Care Home: Clayton Road, 62

Similar services:

• 22 Sandown Road
• The Highlands
• Dilston College Of Further Education
• West View House
• Prince Bishop Court
• Park View (15)
• Craigmore House
• 1 Lanark Close

What the care home does well Staff get good information about people who want to stay in the home so that they get the right care. They take time to introduce people to the home and other visitors, you can visit as many times as you want.Staff take time to treat people nicely and help them get out and about and do things they like.People who visit Clayton Road can see a doctor or anyone else they need if they are unwell.Proper checks are carried out so that only people who are suitable to work in a home are employed.Staff get lots of training and help to do their job. What has improved since the last inspection? Staff have had training in person centered planning so they can write care plans that show what a person wants to do and would like to achieve.There is a new shower room and lots of equipment so that people can take a bath or shower safely.New night staff rotas have been introduced so that everyone gets to work together.Staff get support to do their job and to help them be a key worker for people who visit the service.Weekly meetings take place so that staff have a chance to make sure everyone knows what someone staying in the home needs or if anything has changed. What the care home could do better: Reviews of care plans and what support a person needs should involve all the services they attend.People who use the service should be asked if they are happy to have their picture taken and who they want to see it.Staff should make sure that they update care records when they are asked. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clayton Road, 62 62 Clayton Road Jesmond Newcastle upon Tyne Tyne & Wear NE2 1TL The quality rating for this care home is: two star good 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: Elaine Charlton Date: 0 1 0 9 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. They reflect the things that people have said are important to them: 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 39 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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 39 Information about the care home Name of care home: Address: Clayton Road, 62 62 Clayton Road Jesmond Newcastle upon Tyne Tyne & Wear NE2 1TL 01912811956 01912811956 eleyne.dugdale@newcastle.gov.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) : Newcastle City Council Social Services Department care home 10 Number of places (if applicable): Under 65 Over 65 10 0 learning disability Additional conditions: The ground floor only must be used to accommodate service users who have a physical disability Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 39 A bit about the care home Clayton Road is run by Newcastle City Council. Ten people can stay there. Clayton Road is a large house, set in its own garden, but people who need to use a wheelchair have to stay on the ground floor. Bathrooms and toilets are easy to get to and use. Everyone can have their own bedroom. Nobody has to share unless they want to. People who stay at the Care Homes for Adults (18-65 years) Page 5 of 39 home can use a mini bus at the weekend or buses and the metro. There is lots of information to help people decide if they would like to stay at Clayton Road. You can also read the inspection reports. Care Homes for Adults (18-65 years) Page 6 of 39 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: two star good 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 Care Homes for Adults (18-65 years) Page 7 of 39 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is two star, this means that the people who use this service experience good quality outcomes. We looked at documents that have to be kept. These included care plans, staff files, medicine records and some of the homes policies and procedures. (Policies are rules about how to do things and procedures tell people how to follow the rules). Care Homes for Adults (18-65 years) Page 8 of 39 The inspector talked to people who use the home for respite care. They said staff were kind to them, kept them safe and calm and helped them to get out and about. We also looked around the home. This was to make sure it was safe and comfortable. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 39 Staff get good information about people who want to stay in the home so that they get the right care. They take time to introduce people to the home and other visitors, you can visit as many times as you want. Staff take time to treat people nicely and help them get out and about and do things they like. Care Homes for Adults (18-65 years) Page 10 of 39 People who visit Clayton Road can see a doctor or anyone else they need if they are unwell. Proper checks are carried out so that only people who are suitable to work in a home are employed. Staff get lots of training and help to do their job. Care Homes for Adults (18-65 years) Page 11 of 39 What has got better from the last inspection Staff have had training in person centered planning so they can write care plans that show what a person wants to do and would like to achieve. There is a new shower room and lots of equipment so that people can take a bath or shower safely. Care Homes for Adults (18-65 years) Page 12 of 39 New night staff rotas have been introduced so that everyone gets to work together. Staff get support to do their job and to help them be a key worker for people who visit the service. Weekly meetings take place so that staff have a chance to make sure everyone knows what someone staying in the home needs or if anything has changed. Care Homes for Adults (18-65 years) Page 13 of 39 What the care home could do better Reviews of care plans and what support a person needs should involve all the services they attend. People who use the service should be asked if they are happy to have their picture taken and who they want to see it. Care Homes for Adults (18-65 years) Page 14 of 39 Staff should make sure that they update care records when they are asked. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Elaine Charlton Regulatory Inspector – North East Care Quality Commission CQC North East PO Box 1255 Newcastle upon Tyne NE99 5AS Telephone: 03000 616161 Care Homes for Adults (18-65 years) Page 15 of 39 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 16 of 39 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 17 of 39 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 use the service have their diverse personal care and support needs properly assessed so that everyone is sure they can be met. Evidence: The service gets a community care assessment for every person before they start to have respite care. If a younger person and/or their family are referred for support a Childrens Core Assessment is used as a short term measure to make sure the person gets a seamless service. People are introduced to Clayton Road through a series of tea-time visits, over night and weekend stays. These take place at a pace led by the individual and this can be a short period of time or in one case took a year. Visits are also used as part of the assessment process. The service can respond to requests for emergency support for people who are already known to the service. One person who uses the service sent back a Have Your Say questionnaire. They told us they made the decision about using Clayton Road and were given enough information to help them make that decision. Care Homes for Adults (18-65 years) Page 18 of 39 Evidence: Healthcare professionals who sent back questionnaires all said the services assessment arrangements always made sure that accurate information was obtained. We looked at the records for one person who had started to use the service since the last inspection. Records are kept in a standard way and are easy to use. Assessment documentation was in place as well as risk assessments and care plans. Good information about the persons needs was available and included likes/dislikes, communication and personal support needs. Care Homes for Adults (18-65 years) Page 19 of 39 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 who use the service know that their differing and diverse needs for care and support can be properly met in a way they choose, and by who they choose. Evidence: We looked at care plans for two other people who use Clayton Road for respite care. People who use the service, healthcare professionals and staff who sent back questionnaires told us: I am always able to make decisions about what I do, during day, evening and at weekends. The service listens to what people say, seek advice and act upon it. Staff said they always or usually got enough information about the needs of people who use the service. Get training that is relevant to their role, helps them understand and meet individual needs, and keeps them up to date with new ways of working. A project is currently underway to photograph places and activites around the area Care Homes for Adults (18-65 years) Page 20 of 39 Evidence: and wider community to use as a visual prompt when people area making choices. All team members have had training in Person Centered Planning over the last twelve months and are liaising with day support colleagues to plan a programme of person centred reviews. One file we saw had a care plan audit sheet at the start that had been used to identify gaps in records or other areas of weakness. The dates by which these tasks should have been completed had not all been met. The home operates a keyworker system and records show who the keyworker is for each person. Each person who uses the service has a range of Plans of Intervention in place that cover what they need help with and can include personal hygiene, dressing, meal time and night time routines, going out and communication, dependant on individual need. Service user plans also identify how a person will benefit from staying at Clayton Road. For example: needs more social interaction time and time away from relatives with a view to moving to independent living. Staff are given advice, guidance and support to help them deal with any behaviours that may challenge daily routines. They work closely with community nurses and BAIT (Behavioural Assessment and Intervention Team). Where people have difficulty with communication we saw advice about not rushing them and allowing them to answer in their own time, use of communication books, pictorial prompts and Makaton. Some people also bring personal About me books with them. Plans of intervention identify levels of support people need with areas of care and whether they have a preference for male or female carers. These plans are supported by risk assessments and moving and handling plans. People get to use the bedroom they prefer and can share if that is their wish and is appropriate. For other people it is necessary to make changes to bedrooms, taking out items that would make their stay more difficult for them and/or staff. Some files did not have a photograph of the person who uses the service but we were told that a new digital camera has been purchased to make this task easier. Evaluations in care plans differ in content and quality and did not always reflect the benefit a person had gained from the care and support they had received during their stay at Clayton Road. The service provides respite care for 81 people who are allocated 28 nights in a twelve month period. Reviews are carried out in-house, by day services and social workers. Care Homes for Adults (18-65 years) Page 21 of 39 Evidence: The home does not always get up to date copies of the reviews that other services carry out so it was not possible to establish how frequently individual care plans had been reviewed. One person said at their 2008 review that Clayton Road gives me the freedom to have my own space and independence. Care Homes for Adults (18-65 years) Page 22 of 39 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to be independent, maintain friendships and meet new people, get out and about in the local and wider community promoting