Care Home: Coney Green

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What the care home does well Staff help the people living there to keep in contact with their families and the people that are important to them.Staff spend time sitting talking to the people living in the home so that they feel valued.People living there do individual activities inside and outside of the home that they enjoy.People have the food they need to help them keep well. They are given a choice of food that they like.Complaint procedures are available to people so that they know how to make a complaint if they are unhappy about something.People who live at the home all have their own bedrooms that contain their personal things.Staff have training to help keep people safe from abuse.Systems are in place to help run the home in the best interests of the people who live there. Equipment in the home is regularly checked so that it is safe to use.Half of the staff team have a qualification in care so they should have the skills and knowledge they need to meet the needs of the people living there. What has improved since the last inspection? The service user guide is up to date so that people know what to expect from the home.Each person living in the home has a care plan so that staff know how to support them to meet their needs and goals.Minutes of meetings with people are now in an easy read format with pictures so that they are easier for people to understand.The way in which people`s money is used has been reviewed so that they are not paying for things which the home should pay for.Staff recruitment records show that checks are done to help make sure suitable people had been employed to work with the people living there. What the care home could do better: Systems to assess people`s needs before they move into the home should be improved so that people can be confident the home can meet their needs.Risk assessments need to be further developed to keep people as safe as possible.Minor improvement is needed to the medication system to make sure people get the medication they need safely.Staff need more training in people`s difficult to manage behaviour so they can keep people safe.Improve the records of fire drills to make sure all staff have the chance to take part in one and know what to do in the event of a fire. Key inspection report Care homes for adults (18-65 years) Name: Address: Coney Green 18/20 Coney Green Drive Northfield Birmingham West Midlands B31 4DT The quality rating for this care home is: two star good 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: Kerry Coulter Date: 0 7 0 4 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 38 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 38 Information about the care home Name of care home: Address: Coney Green 18/20 Coney Green Drive Northfield Birmingham West Midlands B31 4DT 01214781076 01216930187 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kelso Care Consortium Limited Name of registered manager (if applicable) Miss Sophie Kay Donnelly Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 0 care home 9 learning disability Additional conditions: The maximum number of service users to be accommodated is 9 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 (LD) 9 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home The home is on a quiet road in Northfield. It is close to local shops, post office, banks and pubs. Bus stops are close by for Birmingham city centre. The home has its own car that staff use to help people go out. The home is on three levels but does not have a lift. The home provides care for up to nine people who have a learning disability. The home provides care on a short stay and long term basis. Care Homes for Adults (18-65 years) Page 5 of 38 People have their own bedroom with a bath or shower room. The home has two lounges, a dining room, communal bathroom, laundry and kitchen. The front entrance of the home has steps so may be difficult for some people to use. Ramped access is available at the back of the home. The service user guide for the home says it costs from £446.40 to £1148.67 to live at the home. Care Homes for Adults (18-65 years) Page 6 of 38 Copies of our previous reports are available in the home for people to read. Care Homes for Adults (18-65 years) Page 7 of 38 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home This inspection was carried out by one inspector over one day. The home did not know we were going to visit. The manager sent us information about the home before our visit. We met with people who live there and they told us what they thought of the home. We spoke to staff. Care Homes for Adults (18-65 years) Page 9 of 38 We looked at the care records for three people. This is called case tracking. We also looked at staff and health and safety records. We looked at some areas of the home including some peoples bedrooms. We sent surveys to the home to distribute to people who live there, relatives, staff and health professionals. We had lots of surveys returned from people and their relatives, one from a health professional but have not received any staff surveys. What the care home does well Care Homes for Adults (18-65 years) Page 10 of 38 Staff help the people living there to keep in contact with their families and the people that are important to them. Staff spend time sitting talking to the people living in the home so that they feel valued. People living there do individual activities inside and outside of the home that they enjoy. People have the food they need to help them keep well. They are given a choice of food that they like. Care Homes for Adults (18-65 years) Page 11 of 38 Complaint procedures are available to people so that they know how to make a complaint if they are unhappy about something. People who live at the home all have their own bedrooms that contain their personal things. Staff have training to help keep people safe from abuse. Systems are in place to help run the home in the best interests of the people who live there. Equipment in the home is