Care Home: Coopers Mill Ltd

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What the care home does well The service continues to provide a service to the residents that is of a consistently high standard. The Proprietors belief that the residents should be involved in all aspects of the Home and should be supported to make their own decisions about their lives is clearly put into practice. Staff who spoke to us are clear about this aim. Residents like living at the Home and were very keen to speak to us during the visit to give us examples of why they like living there. Comments were made by residents, such as: `I love living here`, `its my home and I don`t want to move`, `I am always asked for my opinion`. Residents continue to take part in a wide range of leisure, educational and work activities. One of the improvements that has taken place is that some of the residents are now more independent and are now able to use public transport alone, or with minimal support. The range of activities has expanded to include more involvement with the local community. The views of the residents are sought as part of everyday life and they are involved in decisions affecting the household, not just those affecting their own life. For example, one of the residents told us about their involvement in recruitment of new staff. There is lots of evidence that action is taken to address any issues raised or suggestions that residents make. The care plans continue to be developed and improved. One of the management team has completed training to enable her to provide training with regard to Person Centred Care. The format of the care plans varies, depending on the preference and communication skills of the resident. A lot of work takes place with regard to communication. All staff use Signalong and some staff have completed BSL training. Signing is used as part of all communication with some residents. BSL interpreters are sought for assistance when residents need them, for example, during health appointments. Staff continue to receive good training and support. They are clear about their roles and about the aims of the Home. They told us that they enjoy working at the Home and that they receive excellent support from the management team. The Home is very well managed by Proprietors who are present in the Home on a daily basis, seven days a week. The Proprietors know the residents well and work as part of the staff team. What has improved since the last inspection? The quality assurance process continues to develop and become more detailed. The views of the residents and staff are sought in a range of ways and there is evidence of action taken to address any issues arising. Staff have continued to attend training in mandatory subjects and the range of other subjects covered in training has extended. More training is provided about issues affecting individual residents. Staffs knowledge and experience of using sign language continues to develop. Residents have spent a lot of time and hard work developing the gardens which looked lovely in the summer. Some of the residents have been supported to move into more independent living accommodation. The proprietors and staff continue to offer friendship and informal support to some of these residents. What the care home could do better: The Proprietors have plans to improve the accommodation in the main house with the addition of more ensuites and to decorate the whole Home. The Proprietors continually monitor the service provided and look for improvements that can be made to enhance residents lives. Key inspection report Care homes for adults (18-65 years) Name: Address: Coopers Mill Ltd Mill Road Walpole Highway Wisbech Cambs PE14 7QL     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: Lella Hudson     Date: 1 6 0 3 2 0 1 0 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 28 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) © 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 28 Information about the care home Name of care home: Address: Coopers Mill Ltd Mill Road Walpole Highway Wisbech Cambs PE14 7QL 01945880020 01945880020 lordofcoopersmill@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Coopers Mill Ltd Name of registered manager (if applicable) Mr Barry Lord Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: Date of last inspection Brief description of the care home Coopers Mill is a converted farmhouse situated in the village of Walpole Highway, approximately 5 miles between Wisbech and Kings Lynn. Set on the edge of the village the Home is complemented by 5 acres of grounds that include large lawns and flower beds. Several animals are kept at the Home including ponies, rabbits and a dog. In 1995 an extension was built to the Home and a further extension was added in 1998. The accommodation consists of both ground and first floor single bedrooms in the main house, some of which are ensuite. There are several communal rooms including a large conservatory. One of the extensions provides accommodation for four clients who are able to live semi-independently but who also have access to the rest of Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 13 2 Brief description of the care home the Home. The Home provides accommodation for up to fifteen adults with a learning disability. Two people with sensory disabilities may be accommodated and the annexe has additional equipment fitted to enable people with hearing loss to live there. Care Homes for Adults (18-65 years) Page 5 of 28 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 report contains information gathered about the service since the last Key Inspection in 2006. Each year we have received a completed Annual Quality Assurance Assessment (AQAA) that the Proprietors have completed which provides us with information about the service and improvements that have been made. This report also includes information gathered during an unannounced visit to the Home that we carried out on the 15th March 2010. During our visit we spoke to the Proprietors, to nine residents, to staff and to relatives. We also looked at records and were shown around parts of the Home. We also received completed surveys from four members of staff and from one resident and relative. The surveys were all very positive about the service provided to residents at the Home and the support provided to staff. The Home was given an EXCELLENT quality rating at the last Inspection. It remains Care Homes for Adults (18-65 years) Page 6 of 28 EXCELLENT following this Inspection. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? The quality assurance process continues to develop and become more detailed. The views of the residents and staff are sought in a range of ways and there is evidence of action taken to address any issues arising. Staff have continued to attend training in mandatory subjects and the range of other subjects covered in training has extended. More training is provided about issues affecting individual residents. Staffs knowledge and experience of using sign language Care Homes for Adults (18-65 years) Page 8 of 28 continues to develop. Residents have spent a lot of time and hard work developing the gardens which looked lovely in the summer. Some of the residents have been supported to move into more independent living accommodation. The proprietors and staff continue to offer friendship and informal support to some of these residents. 