their confidence. Evidence: Staff at Clayton Road aim to support people to be as independent as possible, respect their privacy and dignity and help them to keep and encourage friendships. People use local transport networks and taxis to continue with their day care/college or social commitments during their stays at Clayton Road. The home has access to a mini bus at the weekend if people wish to go out in a group, but the manager is trying to promote more individualised activities and social opportunities in the local and wider community. The home has a private, secure garden, that can be accessed by people who are mobile or need to use a wheelchair. Three bedrooms on the ground floor also look out onto the garden area making them very pleasant rooms to stay in. Care Homes for Adults (18-65 years) Page 23 of 39 Evidence: The garden is used for games, bar-b-ques, and for people to do some gardening and grow things if they wish. There is a conservatory at the end of the lounge that opens into the garden and a games table has been bought for this area so that people can play pool, darts and table tennis. The table folds up so that the space is not always only able to be used for games. Respite stays are planned six months in advance. During the inspection staff were made aware of some respite stays that were not going to be taken up, so they were making calls to people who might like to take advantage of an additional visit. Consideration is always given to who is already staying in the home, what levels of support people need and whether people will get on together. The home has a series of summer and winter menus and staff select from these to meet the needs and likes of people who are coming to stay. Take away meals are also ordered, and specific drinks, jucies and snacks are purchases to meet individual likes and dislikes. A meeting takes place each Friday evening to let people know what events are taking place locally and in the wider community to see if there is anything they would like to go to or any where they would particularly like to visit. The home has a separate budget to promote people getting out and about and socialising. The manager is trying to promote more individualised choices for people staying at Clayton Road. We spoke to a person who was returning home after a longer stay at Clayton Road following the death of a parent. Staff were giving extra support to re-assure the person that when they went home there was going to be someone staying with them all the time so that they could live independently. The person told us that staff were always kind to her. Care Homes for Adults (18-65 years) Page 24 of 39 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to receive personal and healthcare in a way they choose and when they need it. Their wellbeing is promoted through staff supervision and training. Evidence: Care plans are in place that detail how each person wants their personal care to be provided and moving and handling assessments are carried out and plans put in place to support people who need additional help. The home has a range of bathing and shower facilities to meet the differing needs of people who come to stay. These range from a standard bath, shower, adjustable shower chair and shower trolley. Moving and transferring equipment is also in place to help keep people safe. Each person knows who their key worker is and their health needs are monitored during each stay. Staff get advice from a wide range of healthcare professionals as and when a person needs. There is a lockable facility in each bedroom so that a person can keep medication, or valuables, safe during their stay. No one who currently visits the home controls their own medication. Care Homes for Adults (18-65 years) Page 25 of 39 Evidence: Medication is kept securely in the home and there is an additional, separate cabinet for controlled drugs. Staff are not responsible for ordering medication. A medication audit book is used to record the amount of medication a person brings into the home and takes away with them. There are also individual medication administration records (MAR), with photographs, that are used to identify medication, dosage and ensure they are correctly administered. We were told that liaison between staff, carers and GPs has improved giving people a better understanding about why certain medications are being taken. Plans are in place to make sure that staff get additional training in the administering of rectal diazapam and buccal midazolam. Healthcare professionals told us that the privacy and dignity of people using the service was always or usually respected, that people were supported to live the life they chose and the service was able to respond to the differing and vaired needs of residents. Care Homes for Adults (18-65 years) Page 26 of 39 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 know that they can raise issues of concern and that they will be taken seriously. Their safety is promoted through staff training and supervision. Evidence: The local authority has robust policies and procedures in place to support the acceptance, recording, and investigation of concerns, complaints and allegations. Information about the complaints procedure is included in the service user guide and copies of Newcastle City Council Have you something to say leaflet is available in the home. All staff have completed the multi-agency Safeguarding Adults Training. One person who uses the service told us that they knew what to do if they wanted to raise a concern. They said I say I want to complain and I can. Staff said they knew what to do if a resident or relative raised a concern, and healthcare professionals told us that the service always responds to concerns or complaints promptly. Everyone is required to have a Criminal Records Bureau (CRB) check carried out at an enhanced level before they are able to work in the service. They are also employed in accordance with the General Social Care Council (GSCC) Code of Conduct. The manager told us that she was re-introducing the use of a pad to record minor Care Homes for