regularly checked so that it is safe to use. Care Homes for Adults (18-65 years) Page 12 of 38 Half of the staff team have a qualification in care so they should have the skills and knowledge they need to meet the needs of the people living there. What has got better from the last inspection The service user guide is up to date so that people know what to expect from the home. Each person living in the home has a care plan so that staff know how to support them to meet their needs and goals. Care Homes for Adults (18-65 years) Page 13 of 38 Minutes of meetings with people are now in an easy read format with pictures so that they are easier for people to understand. The way in which peoples money is used has been reviewed so that they are not paying for things which the home should pay for. Staff recruitment records show that checks are done to help make sure suitable people had been employed to work with the people living there. What the care home could do better Care Homes for Adults (18-65 years) Page 14 of 38 Systems to assess peoples needs before they move into the home should be improved so that people can be confident the home can meet their needs. Risk assessments need to be further developed to keep people as safe as possible. Minor improvement is needed to the medication system to make sure people get the medication they need safely. Staff need more training in peoples difficult to manage behaviour so they can keep people safe. Care Homes for Adults (18-65 years) Page 15 of 38 Improve the records of fire drills to make sure all staff have the chance to take part in one and know what to do in the event of a fire. If you want to read the full report of our inspection please ask the person in charge of the care home. If you want to speak to the inspector please contact Kerry Coulter CQC West Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4WH Tel 0300 616161 Care Homes for Adults (18-65 years) Page 16 of 38 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 17 of 38 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 18 of 38 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need about the home so they can make an informed choice as to whether or not they want to live there. Assessment of peoples needs should be more thorough to ensure that people can be confident the home can meet their needs. Evidence: The Service User Guide and Statement of Purpose were available in the home and had recently been reviewed so they were up to date. People are provided with a copy of the guide before they move into the home. The guide that is in an easy read format that includes pictures. It tells people about the home including the fact that the home may accommodate people who are having respite (short term) care in addition to people who are living there long term. It is good that people moving to the home receive an induction. This includes the opportunity to visit prior to moving in. The induction record shows that people had in addition to receiving a copy of the service user guide been given information about the fire procedures and house rules. People told us that they had received enough information about the home. Care Homes for Adults (18-65 years) Page 19 of 38 Evidence: We looked at the admission procedures followed for three people who had moved into the home since we last visited. For two people an assessment of their needs had been completed before they moved to the home. For the other person it had not been possible to do this as they moved in as an emergency. We saw that the home had completed an assessment of this persons need the day they moved into the home. Assessments of peoples needs included their communication, physical health, mental health, behaviour, medication, activities, daily living skills, social, religious and cultural needs. People who knew the person well such as their relatives and other care professionals had been consulted as part of the process. Since moving to the home some people have displayed behaviours which have meant on two occasions physical intervention had to be used to protect them and others from harm. We saw that for these people their initial assessments regarding their behaviour were not very detailed. A more in depth assessment of their behavioural needs should have been completed. Discussion with the manager after our visit to the home indicates that the home had already identified that their assessment procedures could be improved and were taking action to do this. Care Homes for Adults (18-65 years) Page 20 of 38 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. Care plans and risk assessments give staff most of the information they need to support people to meet all their needs and achieve their goals in a safe way. People who live in the home are supported to make decisions about their lives to enhance their independence. Evidence: We looked at the care records of two people who live at the home and for one person who goes there for short term care. At our last visit to the home not everyone who lived there had a care plan. At this visit each person had an up to date care plan that gave staff information about the support each person needed. It is good that for all people who live there or have short term accommodation a review of their care is carried out every three months by the manager. For one person the home was working on adding pictures to their plan so that it would be easier for them to understand. One relative told us people are treated as individuals and another said they seem to deal with things in a human and personal way unlike some large institutions. Care Homes for Adults (18-65 years) Page 21 of 38 Evidence: Surveys we received from the people told us they were involved in making decisions. Records and discussions with staff show that people are involved in decisions regarding the running of the home, for example they have the opportunity to participate in interviews for new staff. During our visit to the home we observed staff encouraging people to make decisions and choices about what they wanted to do that