Care Home: Churchfields

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What the care home does well Churchfields has an informal, and homely environment. Most residents have lived at the home for a number of years and see it as their own home. There is a wide variation in the age of people who live at Churchfields but all appear to live happily together. There is a full programme of social activities organised in the day centre where the atmosphere is lively. Residents enjoy drama, photography, filming, art, puppet making, pottery making and gardening. Annual holidays are arranged for residents and for those unable to stay overnight, the minibus is used to take them on day trips every day for the week. Residents are involved in all activities and life at the home as far as they are able, for example attending meetings where they are able voice their opinions, interviewing staff, gardening and growing vegetables. Residents are encouraged to lead as independent a life as they are able with opportunities for education and employment taken up. The home enters a garden in Bloom competition annually and the organisation`s own garden competition. Rooms are well personalised and residents are able to choose decoration and furnishings. Care planning is person centred and regularly reviewed. Standards for administration of medicines are good.There is good access to health care and good liaison with health and social care professionals. Residents` individual relationships are supported through a risk management process. Advocacy services are arranged for specific issues. Staff recruitment is robust and there is a bank of staff with no agency having been used for some time. There is a planned programme of staff training. The home exceeds the recommended standard for NVQ level 2 training having 67% of care staff with the qualification. Staff are motivated, work well as a team and are well supported through staff meetings, supervision and training. There is an open and supportive manager who is keen to support staff development. Standards of health and safety are good. Equipment is available to meet residents needs and is well maintained. There are regular audits undertaken which includes monthly checks on profiling beds and bed rails. What has improved since the last inspection? Health action plans have been developed for all individual residents. Drama has been developed to become a medium for expressing thoughts and feelings. One staff member has attended Makaton training and there are plans for this to be cascaded to other staff. Equality and diversity training has commenced for all staff. Signs have been put up to enable residents to understand the use of some rooms, for example office space. The programme of refurbishment has continued with some rooms being redecorated and a kitchen refurbished. Decking has been provided to improve access for wheelchair users and a gazebo has been provided in the Croft garden. Air conditioning units have been provided in St Paul`s and St Katherine`s units. There has been a reduction in use of agency staff by a bank of care staff being recruited. What the care home could do better: The programme of refurbishment should continue to provide new kitchen facilities and an upgraded shower room in the Croft. Staff handwashing facilities (liquid soap, paper towels & foot operated pedal bins) need to be provided in all areas where personal careis provided. Systems should be in place to ensure that liquid soap and paper towels are kept replenished in all key areas including the kitchens and laundry rooms. Clinical waste must be disposed of appropriately in designated bins. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Churchfields Avenue Road Witham Essex CM8 2DT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diana Green     Date: 2 7 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Churchfields Avenue Road Witham Essex CM8 2DT 01376521553 01376521554 churchfields@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Active Care Partnerships (Churchfields) Ltd care home 34 Number of places (if applicable): Under 65 Over 65 5 0 learning disability physical disability Additional conditions: 34 11 Eleven named people, under the age of 65 years, who require care by reason of a learning disability and who also have a physical disability Five named people, aged 65 years and over, who require care by reason of a learning disability Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 34 persons) The one service user in the room that does not meet the space requirements of the National Minimim Standards for people with physical disabilities may continue to use that room. Once they vacate the room it may not be used by a person with a physical disability, the details of which were made known to the Commission The total number of service users accommodated in the home must not exceed 34 persons Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home Churchfields is a care home providing personal care and accommodation for a total of 34 adults with learning disabilities, including 11 people with physical disabilities. Active Care Partnerships Ltd owns the home and the registered manager is Stella HarringtonKeeton. Churchfields is situated in a residential area of Witham, and is within easy reach of local shops, railway station, pubs, library, post office and other amenities. The home was opened in 1999 and consists of 11 separate self-contained accommodation units ranging from single bedroom bungalows to 6 bedroom flats. Accommodation on the first floor is accessed by a passenger lift. All the homes bedrooms are for single occupancy. The home has private grounds and car parking facilities. The gardens provide an attractive setting with some areas secure but all allowing for wheelchair access. Fees for care in the home range between £551.88 and £1529.01 and are dependent on the accommodation offered, the source of funding and the dependency of the resident. Extras to the fees include hairdressing, papers, chiropody and toiletries. Inspection reports may be obtained from the home and from the CSCI website www.csci.org.uk 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: 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 quality rating for this service is 3 star. This means that people who use this service experience excellent quality outcomes. This unannounced inspection took place on 27th May 2009. All of the Key National Minimum Standards (NMS) for Younger Adults, and the intended outcomes, were assessed in relation to this service during the inspection. This report has been written using accumulated evidence gathered prior to and during the site visit, including the homes Annual Quality Assurance Assessment (AQAA). The Annual Quality Assurance Assessment (AQAA), a self assessment that focuses on how well outcomes are being met for people using the service, was completed by the home and returned to us prior to the visit to the home. Information