Adults (18-65 years) Page 27 of 39 Evidence: issues and/or telephone calls about things like missing items of clothing. This will give the service a better audit trail of minor concerns. Care Homes for Adults (18-65 years) Page 28 of 39 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 stay in a home that is homely and comfortable, gives them access to private and communal space, but is in need of refurbishment. Not all areas are easy to access but the home is clean, tidy and odour free. Evidence: Clayton Road is a semi-detached house located in a residential area of Jesmond. Bedrooms are located at ground, first and second floors. There is no passenger lift so people with mobility problems use bedrooms on the ground floor. Specialist beds are provided in some bedrooms to make it easier for staff to support people and to keep them safe. The building is reasonably well maintained, and two bedrooms and the hallway are due to be redecorated during the month of September. We were told that plans to reprovide the service in purpose built accommodation by November 2009 are well advanced. This new facility will be welcomed by staff and people who use the service. Kitchen facilities in the home are poor useable and the boiler is located in a cage in this area. If the service was not moving to a new site the kitchen would require complete refurbishment. There is an emergency call system in operation in the home so that people can alert staff if they get into difficulty. Care Homes for Adults (18-65 years) Page 29 of 39 Evidence: Staff have access to personal, protective clothing that they use when delivering personal care. Infection control procedures within the home are under review. The laundry is located on the ground floor where there is washing machine and drying facilities. The washing machine can be programmed to carry out high temperature washes. All areas of the home were seen to be clean, tidy and odour free. Staff work hard to achieve this. One resident told us that the home was always fresh and clean. During the tour of the premises we identified diffuser covers for flourescent tubes in the kitchen and office that were in need of cleaning. Care Homes for Adults (18-65 years) Page 30 of 39 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 who use the service are kept safe through recruitment and selection policies and procedures that are properly followed, staff training and supervision. Evidence: Newcastle City Council has clear and robust policies and procedures for the recruitment and selection of staff. All personnel files are held centrally at the Civic Centre. Mandatory training is oganised by the personal development section of the Council. Individual needs are discussed and indentified through supervision which is carried out by the manager and her deputy. Staff team meetings are held monthly for day staff, and quarterly for domestic and night staff. The manager has identified a need to increase the frequency of team meetings for night staff. Rotas for night staff have been changed and now work on a rolling basis. This means that all members of night staff get the chance to work together promoting a flexible service and sharing knowledge. Two agency staff are currently working on the night shift team but they never work together so that there is always a permanent member of the team on duty. One person who uses the service said the manager and staff always treat me well and Care Homes for Adults (18-65 years) Page 31 of 39 Evidence: listen and act upon what I say. Healthcare professional said that the manager and staff always or usually have the skills required. Four staff said that their induction covered everything very well and one person said in partly did. Everyone said their recruitment and selection was properly carried out, that references were sought and CRB checks carried out. They also felt that they got enough support. Staff have attended training in communication, a workshop on challenging behaviour for someone who uses the service. The facilitators did a from birth to now presentation to make the session more personal. Moving and handling, medication and downs and dementia. Supervision arrangements have changed recently. Staff now have a monthly meetings. One by agenda followed by a keyworker role meeting the following month. At the key worker role meeting issues like files and audit sheets are followed up. Staff levels are adjusted according to resident need. On Tuesday, Wednesday and Thursday mornings two staff are on duty between 07:00 and 14:30. During the same period on Mondays and Fridays three people are on duty and four at the weekend. Afternoon shifts, into the early evening, follow the same pattern. Two waking night staff are on duty and there is a sleep-in, one week in three, when the on-call is shared with Connie Lewcock and Harehills two other local authority services. There is a full time domestic post and two part time ones. Care Homes for Adults (18-65 years) Page 32 of 39 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in an open and inclusive way that promotes the health, safety and well being of people who use the service. Staff do not always remember to keep records up to date which could place some people at risk. Evidence: The manager provided us with a comprehensive copy of the homes Annual Quality Assurance Assessment (AQAA) when we asked for it. She has eight years experience working at Clayton Road, has just completed a National Vocational Qualification at level 4, and manages the service in accordance with the local authority policies and procedures. Staff have access to a comprehensive range of policies and procedures within the home and through the local authority intranet. There is a computer for staff use in the sleep-in room. The home is run in an open and transparent way and in the best interests of people who use the service. One person who uses the service said they keep me safe, help me keep calm, give me choices, it is like being at home. The same person thought there should be more Care Homes for Adults (18-65 years) Page 33 of 39 Evidence: bedrooms so