day. Regular meetings are held with people who live at the home. Minutes of the meetings show that people have been given the opportunity to make decisions about things such as activities, holidays and menus. It is good that the minutes of these minutes are made available to people in an easy read format that includes pictures. This makes them easier for people to understand. Previously we identified that the home had not completed assessments for all areas of risk for people at the home. At this visit we saw that the risk assessment process had been improved and up to date assessments were available. The majority of assessments were detailed and provided staff with the information they needed to reduce the risk of people being harmed. However assessments did not always indicate the level of risk. One person had on several occasions broken items in their bedroom. Their assessment would benefit from further detail regarding the measures in place to prevent them hurting themselves should this behaviour occur. Care Homes for Adults (18-65 years) Page 22 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place so that people living at the home experience a meaningful lifestyle that includes doing activities they enjoy. People are offered a healthy and varied diet that they enjoy. Evidence: People who live at the home have their own individual timetable of activities. Staff told us these are completed weekly with people and so are based on the things they enjoy. We spoke with staff and looked at records and these showed that activities on offer include shopping, cooking, music, bowling, meals out, walks, pubs and visits to local places of interests. One person told us they go to college and they enjoy this. The annual quality assurance assessment (AQAA) recorded that for one person a referral has been made for them to attend a day centre where they would be able to meet with people of a similar cultural background. Care Homes for Adults (18-65 years) Page 23 of 38 Evidence: During our visit most people went out on various activities, this included shopping and vising their family. In house activities were underway, some people were playing board games with staff, some people were dancing to music. We saw that the home had a relaxed atmosphere, people were enjoying themselves and were laughing together. The AQAA told us that the home was intending to find activities for people that involve excercise that they enjoy doing so they have a healthier lifestyle. People told us I enjoy the activities, I like living here, I help with the cooking and I like going shopping and on trips. One visitor to the home told us that their relative had a more active social life than they did. The home has an open visitors policy but they are advised to telephone before visiting as people are often out on activities. Records indicated that people maintain contact with their families and friends and this is supported by staff. One person had a visitor and we saw they were made to feel welcome by staff. Peoples relatives told us they were supported to stay in touch, two relatives commented they were always made welcome. One relative told us I have been to a birthday party at the home, its a lovely place. Staff told us that the menus are completed weekly in consultation with people. Food records sampled showed that people are offered a varied and healthy diet that includes fresh fruit and vegetables. At lunch time and for the evening meal people were seen to have choices of what they wanted to eat. People told us I like some of the food, the food is good and the food is very good. One person had commented in a meeting that they would like more choice of food appropriate to their culture. We saw that the home was taking action to meet this request. Staff had met with the person a few days before our visit to compile a very detailed list of the foods they would like adding to the menu. Care Homes for Adults (18-65 years) Page 24 of 38 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home receive personal support in the way they prefer and require and their health needs are met. Medication practice ensures people receive the medication they need in a safe way. Evidence: Care plans sampled included how staff are to support the person with their personal care. It was evident that they are able to dress, use cosmetics and have hairstyles that are individual and of their own personal choice. The home employs a mix of staff that reflects the gender of the people living in the home so people can chose who they want to support them with their personal care. Interactions between staff and people who live at the home observed on the day were entirely positive and respectful. Care plans sampled stated how staff are to support the person to meet their health needs. Staff said and records showed that a range of other health professionals are involved in the care of individuals. Records sampled showed that staff support people to attend health appointments where needed to ensure they get the health care they need. Staff also monitor whether or not the person has lost or gained weight. This is good practice as a significant loss or gain of weight can be an indicator of an underlying health Care Homes for Adults (18-65 years) Page 25 of 38 Evidence: need. Some people have specific health needs, for example epilepsy. Discussions with staff indicated they had received training in this and staff spoken to knew what to do if the person had a seizure. One health professional told us staff are fully supportive of any advice and recommendations in terms of meeting the health needs of the service user. People are assessed to see if they are safe to administer their own medication. At the time of our visit all the people at the home were assessed as needing staff to administer their medication. Medication is stored in a locked cabinet that is tidy and organised which helps staff to know what medication to give to whom. Staff who administer medication have received training. At the front of each persons Medication Administration Record (MAR) there