Care Home: Coleraine Road 30 & 37

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well This is an extremely well managed home that provides high quality support and care for residents, which they appreciate. Some of the residents have complex needs, and the home maintains high quality documentation to assist in how residents can be supported to meet these. The home is sensitive to residents` cultural and religious needs. The home involves residents at all stages in working on the most effective ways of helping them as individuals to gain the skills and confidence to be more independent in their daily lives. Residents continue to enjoy a wide range of activities including opportunities to develop their skills in the home, in the community and on exciting holidays abroad, with a holiday to the Philippines currently being planned. The two houses are maintained to a high standard with facilities that exceed the national minimum standards for provision of accommodation. Staff have a wide range of training and development opportunities including effective induction and other core skills training when they are first recruited. Staff receive a high standard of support and supervision from management to ensure that they work in line with best practice. A very high standard of health and safety documentation is maintained at the home and clear systems are in place to address maintenance issues as these arise. Feedback from residents praised `nice holidays abroad, good food, good outings, good communication, advice and medical support, football, long walks, yoga, cinema and dinner out.` One person noted that they `always get the opportunity to speak up,` and that they are respected and given choices. Another resident advised `the staff support me with my daily life - I am happy at Coleraine Road,` and another person advised `everything is OK.` Feedback from a relative noted `my relative is very settled at Coleraine Road, after two failed placements. Edward, Kamrul and all the staff have worked so hard to understand their needs, exercising enormous patience and helping them to overcome difficulties.` Another relative advised that `all of the staff at Coleraine Road have a great connection with my relative, I have never seen them happier. They know how to get the best out of them.` Feedback from healthcare professionals indicated that the home`s management` plan and gear services to an individual manner` and also provide `appropriate social activities and holidays.` Another professional noted that it `provides a holistic approach to its residents, and treats residents and staff well.` It was noted that `other providers could emulate this service,` and that this is `an excellent provider of services.` Staff advised that the home runs very smoothly, and felt that the home`s strengths lay in giving residents choices, respect, encouraging independence, and regular monitoring of their well being, high standards of training for staff, equal opportunities, and very good holidays abroad. What has improved since the last inspection? As required at the previous isnpection risk assessments for each resident were being reviewed at least six monthly. `As and when` medicines taken out of home in case of need, were being recorded in and out of the home as recommended, and there were clear records of resident`s valuables which are kept in office for safekeeping. Both houses were in the process of being redecorated at the time of the inspection, with some items of furniture renewed including the sofas in each house. A new person centred plan format had been introduced for the home which provides more detailed information regarding residents` preferences. Resident representatives are now invited to staff meetings, further empowering them regarding the running of the home. The home is currently working towards accreditation with the National Autism Society. What the care home could do better: Staff must sign for medication administration at the time that it is administered to avoid the risk of mistakes being made. It is recommended that consideration be given to providing covered areas within the rear gardens of the houses, for those wishing to smoke, and that regular `mock inspection` visits be undertaken to the home as a quality audit tool, and to ensure that staff are fully aware of all relevant information relevant to the wellbeing of residents. Key inspection report Care homes for adults (18-65 years) Name: Address: Coleraine Road 30 & 37 Coleraine Road 30 & 37 London N8 0QJ     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: Susan Shamash     Date: 0 7 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Coleraine Road 30 & 37 Coleraine Road 30 & 37 London N8 0QJ 02088884348 02083428161 kamrul4@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Edward William Marcus care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home The Coleraine Project is made up of two mid-terraced houses located opposite each other in Coleraine Road. The project is located in a residential area of Wood Green North London, less than a 100 yards from Wood Green High Road and the extensive shopping, transport and leisure facilities that the area has to offer. The two houses, which comprise the project, are registered as one care home offering personal care and support for up to eight residents whose primary need for care is that they have a learning disability. There are four bedrooms in each house, and the communal areas include a lounge, kitchen diner, utility room and back garden. Both houses have a ground floor toilet, and first floor bathrooms and additional toilet. Neither house has been adapted to provide for residents with a physical disability. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 Brief description of the care home The registered provider both owns and manages the home. The staff team of the project work in both houses to ensure that they become familiar with and to all the residents. The aim of the service is to provide a home, which encourages and supports residents to build a home life and participate actively in a lifestyle, which reflects their values and preferences. In addition, the home aims to promote the independence and integration of residents within the local community from a secure and homely base. The most recent inspection reports can be obtained from the main office at the home and from the CQC website www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took approximately five hours. The deputy manager for the home, Mr Kamrul Hassan-Shiblee, was present for the majority of the visit. He has been delegated significant areas of responsibility for managing the home on a day-today basis, and remains extremely knowledgeable about both the management issues in the home and the needs of the residents. There were six residents accommodated at the home, with two vacancies at the time of the inspection. The inspection included meeting and talking to five residents, talking with the deputy manager and three other staff members, independently, a tour of the premises and inspection of a range of documentation kept in the homes including staff and residents records. Completed feedback forms were received from six residents, two health or social care professionals, two relatives/visitors to the home and twelve staff members. These Care Homes for Adults (18-65 years) Page 6 of 30 provided very positive feedback about the home. Information provided in the most recent Annual Quality Assurance Assessment for the home, was also taken into account as part of this inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: This is an extremely well managed home that provides high quality support and care for residents, which they appreciate. Some of the residents have complex needs, and the home maintains high quality documentation to assist in how residents can be supported to meet these. The home is sensitive to residents cultural and religious needs. The home involves residents at all stages in working on the most effective ways of helping them as individuals to gain the skills and confidence to be more independent in their daily lives. Residents continue to enjoy a wide range of activities including opportunities to develop their skills in the home, in the community and on exciting holidays abroad, with a holiday to the Philippines currently being planned. The two houses are maintained to a high standard with facilities that exceed the national minimum standards for provision of accommodation. Staff have a wide range of training and development opportunities including effective induction and other core skills training when they are first recruited. Staff receive a high standard of support and supervision from management to ensure that they work in line with best practice. A very high standard of health and safety documentation is maintained at the home and clear systems are in place to address maintenance issues as these arise. Feedback from residents praised nice holidays abroad, good food, good outings, good communication, advice and medical support, football, long walks, yoga, cinema and dinner out. One person noted that they always get the opportunity to speak up, and that they are respected and given choices. Another resident advised the staff support me with my daily life - I am happy at Coleraine Road, and another person advised everything is OK. Feedback from a relative noted my relative is very settled at Coleraine Road, after two failed placements. Edward, Kamrul and all the staff have worked so hard to understand their needs, exercising enormous patience and helping them to overcome difficulties. Another relative advised that all of the staff at Coleraine Road have a great connection with my relative, I have never seen them happier. They know how to get the best out of them. Feedback from healthcare professionals indicated that the homes management plan and gear services to an individual manner and also provide appropriate social activities and holidays. Another professional noted that it provides a holistic approach to its residents, and treats residents and staff well. It was noted that other providers could emulate this service, and that this is an excellent provider of services. Staff advised that the home runs very smoothly, and felt that the homes strengths lay in giving residents choices, respect, encouraging independence, and regular monitoring Care Homes for Adults (18-65 years) Page 8 of 30 of their well being, high standards of training for staff, equal opportunities, and very good holidays abroad. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents receive sufficient information about the service prior to admission, and have opportunities to visit and stay at the home. They can be confident that their aspirations and needs will be assessed to ensure that these are met when they move into the home, and that every effort will be made to ensure that they will mix well with future people admitted to the home. Evidence: No new resident had been admitted to the home since the last inspection. One resident had moved on to more independent accommodation, and one resident had passed away since the previous inspection visit, leaving two vacancies at the home. Discussion with the deputy manager indicated that several prospective new residents had been referred to the home, however the management take a great deal of care in ensuring that new people admitted will fit in well with existing residents. Thus far there had been incompatible factors relating to those referred to the home. The service is commended for the care taken to ensure that people living in the home will be compatible in the interests of ensuring all residents have a high quality of life. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The files for three residents were inspected and these included a comprehensive range of multi-disciplinary assessment information, including the current legal status of each resident under mental health legislation. There was also evidence that the home had undertaken significant assessment work of its own to make sure that it had the necessary resources to meet the residents needs. From records seen and from discussion with staff, it was also evident that work had been undertaken to minimise any potential disruption to other residents and to facilitate a smooth transition for all. Residents were spoken to independently and all were positive about the admission process and about the home. They confirmed that they had been given copies of the service users guide on admission to the home and that it contained useful information as appropriate. They also confirmed that they had been able to visit, and stay at the home for increasing periods of time, for however long this might take, to ensure that they wished to move in on a permanent basis. In one persons case it had taken three months before they permanently moved into the home. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents changing needs and personal preferences are clearly documented to assist staff and relevant others to meet their needs and wishes. They are supported to make informed decisions about their daily lives with any restrictions being agreed with them and recorded. They are also supported to take appropriate risks in their lives in order to safely achieve their aspirations. Evidence: Care plans for three residents were inspected in depth. All the care plans seen were detailed, current and were broken down into assessed needs with clear guidance for staff on how to meet each need. The plans were also informed by relevant risk assessments; and included monthly summaries of progress made in meeting the identified needs. They were signed by the relevant resident to evidence that they had been involved in making and monitoring the plans. Person centred plans (PCPs) were available for each resident. These included: a Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: record of the latest assessed needs for the person taken from the last review; the care plan, an individual support plan; a person centred plan; a communication passport; a heath action plan and the latest resident involvement questionnaire regarding the quality of support in the home. The deputy manager had recently introduced a new PCP format including more detailed information about residents preferences. This had been completed for one resident at the time of the inspection. The service is commended for work in this area as it evidences a high degree of resident participation in the process. This was confirmed by independent discussion with residents. Residents spoken to confirmed that they were supported to make decisions for themselves. The majority can and do travel independently in the community. Where restrictions are placed on this, these are clearly recorded including discussions with those residents on the implications of these restrictions. The home undertakes a range of relevant risk assessments for each resident alongside a number of generic risks that are assessed for all residents on an individual basis. These include: issuing of front door keys, travelling independently in the community, window restrictors, use of hot water and smoking. These are supplemented by additional risk assessments for residents where other risk factors have been identified. There was evidence that the risk assessments are reviewed regularly with each resident to ensure that they are up to date and that the guidance for staff on how to minimise these risks remains effective. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy a range of appropriate activities at home and within the local community, including a high level of support to find employment. The service is commended for providing residents with support to enjoy regular holidays to long haul destinations abroad that significantly contribute to enriching their life experiences. They are supported to maintain relationships with friends and family members and their rights and responsibilities are respected. They enjoy balanced, healthy and varied meals of their choice. Evidence: Residents attend a range of relevant daytime activities within the local community. This includes day services and attendance at local education facilities, and support to find employment. Staff at the home described the extensive support provided to one resident to find and maintain their employment at a local garden centre. Support includes use of a token reward scheme for meeting particular elements of the required Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: competencies to keep their job. Residents confirmed that their cultural needs were being met. One resident, who is a practicing Muslim, is supported in their dietary requirements, and receives staff support to attend their Mosque for worship. They were also supported to observe the festival of Ramadan and celebrate Eid. Celebrations for Eid, Diwali and Christmas are held within the home, and one person is supported to attend church according to their wishes. The resident advised that this support was given in a sensitive and supportive way. Evidence was seen that staff had worked with individual residents to develop their communication passports as referred to in the Individual Needs and Choices section of this report. Residents had recorded in these their likes and dislikes as well as