Care Home: Clevedon House

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What the care home does well Individuals benefit from a well managed service that is run in their best interest. Individuals have a lot of influence in the day to day running of the home. Individuals have a wide range of activities both in the home and the local community. They were leading full and varied lives with plenty of opportunities. The people living in Clevedon House benefit from a service that is person centred and tailored to the individual. Staff had a good understanding of their roles in supporting and enabling individuals. There were good support mechanisms in place for staff including training, supervisions and appraisals. What has improved since the last inspection? There were no requirements from the last visit and the manager and the staff continue to make improvements in all aspects of the running of the home to the benefit of the people living there. What the care home could do better: There were no requirements from this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Clevedon House 70 Clevedon Road Weston Super Mare North Somerset BS23 1DF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Paula Cordell     Date: 1 4 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Clevedon House 70 Clevedon Road Weston Super Mare North Somerset BS23 1DF 01934624836 F/P01934624836 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Freeways Trust Limited Name of registered manager (if applicable) Mr Simon Rowley Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Clevedon House is part of the Freeways Trust and is a community home for people with a learning disability. It is situated in a quiet residential area of Weston-superMare, close to local amenities, the seafront and the town centre. The home is two converted semi-detached Victorian houses. The current range of fees is £556.81 to £722.99. 12 Over 65 12 Care Homes for Adults (18-65 years) Page 4 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: This was an unannounced visit as part of a key inspection process. The purpose of the visit was to review the requirements and recommendations from the visit in February 2007 and to monitor the quality of the care provided to the individuals living at Clevedon House. There have been no additional visits between this and the visit in February 2007. Although the Care Quality Commission has completed Annual Service Reviews to ensure that the service continues to operate to a good standard. This included seeking the views of people living in the home, staff and other professionals. In addition the manager has completed an annual quality assurance assessment which provides information about how the service could evidence how it was meeting the National Minimum Standards and what improvements were planned for the forth coming twelve months as well as some statistical data. Care Homes for Adults (18-65 years) Page 5 of 29 The visit was planned using information that had been received since the last visit including notifications in respect of incidents that effect the well being of the individuals and general correspondence. During the visit opportunities were taken to speak with people who use the service, staff and the manager. Records were viewed in respect of the running of the home including care documentation, staffing and health and safety. A tour of the home was completed ensuring it was a safe place to live and work. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: 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. Care Homes for Adults (18-65 years) Page 7 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 8 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. Individuals have sufficient information about the service being provided at Clevedon House. Good assessment of the persons needs ensures that their care needs could be met whilst living at the home. Evidence: A statement of purpose and service user guide was in place that met with the National Minimum Standards. The information had been reviewed and amended to include the change in management and clearly described the service provided at Clevedon House. There was one vacancy at the time of the visit. One individual was staying at the home for a couple of days as part of the assessment process. Both the manager and the assistant manager said that the person had been encouraged to visit to ensure that the staff could meet the individuals care needs. In addition the manager said it was important for the individual to spend time participating in life at Clevedon House ensuring they were happy to move there and to ensure that they got on well with the other people living there. From the conversations with the manager and the assistant manager it was evident the visits were tailored to the individual including overnight Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: stays. It was evident that the manager was being proactive in seeking out as much information as possible about the person involving both the individual and other professionals. A copy of the placing authorities assessment and care plan had been sought and other valuable information from the individuals previous placement including risk assessments and care plans. The assistant manager stated that this would be used to inform the homes care planning processes. Once individuals move to Clevedon House, staff complete a check list, so that each person is clear about issues such as confidentiality, the sort of information that would be kept about them, who the staff are, what their rights are and an introduction to the other people they will share with. Staff also show the person how to use the homes facilities, such as the television, kitchen and laundry equipment. Contracts were seen in care files. These had been signed by the individuals where