is a photo of the person so that unfamiliar staff would know who to give it to. Staff had signed the MAR sampled appropriately indicating that medication had been given as prescribed. Where people are prescribed medication on an as required basis there are guidelines in place for staff to follow. This helps to make sure people get the medication they need. Some handwritten changes had been made to the MARs, for example when a medication had been stopped or the dose changed. Hand written amendments should be checked and signed by two staff to make sure any changes made are accurate. Care Homes for Adults (18-65 years) Page 26 of 38 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the views of the people living there are listened to and they are protected from harm. Evidence: The complaint procedure is on display in the home, an easy read version with pictures is also available for people who live there. This makes it eaiser for people to know how to make a complaint. Minutes of meetings held with people at the home show they are regularly asked if they have any complaints. Surveys we received from people living at the home indicate they are aware of the complaints procedure and know who to speak to if they are unhappy. The majority of surveys from peoples relatives indicated they were aware of the homes complaint procedures. We have not received any complaints about the home but received a concern. The person later raised their concern with the home. This related to a visitor to the home who felt they had not been made to feel welcome. The homes complaint log showed that the persons complaint had been investigated but had not been upheld. The homes response to the person did however include an apology if they had felt unwelcome and made clear they were welcome to visit the home in future. Staff training records showed that staff had received training in the prevention of abuse so they know how to protect the people living there. Staff spoken with during our visit knew what to do to keep people safe should an allegation of abuse be made. Care Homes for Adults (18-65 years) Page 27 of 38 Evidence: The home had followed safeguarding procedures in making a referring to the Local Authority when a person living at the home had made an allegation. The allegation did not relate to the care home. We were told this matter has now been closed. Training records sampled showed that staff have completed training in the Mental Capacity Act and Deprivation of Liberty Safeguarding (DOLS) legislation. Where staff have not yet had training this is being arranged. This will ensure that staff know the implications of this legislation for the people living there. There was evidence that the home had already put DOLs into practice and referred one person who they thought might have a deprivation of their liberty. As stated earlier in this report their have been two incidents where people have displayed behaviour that has resulted in physical intervention from staff. Discussions with staff indicate that this is only used as a last resort to protect people and records sampled supported this. The staff who had used physical intervention had been trained to do so, however not all staff have been trained in this and refresher training had not taken place. Discussions with staff and the manager indicate that this training is being arranged. At our last visit to the home improvements were needed to financial systems in the home. Sometimes people had been paying for staff on activities and for meals out. The homes procedures have now been improved. We sampled the records of two people and these showed that they had not paid for things that the home should pay for. Care Homes for Adults (18-65 years) Page 28 of 38 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, safe and clean environment that meets their individual needs. Evidence: We looked at all communal areas of the home and four peoples bedrooms. The home was well decorated and maintained so it is comfortable and homely for people to live in. There were a number of contemporary ornaments and furnishings in communal areas making it homely. Staff regularly monitor and record the temperatures in the home so they can make sure it is comfortable for people. The accommodation consists of nine bedrooms offering en-suite bath or shower facilities. The ground floor has sufficient communal space for the size of the home and number of people to be accommodated. This consists of a large lounge, kitchen, separate dining room and a smaller lounge. A laundry room is provided and the layout of the building indicates that any soiled linen would be transported without having to go through the communal and kitchen areas. All bedrooms had suitable locks that guarantee peoples privacy but could be overridden in an emergency by staff. People are offered keys to their bedroom if they want one. Bedrooms were personalised according to individual needs, tastes and interests. One person has a small pet in their bedroom. People told us they were happy with their Care Homes for Adults (18-65 years) Page 29 of 38 Evidence: rooms. The annual quality assurance assessment told us that new aerials had been fitted in peoples bedrooms after they identified the television picture quality was poor. The home has a small rear garden and this is fully accessible to people who wish to use it. The home was clean and there were no offensive odours making it pleasant for people to live in. Surveys we received from people told us that the home is always fresh and clean. Care Homes for Adults (18-65 years) Page 30 of 38 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. The arrangements for staffing, their support and development ensure that the needs of the people living there are met. Evidence: Direct observations of staff interactions with people who live at the home provide evidence that they have a good relationship with people in their care and a good general understanding of their needs. Half of the staff have a National Vocational Qualification in care and this means that the people who