received in the AQAA provided us with some detail to assist us in understanding how the registered Care Homes for Adults (18-65 years) Page 6 of 29 persons understand the services strengths and weaknesses and how they will address them. The inspection process included reviewing documents required under the Care Home Regulations. A number of records were looked at in relation to residents, staff recruitment and training, staff rotas and policies and procedures. Time was spent talking to staff and the manager. Surveys were sent to service users and their representatives. The manager and staff were welcoming and helpful throughout the inspection. What the care home does well: What has improved since the last inspection? What they could do better: The programme of refurbishment should continue to provide new kitchen facilities and an upgraded shower room in the Croft. Staff handwashing facilities (liquid soap, paper towels & foot operated pedal bins) need to be provided in all areas where personal care Care Homes for Adults (18-65 years) Page 8 of 29 is provided. Systems should be in place to ensure that liquid soap and paper towels are kept replenished in all key areas including the kitchens and laundry rooms. Clinical waste must be disposed of appropriately in designated bins. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 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 planning to live at Churchfields can be assured their needs will be fully assessed prior to admission to ensure these can be met. Evidence: The home had a statement of purpose and service user guide that were comprehensive documents. Copies of both documents were provided during the site visit and had been recently reviewed. The service user was in pictorial format with photographs of the premises and facilities included for service user information. The manager confirmed that these would be made available to potential residents and their representatives. The admission process was discussed with the manager of Churchfields. There had been one admission since the previous key inspection, the majority of residents having lived at the home for a number of years. The assessment documentation for one resident was Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: viewed. This included a pre-admission assessment form that was used as prompts to obtain information on the care needs. A full assessment was undertaken within 48hours of admission and the information was used to develop the care plan. The care file included a pen picture that detailed the support needed. 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 at Churchfields can expect to have their care needs met through robust care planning and to be fully supported to make independent decisions about their lives. Evidence: The arrangements for care planning were discussed with the manager of Churchfields and a care file was viewed. Each resident had a file that included full information and archived information together with a daily record. Care plans were person centred and included a pen picture detailing the support needed. Additional disability profiles were included for specific needs, for example autism spectrum. Assessments included all elements of need (independence, life skills, inclusion, rights, religious needs, healthcare needs, choice, nutritional needs etc.) showing that staff were aware of residents needs in order to provide appropriate support. A health and social care assessment was undertaken and included various risk assessments, for example falls, nutritional risks, continence and individual risks, for example hot water, when bathing, Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: use of the swimming pool and general risks. This demonstrated that residents were enabled to take risks as part of a independent life style. All care plans and risk assessments were reviewed monthly and included monitoring of weights with action taken as relevant to reduce weights and encourage healthy eating. Most residents had a family member that was involved in their care and assisted them in making decisions. Advocacy services were also arranged. One visitor was spoken with during the site visit and confirmed that they regularly visited their relative and could visit at anytime. We were informed that several residents were in a relationship. One resident spoken with said that their girlfriend visited and sometimes stayed overnight and they had been able to have a holiday together. Churchfields had a risk management strategy in place. Risks were assessed and minimised as far as possible without restricting individuals independence. Risk assessments were seen for individual risks, for example management of seizures, hot water, when bathing, use of the swimming pool etc. 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 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 Churchfields can expect to have well balanced and nutritious meals in a family environment and to enjoy a full and stimulating lifestyle with opportunities for education and employment and a full programme of social activities. Evidence: The home had an active day care facility where various projects were organised and included art projects, tai chi, music and movement, cooking, communicating skills, and gardening. The AQAA informed us that drama is used as a medium to discuss needs, feelings and choices. Residents had taken part in the play recently which was also filmed by others. A group of residents spoken with confirmed they were fully involved in the programme which includes making costumes, props etc. Evidence of this was seen on display in the centre and on collages displayed throughout. Several residents attend college and one had continued to attend an external day centre they had been Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: involved with prior to their admission to Churchfields. The daily records for one resident viewed confirmed they went ice skating and were involved in cooking, a drama class, bowling, a computer course and music and movement. Another resident spoken with had two part-time jobs, one at a lunch club and another at a childrens centre. They were clearly excited about a trip that had been organised to celebrate their birthday which included going to see the musical Grease and being taken by limousine. One resident was attending a weight watchers class locally and we were informed that weight management programmes for a number of residents had been successful. A relative told us their loved one also attended an adult training centre four days per week. The arrangements for residents to experience a holiday were discussed with the manager. Most residents have one holiday per year. Last year two residents went to Disneyland Paris. Others who cannot stay overnight are takeout in a minibus that can take eight wheelchairs for daily excursions. The statement of purpose included the homes visiting arrangements. One visitor spoken with said they were able to come at any time. They found the staff good and the home brilliant. They also told us that their relative loved it at Churchfields and the community atmosphere was ideal as they live together as a family. We were informed that several residents had relationships and these were supported as far as practicable. One resident told us I go to my brothers house for the weekend and another had been a bridesmaid at a relatives wedding. Each unit has a domestic size kitchen and dining area/lounge. One recently renovated kitchen was well fitted with a hob, oven, microwave, fridge-freezer that was well stocked. Staff on each unit cooked the meals and residents were responsible for cleaning and tidying their rooms with staff support. One resident told us I keep my house clean and tidy and staff another resident helps me. 