appropriate. The information was up to date in relation to the fees charged and any additional amounts. Care Homes for Adults (18-65 years) Page 10 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. Individuals were well supported in making decisions about how they want to live. Care is tailored to the individuals. Individuals were involved in day to day life at Clevedon House. Evidence: Four care files were looked at as a means to determine the outcomes for people living at Clevedon House. Care files were well organised and contained information relevant to the individual. Care files contained a pen picture detailing any relevant history, a Listen to Me booklet which detailed how the person likes to be supported, what was important to them and other relevant information, a health action plan, a record of medical appointments, monthly and annual reviews, daily records, correspondence and risk assessments. In addition some of the individuals had a person centred plan that was pictorial and Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: detailed the goals the individual had for the forth coming year. It was evident from reading the care documentation and speaking with individuals that they were empowered to lead the life they chose. Monthly reviews were completed with the individual and the key worker with a comprehensive report being completed. This included goals for the forthcoming month, social outings, general review of the person including health monitoring. It was evident that the monthly review included reviewing all relevant documentation including the person centred plan, the listen to me booklet and other associated care documentation. From conversations with individuals it was evident that they were being encouraged to be as independent as possible. Individuals were being encouraged to have more control over their finances, medication and decisions on how they want to spend their time. This was confirmed in conversations with individuals, care records and conversations with staff and the manager. Care plans were broken down into different areas such as physical health, mobility, daily living, psychological and emotion well being, social and leisure interests, personal safety and risks and vocational and education occupation. Care plans were being reviewed monthly, six monthly and annually. The manager and the assistant manager described a service where individuals were being encouraged to actively take part in the running of the home, making day to day decisions on how they would like to spend their time and be supported. The manager said that the individuals and the staff were embracing this change in philosophy well. This was evident in conversations with both the individuals and the staff. One member of staff said that if a person wants to do something this is supported and the same is true if a person does not want to. Another member of staff said there were real opportunities for the people living in Clevedon House and not just in the home but in the community and it was their role to support people to find them. It was evident that the individuals were empowered to live how they wanted to. Risk assessments covered a wide range of activities both in the home and the local community. It was evident that these did not unduly restrict the person. Care Homes for Adults (18-65 years) Page 12 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. Individuals were encouraged to lead active lifestyles both in the home and the local community. Individuals had been empowered to make decisions that effect them and that of the running of the home. Individuals were aware of their rights. Good contact was maintained with friends and family. Individuals had a healthy balanced diet. Evidence: Individuals had a structured activity plan as part of their day care. Individuals attend various day centres, work placements. college courses and activities with the staff and independently. The assistant manager said much work had been completed over the last year to ensure that activities remain appropriate and new activities had been organised due to the closure of one of the day centres. Individuals spoken with during the visit enthusiastically described how they spend Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: their time either at work or participating in leisure activities. From the conversations it was evident that new opportunities had been opened up to them. Each person had a life skills day to enable them to complete personal chores with support which included some one to one time with staff. Individuals confirmed they could go shopping or out for lunch. One person said they were supported on a weekly basis to go and buy their favorite magazine. From reading the monthly reviews it was clear that individuals were supported to go out at frequent intervals. Individuals were keen to talk about the Christmas party that had been recently organised and how successful it had been. From the conversations with individuals it was evident that they had busy social calendars with further parties and festive celebrations to attend. There was a mini bus to assist with individuals accessing their day care and general social activities. However it was evident that some of the individuals travel independently using pubic transport. Individuals were supported to attend church if they wanted. It was evident that individuals cultural and religious needs would be met from reading care documentation, speaking with individuals and the staff. Individuals were supported to have an annual holiday. One individual said they had been to Butlins and had really enjoyed it there. Photographs were displayed throughout the home of day trips and holidays that had been experienced throughout the year. Individuals were supported to attend social clubs in the local area to meet with friends