live there are supported by a well qualified staff team. The home does not usually use agency staff. This means that people living there are supported by staff that they know. One health professional told us Staff are friendly and professional. There were enough staff on duty to meet peoples needs when we visited. Staff told us that there were a minimum of three staff on duty during the day but that this increased if more people were staying at the home. People told us that staff treat them well and listen to what they say. One person said staff are friendly another said staff are good. Comments from peoples relatives included staff are always helpful, I could not wish for a better place for her to be, all members of staff seem genuinely concerned and very caring and would like to personally thank the staff. We looked at the recruitment procedures followed for three new members of staff. These Care Homes for Adults (18-65 years) Page 31 of 38 Evidence: had improved since our last visit. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau (CRB) check had been completed. This helps to ensure that suitable people are employed to work with the people living there. As stated earlier in this report people have been involved in the recruitment of new staff. This means they have a say in who is recruited to work with them. New staff receive an induction so that they have the basic skills needed to do their job. Training records show that staff receive the training they need, this included safeguarding people from abuse, food hygiene, health and safety, first aid, fire, autism, learning disabilities, epilepsy, manual handling, managing behaviour and infection control. We were told that arrangements are being made for staff to have training in the use of physical intervention and that several staff are currently undertaking equality and diversity training. Staff meetings are held regularly and there are systems in place to ensure regular staff supervision takes place. This helps keep staff updated with how to meet the needs of the people living there, changes within the organisation and with best practice. Care Homes for Adults (18-65 years) Page 32 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements help to ensure that the home is run in the best interests of the people living there and their health, safety and welfare is promoted and protected. Evidence: The home has an experienced manager who is registered with us. The manager is a qualified nurse who also has a management qualification. When we visited it was the managers day off. A senior member of staff was therefore in charge of the home. We found the senior to be knowledgeable about peoples needs and they were very professional in their response to the inspection visit. The home has a variety of methods in place to assess the quality of the care they are providing. Internal audits are al completed and cover areas such as peoples care files, staff files, medication, health and safety, meals, accidents and money. Since our last visit the manager has introduced an annual audit tool that includes sending out questionnaires to people who live at the home, staff, care professionals and relatives. Care Homes for Adults (18-65 years) Page 33 of 38 Evidence: The manager has completed a report of the responses received and this indicated people were happy with the service. We were told that the provider regularly visits the home to make sure it is being well managed. However reports of their recent visits were not available. These should be available in the home so that people can be confident the home is well managed. Systems are in place to make sure the safety of people at the home is promoted. Fire records showed that staff test the fire equipment regularly to make sure it is working. An engineer has serviced the fire equipment to make sure it is well maintained and in good working order. Fire drills had been held so that staff and the people living there would know what to do if there was a fire. The record of drills held did not include the names of participants. The inclusion of peoples names would help the home to track that everyone had the chance to participate in a drill and know what to do if a fire occurs. Certificates sampled showed that gas and electrical installations in the home had been checked by a qualified engineer to make sure they were safe. Staff check the water temperatures regularly to make sure they are not too cold or hot which could put people at risk of being scalded. Staff have had training in first aid and it was good that the staff rota identified who the nominated first aider for that day. Care Homes for Adults (18-65 years) Page 34 of 38 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 35 of 38 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 2 2 9 Assessment of peoples needs should be more thorough to ensure the home can fully meet their needs. Risk assessments should be further developed to make sure they make clear what the level of risk to the person is, and the control measures in place. Hand written amendments to medication administration records should be checked and signed by two staff to make sure any changes made are accurate. Increase the numbers of staff trainined in the use of physical intervention. So that people can be sure any physical intervention is carried out by staff who are qualified to do so and people are kept safe from harm. Copies of reports of the providers monthly visits to the home should be available. So that people can be assured the provider is making sure the home is being well Page 36 of 38 3 20 4 23 5 39 Care Homes for Adults (18-65 years) 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 managed. 6 42 The inclusion of peoples names on the fire drill record would help the home to track that everyone had the chance to participate in a drill. This will make sure all staff know how to respond should a fire occur. Care Homes for Adults (18-65 years) Page 37 of 38 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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