that more people could benefit from the service. Healthcare professionals, when asked what the service did well, said: Clayton Road contacts me and my colleague if they have any concerns with the moving and handling of service users in light of the potential safeguarding issues that can arise with poor or controvercial handling. I train all employees yearly and I am available at short notice to answer any concerns as they arise. Identify own training needs and undertake these. Meet the needs of the people who use the service and adapt the care to suit the individual regarding interests and choices. Staff said: Meets the basic needs of most of those who use the short breaks service. Meets the needs of individuals. Staff know service users well. Respond to a wide range of individual needs. Create a welcoming environment and encourage community presence. Good introduction process for service users. Promotes community presence by using local facilities. Meets the needs of service users. Introduces new experiences to service users to enhance their life experiences. Trains staff to a high standard. Support service users and carers to help maintain their presence at home, by providing a break for them. People felt the way the service could improve was with the provision of purpose built accommodation. Staff also raised issues about being able to think for themselves, how staff are addressed, staffing levels and sickness management. These issues were discussed with the manager during the inspection but people who had made comments also said they did not want to speak to an inspector so it was difficult to clearly identifiy particular issues that could be addressed. File audits are carried out and areas for improvement and omissions are identified and followed up through supervision. A new weekly staff meeting has been introduced where people get the chance to discuss who has been in, who is coming in, and pass on any issues of concern or need for change. These started in January this year and are said to be valued by staff. No regulation 26 visit notes were available in the service. We were told that these were with the administration team for typing. A repairs book is completed by staff when things are reported and these are usually, but not always, signed off/dated when completed. A random check of the system used to record and keep money on behalf of people using the service was carried out. Each person has an individual, sealed pocket and sheet that records the amount of money they brought in with them, when they have had access to it and how much money they have returned to staff for safe keeping. As well as this there is a house in/out book that shows the total amount of money being kept. Care Homes for Adults (18-65 years) Page 34 of 39 Evidence: When people return home they take their money and any receipts away in a sealed envelope so that they and their carers know what has been spent and where. During the check we identified a minor recording issue and a discharge entry that had been missed. Water, refridgerator and freezer temperatures are ususally checked and recorded but some gaps were seen in the records. The fire log showed that checks on fire alarms are not always recorded on a weekly basis, there was no check of lights recorded for March and no equipment check for May. A risk assessment and advice about legionnaires disease and checks that must be carrried out are in place. A new system for recording health and safety checks was introduced in April this year. Staff are still not recording on a regular basis that they have carried out the checks on overhead tracking equipment, hoists, and bath chairs. Care Homes for Adults (18-65 years) Page 35 of 39 Are there any outstanding requirements from the last inspection? Yes  No  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 36 of 39 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 Description 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 Description Timescale for action 1 42 13 Staff must carry out and record fire and health and safety checks. 01/10/2009 This will help to keep people who use the service safe and well. 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 6 Work should continue to make sure that service user and care plans are more person centred and properly reflect the hopes, needs, wishes and dreams of people who use the service. The local authority should consider introducing a system that promotes the involvement of social work, day care and respite services carrying out reviews together. This would help to promote a more person centered approach to care planning. 2 6 Care Homes for Adults (18-65 years) Page 37 of 39 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 3 6 Each persons file and medication record should include an up to date photograph of the person. This will mean that new or agency staff are easily able to identify the person they are working with. Consideration should be given to introducing a consent form for people to sign to say that they are agreeable with their photograph being taken and what the limitations for the use of photographs are. This will help to promote the privacy, dignity, choice and independence of people who use the service. Diffuser covers for flourescent tubes in the kitchen and office should be cleaned out to promote infection control. The frequency of team meetings for night staff should be increased to improve the level of support they get. File audit sheets should clearly show where staff have met timescales and if not why. This will promote the safety and well being of people who use the service. Staff should ensure that all records are properly and fully completed, dated and signed. This promotes good practice and helps to make sure that people who use and work in the service are kept safe and well. 4 6 5 6 7 30 36 36 8 41 Care Homes for Adults (18-65 years) Page 38 of 39 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. 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. Care Homes for Adults (18-65 years) Page 39 of 39 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!