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 living at Churchfields can expect to have their personal and health care needs met and to be safeguarded by the homes medication policy, procedure and practices. Evidence: The AQAA informed us that the daily routines were flexible to enable residents to take part in their various activities and outings. Residents were observed to have a choice of taking part in activities or spending their time as they chose (watching TV, spending time alone in their rooms etc.). All residents had a key worker who was responsible for taking care of their general need. From observation and the records viewed it was evident that residents were enabled a choice in what clothes they wore, how they wore their hair, makeup etc. Consistency of support was promoted through links with residents relatives, advocates and external professionals where relevant and confirmed from staff discussion and the records viewed. Residents were also involved in staff interviews giving them responsibility for events in the home and providing them with some choice in who supported them. From discussion with staff, the manager and an inspection of records it was evident Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: that residents had access to GPs, district nurses, physiotherapists, occupational therapists, dentists, community specialist nurses as relevant. We were informed that district nurses provided support by offering training for care staff. The records also confirmed that residents attended outpatient appointments as necessary. The medication systems for the home were discussed with a staff member who was designated to give medication. A review of medication systems was undertaken on Croft Unit. The home had a medication policy and procedures for staff guidance that were kept under review. A list of staff initials and signatures was maintained to enable appropriate follow in the event of an adverse incident occurring. All designated staff received appropriate training and were assessed as competent prior to them being responsible to give medication (also confirmed from the records). Medication is provided by the local pharmacy in a monitored dosage system and individual containers and systems were in place to ensure that medication received and disposed of was appropriately checked. Medication was stored in each unit with as required medication (PRN) kept in the main offices. There were systems in place to monitor and record room temperatures to ensure they remained within safe recommended levels (maximum 25 degrees Centigrade. The medicines administration records for three residents were viewed. All were accurately completed with no omissions present. 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 living at Churchfields can expect to have their complaints listened to and acted upon and to be protected by safeguarding adult procedures. Evidence: Churchfields had a complaints policy and procedure that included timescales for a response and met regulatory requirements. The procedure was included in the statement of purpose and service users guide. No complaints had been received by the home or the Commission since the previous key inspection. The Home had a safeguarding policy and procedures and a whistle blowing policy in place to ensure residents were safeguarded from abuse.The records viewed during the site visit confirmed that staff received training on abuse during their induction, through NVQ level training and regular updated training was also provided. The home had copies of the Essex Safeguarding procedures available for staff guidance to be used in the event of an allegation being made. There had been three safeguarding alerts made since the previous key inspection, one of which was not accepted as a safeguarding issue and the other two had been investigated in line with procedures and appropriate action taken. The systems for supporting residents with their finances were discussed with the manager. The majority of residents had a relative/advocate to assist them. However it was evident that arrangements would be made to refer to the Court of Protection Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: where there was evidence of potential abuse. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Churchfields can expect to live in a clean, comfortable home that is appropriate for their needs but cannot always be assured that staff practices will safeguard them from infection. Evidence: A tour of the premises was undertaken during the site visit. The home comprised eleven units each with its own front door. The Croft is the largest unit and caters for six people with complex, high dependency needs. Four bungalows have single occupancy, there are two four bedroom bungalows and one two bedroom. In addition there are two first floor flats accommodating five people each and a ground floor flat with four bedrooms. The AQQA informed us that since the last inspection most of the boilers on site have been replaced, a large decked area has been added to the back of the Croft making its gardens more accessible to wheelchairs users. An additional patio are has been added to St Peters and St Elizabeths garden to improve accessibility and a number of rooms have been decorated. One recently refurbished kitchen was seen. This was domestic in size and was well Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: fitted with hob, oven, dishwasher, fridge, freezer and microwave. In contrast the kitchen in the Croft was seen to be in need of refurbishment. Rooms were seen to be clean, bright and comfortably furnished. Some residents individual rooms were seen with their agreement and were well personalised with photographs and personal items. Fire safety equipment was available in each of the units and records confirmed that it was appropriately maintained and that fire safety practices were in place to meet the needs of the requirements of the local fire service. The home was clean and odour free. There were infection control policies and procedures for staff guidance. Each unit had a laundry room that was domestic in size and was fitted with a washing machine that had the capacity to carry out sluice cycles (wash at minimum 65 degrees for not less that 10minutes) and a tumble drier. Limited storage facilities were available, meaning that equipment was stored in bathrooms. Staff handwashing facilities were provided in kitchens and bathrooms but practices were clearly not always adhered to as paper towels were not available in some areas and liquid soap was found in a cupboard therefore not easily available. A clinical waste bag with used disposable equipment spilling out was observed on the ground outside rather than in the designated bin. Although antibacterial handwash was available, there were no handwashing facilities (liquid soap and paper towels) in the laundry or residents rooms where personal care was provided. This posed a risk of infection as staff had to go either a bathroom or the kitchen to wash their hands after dealing with body fluids. 