both during the day and in the evenings. Individuals confirmed they could invite friends and family to the home and keep in contact with them. A record of visitors was being maintained. Individuals had recently been informed of their rights and a copy of the booklet was displayed on the notice board. One of the individuals belongs to a local advocacy group supporting other people with a learning disability. One person said that whilst they like living in Clevedon House they want to return to Bristol. It was evident that this decision was being supported and the person was visiting homes with staff support. House meetings were being organised on a monthly basis with minutes being maintained. It was evident that individuals were proactive in making suggestions Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: about the running of Clevedon House, including decoration and repairs, menu planning and social events. The recent minutes were displayed on the notice board along with community events, a user friendly copy of the complaints procedure and other valuable information for the individuals to read about Freeways Trust. Individuals had available to them a pictorial staff rota which depicts who is working in the home over a 24 hour period and a board to enable individuals to show whether they were in or out of the building. This is good practice. The assistant manager said that this had been positive in relation to reducing anxieties for some of the individuals about who was working and who was in or out of the home. Individuals spoken with confirmed they were involved in the menu planning and were regular asked what they would like to eat. Individuals were involved in the making of their breakfast and lunch and take it in turns to assist with the preparation of the evening meal. Individuals were observed making hot drinks throughout the visit either independently or with staff support. The menu demonstrated that a healthy and varied diet is available. Care Homes for Adults (18-65 years) Page 15 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. Individuals personal and health care needs were being met. Individuals were being protected by the medication systems that were in place. Evidence: Care files included information about how the person liked to be supported with their personal and health care needs. Records were maintained of health care appointments and follow up treatment. Each person had a health action plan. They were phased very much from the point of view of the person to whom they belonged and included clear information on how they liked to be supported. From reading the care documentation it was evident that the individuals had regular access to Dentists, Opticians, Chiropodists and other health professionals including the local Community Learning Disability Team. All the individuals were registered with a local GP. As part of the monthly reviews a record was made of all health appointments and any incidents that had effected the wellbeing of the person. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: The medication system was reviewed and records seen were clear and thorough of medication entering the home, administration and disposal. Each person had a medication profile detailing the support they required, medication prescribed, what it was for and side effects. Surplus medication was stored in a cupboard under the stairs. The manager said they were in the process of ordering a new medication cabinet as the present cupboard was not big enough. No requirement was made as the manager said this would be resolved and they were already in discussions with the pharmacist. A medication policy was in place as seen at previous visits. Staff receive training as part of the organisations induction where their competence is assessed. Staff in addition had received training from the local pharmacist. The manager said they were planning to organise medication training for all staff annually. Good practice would be staffs competence be reassessed at periodic intervals with a record maintained. Presently once staff had been assessed as competent when they first start working for the organisation this is rarely reviewed. The manager said that the organisation was in the process of reviewing medication practices with the plan to improve staff training in all the homes. Some of the individuals self medicate and it was noted that suitable safeguards were in place. Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals were being empowered to raise concerns about the service being provided. It was evident that the views of the people using the service were sought thus improving the outcome for individuals living at Clevedon House. Systems were in place to ensure individuals were being protected from harm Evidence: There was a complaints procedure in place to guide individuals on the process of raising concerns including the timescales. This was available in an accessible format including pictures, plain English and large print. Five individuals were consulted about how they felt about raising concerns about the care they were receiving. All said they would discuss with a member of staff or the manager. The complaint record demonstrated all complaints were taken seriously and addressed promptly. The record included the nature of the complaint, what actions were taken to address each issue and what outcomes were achieved. The complaint was signed off by the complainant, the manager and senior management in the main Trust Office. It was evident that individuals were empowered to discuss their concerns and feelings about the care they receive. Individuals said that at times group living can cause friction but the staff were supportive and had strategies to respond to the situations that occasionally arose. It was evident that the concerns individuals had about others Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: was recorded. This demonstrates an open, transparent and an empowering service. The manager said that a lot of work continues to ensure that the individuals have the confidence to raise concerns thus improving the service for them. Individuals living in the home had recently been given a copy of their rights in an accessible format The Care Quality Commission had not received any complaints about the service provided at Clevedon House. Staff had completed safeguarding training and the manager was in the process of ensuring that this was being refreshed for all staff. This was also completed as part of the staff induction and the Learning Disability Qualification. Staff had a good awareness of what constitutes abuse and the procedure in place. The Freeways Safeguarding policy was clearly displayed in the office and that of the local Council in respect of reporting allegations of abuse. The majority of staff had attended training in supporting individuals that challenge and updates for those staff that need it. This was confirmed in staff training records. One member of staff said they were planning to attend this training in the new year. They commended the training that was in place. Care files included a plan to support individuals with behaviours that challenge. From talking with staff and the manager it was evident that due to the person centred approach being adopted and the staff being proactive in reducing anxieties, behaviours that challenge have been reduced. It was evident that individuals were encouraged to talk through their anxieties as observed with two of the individuals during the visit. Staff enabled the individuals to go somewhere quiet and in private to discuss what was concerning them. Individuals spoken with during the visit said staff were always available to talk to them. Finances were not checked on this occasion. Finances were being checked at frequent intervals by the staff in the home, the manager and a representative from Freeways Trust on a monthly basis. Financial policies were in place to guide staff and individuals risk assessments detail the support the person needs and the level of control and responsibility they have. Care Homes for Adults (18-65 years) Page 19 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. Clevedon House provides a safe and homely environment for the individuals living there. Evidence: Clevedon House is situated in a quiet residential area of Weston-super-Mare, close to local amenities, the seafront and the town centre. It is in keeping with the neighbouring properties. The home is made up of two semi-detached properties. Individuals benefit from a large lounge/dining room with French windows leading to the enclosed garden to the rear of the property. There was a smaller television lounge and an activities room leading off from the main lounge. Since the last visit the kitchen had been replaced and new appliances had been installed. Individuals were making full use of the kitchen during the visit making their own lunch and hot drinks and assisting with the unloading and the loading of the dish washer. A number of bedrooms were viewed. All bedrooms seen were comfortably furnished and decorated to the taste of the individual. Individuals confirmed they could choose the color scheme and were supported to purchase furniture if required. A new person Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: was visiting the home for a weekend and they were encouraged to bring personal items to make their bedroom more homely. Indviduals confirmed they could have a key to lock their bedroom door if they wished. Staff were observed knocking on doors prior to entering ensuring the privacy of the person was respected. Two staff sleep in at night in and two rooms were allocated for this. One was sited on the ground floor and the other on the first floor. The ground floor sleep in room was sited next to the office leading from the lounge. Sufficient bathrooms were situated throughout the home. Some of the bedrooms have ensuite facilities. All bathrooms and toilets were lockable but could be overridden in the case of an emergency. The home was clean and free from odour. Cleaning schedules were in place to demonstrate that routine cleaning was completed. Individuals living in the home confirmed that they were actively involved in household chores. Each person had an allocated day a week to complete life skills which included cleaning of their bedroom and the laundering of their clothes, where required staff would support them with this. It was evident from talking with some of the individuals they enjoyed the responsibility of completing the chores. Carpets throughout the hallways of the home were stained and required a deep clean. The manager said that quotes are being obtained for this. Whilst this does not distract from the care that is being provided it would enhance the home. An inspection was completed by Environmental Health in January 2009 with a one star award being given. There were a number of requirements and recommendations and it was evident that these have now been met with better recording being in place. The new refurbished kitchen had assisted in improving the cleanliness. There were a number of adaptations to assist people with mobility and personal care including walk in showers, specially adapted baths and hand rails. From talking with the assistant manager and the manager it was evident that where individuals needs were changing advice would be sought and the appropriate equipment would be purchased. There was a separate laundry facility sited away from the kitchen area and the preparation of food. Staff said that this was adequate for the needs of the home. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Staff had attended infection control training as part of their induction and this is periodically updated. Infection control guidelines were in place as seen on previous visits. 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. Individuals were being supported by sufficient and competent staff. Individuals were being protected by a robust recruitment process. Good support mechanisms were in place to guide and direct staff ensuring a consistent approach. Evidence: Clevedon House is staffed 24 hours a day. The minimum staffing levels was two throughout the day and evening and two staff sleeping in at night. On the day of the visit there was three staff working in the home. From talking with staff and the individuals it was evident that sufficient staff work in the home. The assistant manager stated the home is fully staffed. Recruitment information was seen for two staff. All information was in place to demonstrate a robust recruitment process had been completed including two references, a completed application and a memo from Freeways Human Resources stating a satisfactory enhanced criminal record bureau disclosure had been received prior to staff commence working in the home. Staff complete an in-house induction and the Learning Disability Award Framework. All staff had completed this within the timescales and good records were maintained. Newly appointed staff complete all statutory training as part of their induction Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: including first aid, manual handling, fire and health and safety training. These are then updated annually. Other training attended as part of the induction was a values day in relation to supporting people with a learning disability, financial training, safeguarding and medication training. This was confirmed in conversations with staff, the manager and staff training records. Standard relating to 50 of the workforce having a National Vocational Award had been exceeded. Nine out thirteen staff have a National Vocational Award at either level 2 or 3. It was evident from talking with staff there was a commitment from the organisation to ensure they have the skills and knowledge to enable them to fulfil their roles. The assistant manager said she had the role of reviewing staff training and the responsibility to develop a training plan for the team. Recent training has included Human Rights and Equality and Diversity. The manager said they were working with North Somerset Council and completing a review of how the service is meeting equalities and diversity for each person. Other training has included supporting individuals that challenge and dementia. From talking with staff it was evident that they felt supported in their roles, informally and formally with monthly supervisions and annual appraisals taken place. Staff meetings were being organised monthly with a variety of topics being discussed relevant to the running of the care home and meeting the needs of the individuals. Staff meetings included an element of training. 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. Individuals benefit from a well managed service. There was an open culture where by the views of both staff and individuals were sought in making improvements to the service provided. Individuals had a high degree of influence in the running of the home. Clevedon House provides a safe place to live. Evidence: Mr Simon Rowley is the registered manager. He has been in post since January 2009 and successfully completed the fit person process with the Care Quality Commission in October 2009. Mr Rowley was the assistant manager prior to becoming the manager and has supported individuals with a learning disability for many years. He has completed the Registered Managers Award. Staff described an open door approach to the management of the home. Individual staff had designated responsibilities for particular aspects of the running of the home, according to their interests and skills. Regular meetings were taken place enabling the staff to participate and express their views. Staff said morale was good in the home Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and described a cohesive team working together to support the individuals living at Clevedon House. From talking with staff it was evident they were clear about their roles and the mission statement of the service to empower the individuals living in the home. Good quality assurance systems were in place including audits of the environment, care reviews, medication audits, training analysis for staff including supervisions and support. In addition the provider was completing monthly visits (Regulation 26). The reports were informative and assess the quality of the care and the general running of the home. There was also a business plan for the service to develop further. Questionnaires were given to relatives, visitors and individuals using the service enabling them to express their views. The fire log book demonstrated that there was regular checks on the fire equipment and staff were participating in regular training and fire drills. A monthly health and safety check of the environment was also being carried out. As seen at the last visit Freeways had comprehensive health and safety policies and risk assessments on site. The risk assessments included fire, chemicals hazardous to health, food hygiene and other tasks that staff were involved in. These had been kept under review. Electrical, gas appliance and manual handling equipment checks were being completed by external contractors at appropriate intervals with certificates being kept. Water temperatures were being routinely checked and radiators were covered to prevent individuals being scalded. It was evident the team were ensuring the safety of the individuals. 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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