their aspirations for the future. The process of developing the communication passports allowed staff and residents to explore options for residents to try out new experiences including identifying valued daytime activities for them to undertake. One resident told me that they like the home more than any of their previous placements advising I have more freedom here. Evidence was seen that residents are able to access the varied local community resources including shops, pubs, restaurants, cinema and recreational facilities. Other activities enjoyed by residents included playing pool and snooker, handball, football, swimming, horse riding and attending a local leisure centre, the cinema, college, work experience, daycentres and visits to places of interest around London. Several residents had also recently taken up a yoga class on a regular basis. Cable television, a playstation and table football are also available to residents in the home, and over the summer barbeques were held at the home, and day trips had been arranged to the seaside. Residents continue to be supported to go on holidays abroad each year, often to exotic long haul destinations. In recent years residents have been supported to go on holiday to Borneo, Malaysia, Mexico, Thailand and Goa. Discussion with staff and residents, and records of resident meetings confirmed that the next planned holiday over the current winter was planned to the Philippines. One resident who prefers not to travel abroad was supported to attend a holiday in Kent this year, and confirmed that they generally have two short holidays within the UK each year. The home had a four weekly menu, and I saw evidence that residents are involved in planning this at monthly resident meetings. The home can cater for different dietary requirements and cultural needs and food stocks in the home and menus recorded confirmed this. Meals are prepared, cooked and eaten in the kitchens/dining rooms at both houses. Residents are actively encouraged to be involved in the preparation and Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: cooking of meals. The kitchens in both houses were inspected and were clean, tidy and satisfactorily equipped. The food was stored appropriately and matched the menu including Halal meat for Muslim residents. Satisfactory records of fridge and freezer temperatures were seen. A wide range of fresh fruit and vegetables were stocked. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support to meet their physical and emotional needs according to their preferences. They are protected by robust polices and procedures regarding medication and its administration and are encouraged to take as much responsibility for administering their own medication as possible to promote their independence in this area. Evidence: Care plans, daily notes and health need summaries for each resident indicated that their personal care, and health care needs are being met appropriately. This was confirmed by residents and staff members spoken to. Residents also confirmed that they are supported to see health care practitioners on a regular basis. Detailed records of all health appointments attended, ensure that up to date information is maintained regarding all residents needs. These also indicated that proactive healthcare support is sought for all residents without delay. Information provided in the Annual Quality Assurance Assessment for the service indicated that when one resident was seen sitting very close to the television screen, an opticians appointment was arranged, and it emerged that this person had a cataract problem, which was then treated with their Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: consent. Similarly one resident was found to be sluggish in the mornings, and a GP appointment was arranged for them, from which it emerged that this person had a thyroid problem, which could then be treated with medication. All residents had been given the opportunity to have a flu vaccination, and residents attended regular GP, chiropodist, dentist and optician appointments as appropriate. The deputy manager advised that the SPELL model structure continues to be used by staff working with residents. This includes a Structure, Positive approaches, Empathy, Low arousal and Links with the other professionals within the community. Medication and medication administration record (MAR) charts were inspected in both homes. These were found to be satisfactory and showed evidence that residents are encouraged to take as much control over the administration of their medication as possible. Evidence was seen that, where appropriate, identified residents are monitored controlling their own medication rather than having staff administer it directly. Medication was stored appropriately, with the temperature of storage recorded as appropriate. Evidence was also seen from staff files sampled that staff are trained in the safe administration of medication. The deputy manager confirmed that after staff are first recruited they are trained in this area as a matter of priority and also confirmed that all staff undertake regular refresher training in this area. However I observed that one staff member had signed for the administration of medication prior to administering this to a particular resident. A requirement is made accordingly. When particular residents are being supported outside of the home, as and when (or PRN) medication is carried by staff in case it should be needed. Detailed guidance is in place regarding when PRN medications should be administered for each individual resident, and it was noted that these are used very sparingly. As recommended this is signed in and out of the home on each occasion (including the number of tablets taken out of the home and returned) so that a clear audit trail of residents prescribed medicines is maintained. Use of the symbol F on MAR sheets was accompanied by an explanation for why medication was not administered on any occasion, and there were clear records of medicines received into the home and returned to the pharmacy. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives are able to express their views, concerns and complaints and be confident that these will be taken seriously and appropriately dealt with by the home. Robust policies and procedures and staff training protect residents from abuse. Evidence: The home has a robust complaints policy and procedure in place. One complaint was recorded since the previous inspection, and this had been addressed swiftly. Residents are encouraged to express their concerns to staff members or the management, and are also prompted to speak up about any issues prior to resident meetings. The deputy manager confirmed that thorough investigation of complaints and concerns and their resolution remains a clear part of the homes quality monitoring process. A clear adult protection policy is available for the home and staff spoken to were aware of the action to take in the event of suspected abuse. Staff files evidenced that appropriate Safeguarding Adults (SOVA) training had been undertaken by all staff as appropriate. Staff had also received training in non-violent crisis intervention. Since the previous inspection one resident had raised a safeguarding adults alert, with regard to a day service, and the home had taken appropriate action with regard to alerting the local authority, and ensuring this persons safety. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is comfortable, clean, tidy, well decorated and well maintained creating a pleasant environment for those who live and work there as well as for those who visit it. They benefit from well-equipped bedrooms that they are supported to personalise to their taste. Evidence: The home consists of two separate mid-terrace houses in a residential area close to the main Wood Green shopping centre with good public transport links. All accommodation is for residents who are physically able and there are no facilities for residents with physical disabilities. Evidence was seen that the home had a planned maintenance and redecoration programme. One house had recently been redecorated, and the other was in the process of being redecorated at the time of the inspection. Both homes were decorated for Christmas at the time of the visit, with decorated Xmas trees already including wrapped gifts of treats for residents. I had the opportunity to see five bedrooms with the permission of the residents involved. These were appropriately decorated, furnished and personalised to the extent that each resident wished. All residents spoken to indicated that they were happy with their bedrooms. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Both houses were clean and tidy throughout with appropriate laundry facilities for the needs of the residents. New leather sofas had been provided within each house, alongside large plants making the place look homely and inviting. One house had a football table for use by residents. The deputy manager advised that the there were still some items left to be completed as part of the redecoration programme, and that these should be ready well in time for Christmas. The gardens of both homes were well maintained, and residents advised that they enjoyed using these areas during the summer. The home is an entirely non-smoking zone, and residents wishing to smoke, therefore need to use the garden areas. It is recommended that covered areas be provided in the rear gardens for people wishing to smoke. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes robust recruitment procedures. Sufficient staff members are provided with a wide range of relevant training, to assist them in meeting residents needs. They are provided with appropriate support and regular supervision to ensure that they work in line with best practice. Evidence: Staff and residents spoken to advised that sufficient staffing numbers are provided within the home to meet peoples needs effectively. The rota confirmed that two or three staff members are available within each house, throughout the day. Three staff files were inspected including two staff who had commenced employment at the home within the last year. Records indicated that the home continues to implement a robust recruitment procedure throughout the process. All files contained evidence of satisfactory enhanced criminal records bureau (CRB) disclosures that included protection of vulnerable adults (POVA) checks; two written references that were verified where it was felt appropriate by a follow up telephone check; identification with a photograph; an employment history; a contract of employment and a health questionnaire. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The files inspected also showed substantial evidence that the home continues to be committed to staff training. A detailed induction checklist was seen on each file with each element being signed by both the staff member and a manager. Evidence was also seen that these staff had undertaken a range of core skills training since being employed. This included: fire safety, food hygiene, safe use of medication, infection control, communication skills and first aid training Over fifty percent of staff were trained to NVQ level 2 or above as appropriate, and staff had also undertaken non-violent crisis intervention training, with the deputy manager approved as an accredited trainer for this subject. In the Annual Quality Assurance Assessment for the home it was noted that the home intends to become affiliated with a local open college network in order to provide relevant training to staff members. I spoke with three staff members during the visit, including a staff member who had only newly been appointed. All indicated that they had found the training provided to be useful, relevant and that it had assisted them in supporting the residents in their daily lives. Where video training is used, staff are asked to complete questionnaires, and they are also given the opportunity to attend external training when this becomes available. They spoke highly of the support and supervision provided to them by the homes management. Appraisal records indicated that a 360 degree approach is being used, incorporating feedback from colleagues, for which the service is commended. All staff were receiving supervision sessions at least two-monthly, or more often if required as appropriate. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected and supported by an effective and proactive system of management in the home. Their views are taking into account in reviewing the homes strengths and areas for development as appropriate, and their best interests are safeguarded by the homes rigorous record keeping procedures. Health and safety procedures are maintained to a very high standard within the home so that residents safety is safeguarded as far as possible. Evidence: It was clear throughout the inspection process that the registered provider/manager continues to delegate a significant amount of the day-to-day management responsibility for the home to the deputy manager. The deputy manager stated that the registered provider/manager monitors his work and that he continues to be supported by him. The deputy manager had completed his Registered managers Award and is also registered as the manager for another home owned by the provider. Discussion with him confirmed that he continues to be very knowledgeable and closely involved within the home, with strong and supportive relationships demonstrated with all residents. The registered manager is currently undertaking an MA degree course in Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Autism. The high standard of management of the home indicate that the deputy manager is coping extremely well with both roles, and he advised that he has sufficient time to work at this service and the other service for which he has been appointed as registered manager. Staff and residents spoken to confirmed that he provides them with support as appropriate. Staff and residents spoken to throughout this inspection were positive and complimentary about the management of the home. They also indicated that they continued to appreciate the positive and optimistic ethos of the home. Detailed quality assurance procedures were in place for the home. In addition to regular staff meetings and resident meetings, surveys of each residents views of the home had been undertaken. Where residents prefer not to meet formally, they are invited to complete questionnaires on a monthly basis instead. As noted within the Annual Quality Assurance Assessment for the home, resident representatives are invited to attend staff meetings, and the home is commended for this empowering practice. Regular management meetings area also held within the home. It is recommended that regular mock inspection visits similar to regulation 26 visits, be undertaken to the home, to ensure that staff are familiar with all necessary information, and as an additional quality assurance audit tool. A detailed current Annual Quality Assurance Assessment had been completed for the home and returned to the Care Quality Commission as appropriate. The deputy manager advised that the home is working towards becoming accredited with National Autism Society, including regular six-weekly meetings to work towards the standards. Detailed and accurage records were maintained within the home including financial records for monies looked after by the home on behalf of residents, alongside records of valuables kept in the office for residents e.g. passports, bank books etc. A new incident report including more detailed descriptions of precursors and the results of actions taken, had recently been introduced to the home. Health and safety records for the home were inspected, including fire safety records, electrical and gas installation and portable appliances testing certificates. All were found to be in order alongside general risk assessments about the home and appropriate staff training in food hygiene, first aid, health and safety and manual handling. Regular fire alarm testing and fire drills were held within each house, and a monthgly environmental risk assessment is completed for the home. Refrigerator and freezer temperatures as well as cooking temperatures were being recorded daily as Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: appropriate, and the home had received the maximum rating of five stars - Excellent at the most recent Environmental Health inspection of the kitchens. No areas of concern regarding health and safety were observed in either house during the inspection. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must ensure that staff sign for medication administered to residents at the time of administration, to avoid the possibility of mistakes being made. . 31/12/2009 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 24 It is recommended that consideration be given to providing a covered area for people to smoke, outside of the home, for the comfort of residents who wish to smoke. It is recommended that regular mock inspection visits similar to regulation 26 visits, be undertaken to the home, to ensure that staff are familiar with all necessary information, and as a quality assurance audit tool. 2 39 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!