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 living at Churchfields can expect to be cared for by well trained, skilled staff who are clear of their role and who are well supported and well supervised. Evidence: Staff appeared skilled and experienced and motivated in their work. All staff were observed to treat residents with respect and to listen and engage in conversation with them. One relative told staff are very approachable. We were informed that 67 of care staff had an NVQ level 2 qualification which exceeds the recommended standard for 50 care staff. In addition three care staff had an NVQ level 3 qualification. In addition to the deputy manager there were thirteen care staff on duty. The manager arrived during the morning from another home where they had been attending a meeting. Ancillary staff comprised an administrator, one maintenance person and one driver. We were informed that care staff cooked meals and residents assisted with household tasks and laundry. Residents appeared well cared for and were well supervised during the site visit. We were informed that the home had a bank of care staff and agency staff were not used. This ensured that residents were cared for by people they knew and who were aware of their care needs. From discussion with staff it was evident that regular meetings were held and handover sessions to ensure staff Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: were appropriately supported and were kept up to date with residents changing needs. One staff had recently undertaken Makaton training and there were plans to cascade this skill to other staff in the home. This would enable them to communicate more effectively with all residents. The manager explained the recruitment process. Residents who are able are involved in interviewing of staff, giving them choice in who was employed to care for them and promoting their self esteem. The recruitment records for four staff were viewed. All included evidence that the required checks had been undertaken prior to appointment (two satisfactory references,CRB Disclosures, evidence of identification etc.). The record of training was seen and confirmed that since the previous key inspection training had been provided in fire safety, manual handling, food safety, health and safety, safeguarding adults, infection control,first aid and medication. The training records for the same staff were viewed and confirmed that all four had undertaken manual handling, fire safety, food safety, first aid, and safeguarding adults training. Training sessions had also been provided in care issues relevant to the client group (crisis intervention, epilepsy awareness, administration of buccal midazolam etc.). The arrangements for staff supervision were discussed with the manager. Staff had handover sessions between shift and observation of practice was also undertaken. Regular and recorded supervision sessions were arranged. We were informed that two monthly sessions were aimed for and some staff needed to be seen more frequently. A record of supervision was seen in three of the four staff files viewed. 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 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 Churchfields can expect to live in a well managed home with good standards of health and safety that protects them and staff. Evidence: The home manager has 15 years experience of working with people with learning difficulties, nine of which have been as a registered manager. The manager has a BA (Hons) in applied youth and community studies, an NVQ level 4 in health and social studies and the Registered Managers Award. From an inspection of the records it was evident that she was skilled and competent and had undertaken recent updated training relevant to a manager of a care home for people with learning disabilities. Throughout the site visit it was evident that the manager operated an open door policy and was available to support staff. The home had a quality assurance programme that included consultation with residents and their relatives. The manager explained that annual surveys were distributed to residents (in pictorial format) and their relatives to seek their views on Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: how the service was doing. Audits were undertaken in key areas (for example care plans, medication, environment, health and safety, staffing, accidents/incidents), showing that care practice was monitored. Meetings were held for staff, residents and health and safety and issues from these and the outcome of surveys and audits were used to develop an annual plan for the home. Records held on behalf of residents were kept up to date and were stored safely in secure facilities. Records viewed at this inspection included: the statement of purpose, service user guide, assessments/care plans, medication records, complaints, staff meetings, staff recruitment and training records, maintenance records and fire safety records. The home had health and safety policies and procedures that were regularly reviewed. The records confirmed that staff had attended relevant health and safety training. Evidence of a sample of records viewed showed that there were systems in place to ensure the servicing of equipment and utilities and there was evidence of appropriate weekly and monthly internal checks being carried out (e.g. checks on fire equipment fire alarms and emergency lighting etc.). All accidents, injuries and incidents were well-recorded and appropriate action taken. 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 31 The programme of refurbishment should continue to include upgrade all kitchens and the Croft shower room this will ensure facilities are appropriate for residents needs. To reduce the risk of infection, handwashing facilities (liquid soap, paper towels and foot operated bins) should be provided in all areas where personal care is provided. 2 31 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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