staff supported individuals on holidays of their choice. We saw that one person was being supported to live their lives more independently and they had their own semi self contained accommodation, which included cooking facilities. The resident told us they could ‘buy and cook their own food and be independent’. Residents we spoke with told us that they were happy living in the home. One resident told us that they chose the colour of their bedroom. Another person said ‘I am happy here, everything is good’. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 17 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Cherrycroft enjoy a lifestyle which suits them and reflects their choices. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that residents were supported to develop as individuals. They told us that staff had received training in inclusive communication techniques such as makaton and objects of reference. They told us that there was a full activities programme based upon on the wishes of residents and that residents were encouraged to be part of the local community. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 13 When we visited the home we looked at how staff supported residents in enjoying a lifestyle which reflected the person’s choices. We saw that there was a detailed plan for the activities each person participated in each week. We saw that one person who had epilepsy and who suffered regular seizures went regularly to the gym with staff who were trained to support them should they become unwell. We saw that residents had opportunities each day for stimulation and occupation. Residents attended day care centres, local colleges and clubs. Where a resident did not wish to attend this was respected and recorded in their care plan. The was a wide range of social activities available for residents to choose from including going out to pubs, shopping, cinema, bowling etc. In addition there were activities such as music and occupational therapies provided by staff in the home. Residents we spoke with told us that they could spend their spare time doing the things they enjoyed. One person said ‘I like going to the disco I am going tonight’. They also told us that they ‘enjoyed going to the pub for lunch’. Another person told us ‘They let me do the things I like such as coffee morning’. There were regular residents meetings where people could discuss the things, which were important to them. We looked at the minutes from recent meetings. Residents asked for more omelettes and jacket potatoes at meal times and we saw that menus reflected these choices. Residents also discussed and planned holidays and outings. We looked at the holiday diary for one resident. It included pictures of the person enjoying their time spent away from the home. We looked at how residents were supported to eat a healthy well balanced diet, which reflected their dietary needs and their preferences. We saw that the menu was displayed in a picture format with photographs depicting each meal. Residents chose from the options available and there were other options available should a person change their mind at the last minute. One person’s diet had been very poor when they moved into the home. We saw that great improvements had been made in introducing new food groups to this person’s daily diet. Residents had the opportunity to eat out in local restaurants and pubs when they wished and they had regular take away meals such as fish and chips, curries and Chinese meals. Residents we spoke with told us that they enjoyed the meals. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 20 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well cared for and supported for their health and personal care needs. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that each resident had a health action plan, which described how they liked to be supported and by whom. The told us that preferences for gender of support staff was respected and facilitated and that residents were supported to maintain their individuality in terms of dress/haircuts, makeup etc. The manager also said that Cherrycroft provided all equipment needed for individuals to carry out their care including flat floor bathrooms, profiling beds, specialist shower chairs, standard shower chairs, hoists, slings and slide sheets. When we visited the home we looked at how staff supported residents to meet their personal and health care needs. We looked at the care plans for two Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 15 people. We saw that there was very detailed information recorded for both people describing the support they needed to maintain personal care. Information was recorded in a simple way with photographs to help residents understand the information recorded about them. We saw that care plans were reviewed regularly and amended where there had been changes to the person’s needs or the treatment they were receiving. Each person’s preference for how they wished to be cared for and supported such as the times they wished to get up and go to bed, whether they preferred baths or showers etc was recorded. Resident’s health and medical conditions are clearly recorded in their care plans with instruction for staff on how to support residents when they become unwell. There were detailed risk assessments and information about residents so as alert staff of signs of any deterioration in their conditions. Staff had received training in supporting people who have autism, epilepsy and had received specific training for the administration of anti-convulsant medication to residents in the event of epileptic seizure. Residents were supported to attend hospital and doctors appointments. Where a person is unwell staff arranged for their doctor to visit them in the home. We looked at reviews of both person’s care since they moved into Cherrycroft and saw that there had been significant improvements to their physical and mental wellbeing during the time they lived in the home. Risks to the health and safety of residents were well recorded with details of how staff could support residents and minimise risks. We looked at the arrangements ensuring that residents received the medicines, which had been prescribed for them. Staff were trained to safely administer and store medicines. We looked at records and these were well maintained. Medicines were stored safely and there were clear protocols in place for the administration medicines in an emergency situation. Residents were assessed to see if they would be capable of safely keeping and administering medicines, and their consent for staff to do so where this was not practical. We saw that where residents preferred way to receive medicines was in liquid form that they were provided in this form. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 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. Residents are treated well and are assured that their complaints or concerns will be taken seriously and responded to. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that there was a user friendly complaints procedure available in the home foyer for residents, visitors and staff. They told us that each service user had a copy of this given to them as part of their service user guide. They told us that the home fostered an open atmosphere where residents could feel able to come to staff or management with any issues they may have and that there was an open office policy and residents know they can come to the office at any time. When we visited the home we looked at the arrangements for receiving and responding to complaints and how residents were safeguarded from harm. We saw that the complaints policy and procedure was available and accessible to both residents and visitors to the home. We looked at this policy and it described how a person may make a complaint or raise concerns and how staff would act so as to resolve the issues. Some of the people living in the home may not be able to understand the policy in the current written format and we discussed this with the assistant managers. We spoke with four members of staff and they told us that they knew what to do if a resident was unhappy or Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 17 wished to complain about something. We spoke with three residents. One person was able to tell us that they knew how to complain. They told us that they were happy at the home. They said that if they were unhappy they would speak to the manager or key worker. Both other residents indicated to us that they were treated well and that they had no concerns or complaints. We looked at records of complaints received since the last inspection. One complaint had been received. We saw that this had been resolved and the person was satisfied with the outcome. We looked at how people living in the home were safeguarded from abuse. We saw before a person commenced work at the home that all checks including references from previous employers, Criminal Records Bureau disclosures and PoVA First checks were obtained. These checks helped ensure that only people who are suitable are employed in the home. We also saw that all staff undertook safeguarding training as part of their induction when they started work in the home. All staff received information in the staff handbook about how to safeguard people and their responsibilities in reporting any poor practices or concerns. We saw that there was a detailed policy and procedure for staff to follow. This included a whistle blowing procedure, which helped to assure staff that they would be protected from harassment should they need to raise concerns. We saw that there was a copy of the local safeguarding team’s policy and procedures available in the home. This included a detailed flow chart to help assist staff in ensuring that all concerns would be reported appropriately. We spoke with four staff and the manager and they could demonstrate that they understood the home’s policy and were aware of the reporting procedures. We spoke with three residents. Two people told us that they were well cared for. We observed how staff engaged with and interacted with residents. We saw that residents appeared comfortable with staff and spent time chatting and laughing with them. The home had a friendly open and positive atmosphere. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 30 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy clean, safe and comfortable surroundings, which suits their needs and reflects their individuality. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that the home provided a high standard of accommodation and facilities for residents. They told us that resident’s bedrooms were personalised to the specific taste of residents and the communal areas were light and airy and provided facilities for the clients to relax and eat and to entertain their families. When we visited the home we looked at the facilities provided for residents. We saw that they had access to clean, bright and comfortable communal spaces including a large lounge, a conservatory used when residents wished to Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 19 have some ‘quiet time’. We looked at residents bedrooms. All were decorated and furnished according to the individual’s taste. Each resident had their own ensuite shower facilities with any adaptations as required for the individual. One resident who was more independent had a semi self contained flat on the top floor. This was equipped and decorated according to the person’s choices. They showed us around and told us that they liked their accommodation. Residents had access to a large garden area. The assistant manager told us that there were plans to improve the outdoor space as it was not used much by residents. Improvements planned included a sensory garden and a patio area. Staff were responsible for cleaning the home and residents had chores to carry out according to their abilities. We saw that all areas of the home were clean and there were procedures in place for minimising the risk of the spread of infections. There were soap and hand towels in all bathroom and toilet areas to help promote good hand washing practices. We looked at how the home was maintained so that it was safe for residents. We saw records and certificates which showed that regular checks were carried out on fire detection and fighting systems and equipment, gas, electrical and mechanical equipment and installations such as passenger lift and hoists etc. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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, 35 & 36 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. Residents are well cared for and supported by a team of staff who are suitable, competent and who understand resident’s needs. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that the residents living in the home benefit from a consistent committed staff team. They told us that staff knew their job role and the needs of residents and interacted with them well on all levels. They said that staff were aware of each resident’s needs and choices and respect each of these at all times. When we visited the home we looked at how residents were supported by the staff team. We looked at how staff were recruited and trained. We looked at whether staff were employed in sufficient numbers to meet the assessed needs of residents. We looked at staff rota. The home normally employed five staff to cover day duties and two waking staff at night. At the time of the inspection these numbers were reduced on some days as one resident had moved out of Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 21 the home and one person was in hospital. There was no indication that this had any adverse impact upon the way in which residents were supported. There were occasions where the manager used temporary agency staff to cover duties due to unexpected staff absences or illness. We looked at the information the manager obtains from the agency so as to ensure that they would be suitable to work in the home. The agency provided profiles for each person with details of the person to be supplied, including details that references and Criminal Records Bureau disclosures had been obtained in respect of each individual. The profiles did not include a photograph (so that the identity of the person could be determined when they arrived at the home) or evidence that the people supplied had experience or training in respect of supporting people who have learning disabilities. We looked at how staff were recruited to work in the home. We looked at the recruitment files for three people who had been employed since the last inspection. We saw that before a person was employed at the home that checks including references from previous employers, Criminal Records Bureau disclosures and PoVA First were obtained. Candidates were interviewed to further determine their fitness to work in the home. Upon commencing work staff completed a three day induction programme to help them familiarise themselves with the home’s policies and procedures and the needs of people working in the home. We spoke with two members of staff who had been recently employed to work in the home. They told us that staff and the manager supported them while they settled into work at the home. We looked at the arrangements for training and supervising staff so that they could meet the needs of residents. We were provided with a copy of the home’s training programme for staff. We saw in addition to the induction to the home that all staff completed the Common Induction Standards. These are nationally recognised standards for good practice. Staff undertook a comprehensive programme including health and safety, Fire safety, first aid, infection control and moving and handling. In addition staff received training in the safe administration of medicines including buccal midazolam used for the treatment of seizures. All but one member of staff had safeguarding training within the previous twelve months. Training specific to the needs of residents was included in the programme and staff were trained in supporting people with respiratory problems, autism and epilepsy. Some staff had completed training in inclusive communication to help communicate with people who have learning disabilities. Staff were supervised regularly and supported by the management team so as to provide a high standard of care to residents. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 & 42. People using the 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 is well managed and run in the best interests of the people who live there. EVIDENCE: The manager provided us with a detailed Annual Quality Assurance Assessment, which described how the service met the needs of the people who lived in the home. When we visited the home we spoke with the manager and deputy manager, staff and residents. We saw that the home was well managed and that staff had clear roles and responsibilities and that they worked well as a team to meet the needs of the people living in the home. It was clear that the home was managed in an open and inclusive way. Residents were comfortable with staff and came and went from the office as they chose. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 23 We saw that residents were consulted on a regular basis to obtain their views about how the home was managed and how they were supported. We saw that residents were asked questions including whether staff listened to what they say. if they knew who their key worker was, if they knew how to complain and what happened when they did. They were asked if they were happy with the care and support they received and if they were given the opportunity to take part in residents meetings. There were pictures used a references to help residents understand the questions. We looked at the findings from the last quality audit carried out. We saw that where residents had made comments or suggestions as to how things could be improved such as requesting different meals that this was implemented. In addition we saw a copy of the annual action plan for the home. This identified the areas where improvements to the services were planned such as extension of the home and improving the garden and assisting two residents towards living more independent lives. We looked at how the home was maintained. We saw certificates and records, which evidenced that equipment and installations such as heating and hot water systems, fire detecting and fighting equipment, lifts etc were regularly checked, serviced, repaired and replaced as necessary. Regular assessments for the environment were carried out so as to identify any areas of the home which may pose a risk to the health and safety of both residents and staff. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 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 4 2 3 3 X 4 3 5 3 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 3 X X 4 X Version 5.2 Page 25 Cherrycroft DS0000068291.V376039.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. 1. Refer to Standard YA32 Good Practice Recommendations When temporary agency staff are employed the manager should check what relevant training and skills they have so as to ensure that residents needs will be met. Cherrycroft DS0000068291.V376039.R01.S.doc Version 5.2 Page 26 Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.eastern@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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