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 28 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 28 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. A thorough assessment process is carried out prior to a resident moving to the Home. The views and wishes of the resident are central to this process. Evidence: The Proprietors continue to ensure that prospective residents are central to the process of assessment and decision making about moving to the Home. Information is gathered from the resident themselves and from all of those involved in their lives eg families, health and social care professionals. A lot of time is spent with the resident to find out what is important to them. The residents are encouraged to visit the Home as many times as they wish to. They are invited to stay for meals and overnight as part of their decision making process. The Home has written information about the Home and the service that they provide. This is available in alternative formats if required. Care Homes for Adults (18-65 years) Page 11 of 28 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. The care planning and risk assessment process are based on the core belief that the residents should be supported to take control of their own lives and to make their own decisions. Evidence: Two of the residents showed us their care plan. They are aware of what the care plan includes and said that they are always involved in reviewing and updating them. The care plans are provided in different formats, depending on the individual communication needs and preferences of the resident. The care plans are clear and easy for staff to read and refer to for detailed guidance about meeting residents needs. For example, there is clear guidance about the possible triggers for a residents behaviour and how this may be avoided. There is also a clear plan about how staff should act if a situation occurs. There is evidence that the care plans are regularly reviewed and updated. There is Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: also evidence that any advice from health and social care professionals is incorporated into the care plan. Staff told us that they have time to read and understand the care plans and that they find them useful. The residents clearly have a sense of ownership of their own care plans. One of the management team has attended Train the Trainers course with regard to Person Centred Planning and is the co-ordinator for this within the Home. The responses within the staff surveys all indicate that staff receive good information about how to meet residents needs. An additional comment was made about care plans - care plans are really detailed and in an accessible format. The importance of communication is recognised and all staff receive training with regard to alternative forms of communication. Two of the residents living at the Home are deaf. All staff have received Signalong training and use signing when communicating with the residents. Some of the staff have undertaken British Sign Language (BSL) training and other staff are due to start this later this year. One of the members of staff translated for us when we spoke to residents who use BSL. Risk assessments are carried out with clear plans in place to manage risks appropriately. The balance of taking risks through enabling residents to make their own decisions and learn from new experiences and the need to ensure their safety is one that is continually discussed and considered. Staff who spoke to us said that the needs and wishes of the residents come first and that this is the ethos of the Home. This is clearly evidenced through our visit to the Home. The residents spent a lot of time showing us around the Home and telling us about their lives. They are all clear that they receive good support which enables them to make their own choices and to take part in a range of activities. Responses within the staff surveys are positive about supporting residents to gain independence and to make their own choices. This was also confirmed within the resident survey that we received. Regular residents meetings take place but residents told us that they can speak to the Proprietors or staff at any time. They are clear that action is taken if they raise any issues. The Proprietors ensured that advocates were involved in the process of residents moving out from the Home to ensure that their views were sought and listened to. Some residents have been supported to move onto more independent styles of living Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: in the last year. The staff from the Home have been involved in providing training to new staff groups and continue to provide friendship to those residents who have moved but who still regularly visit. Care Homes for Adults (18-65 years) Page 14 of 28 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. The residents continue to be supported to take part in a range of leisure, work and educational activities. Relatives and friends are made to feel welcome. Residents continue to be involved in the whole process of menu planning and meal preparation. Evidence: The residents are involved in a wide range of educational, social and leisure activities. Residents gave us many examples of how they spend their time. Some attend local college courses or formal day services. Others are supported by the Homes staff to take part in meaningful activities. The staff and residents all told us that there is always enough staff to support residents. Additional staff are on duty at weekends to ensure that all of the residents are able to make choices about what they do. The Proprietors and staff are clear about the importance of the residents taking part in activities that are important to them and that they enjoy. The residents are a part of Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: the local community and take part in village life, particularly sporting events that take part there. The Home has several vehicles which are used to provide transport for the residents but the residents are encouraged to use public transport where possible. One of the residents told us that they are now able to use public transport on their own which they were not able to do a year ago. Over time the support from staff had been reduced and other measures put in place, such as the purchase of a mobile phone to provide additional support and reassurance. The care plans include information about the arrangements in place to support the residents to keep in contact with family and friends. This varies for each resident, depending on their individual circumstances. Residents told us about visits they have with family and this clearly shows the additional support that is provided by the Proprietors and staff to ensure that residents are able to maintain this contact. We spoke to some relatives and they were very positive about the support provided to their relative. They said that the staff and Proprietors keep them informed about issues as appropriate and that they provide very good care. The residents are encouraged to be as involved in the menu planning, food shopping and meal preparation as they wish to be. Several of the residents cook their own meals, particularly those living in the bungalow attached to the main Home. There are several dining/kitchen areas where residents can choose to eat their meals. The care plans include information about the nutritional needs of the residents and of their choices. One of the care plans also includes information about additional support that one of the residents needs to have at mealtimes. This additional support has reduced the incidence of difficult situations occurring at mealtimes. Care Homes for Adults (18-65 years) Page 16 of 28 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. The residents personal and healthcare needs of the residents continue to be met to a high standard. Medication is well managed in a way which protects the safety of the residents. Evidence: The care plans contain detailed information about the individual personal and health care needs of the residents. They provide evidence of the extra steps that the Proprietors and staff take to ensure that residents are supported to receive health care in a way in which they understand and can accept. Steps are taken to reduce any anxiety and upset to residents when they need to undergo any appointments or treatment. One of the residents showed us information that staff had assisted them to put together using photos, words and pictures, about a recent operation that they had. The information was for staff at the college so that the resident did not need to keep explaining the situation. The care plans provide evidence that residents are supported to attend appointments Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: for general health care issues such as dentist, opticians and audiology clinics. BSL interpreters are contacted for support at health care appointments for those residents who need them. Residents are able to have the choice about who supports them with personal care and told us that the staff are kind and very helpful. The medication system was looked at and we found that medication is stored appropriately and that records are kept as appropriate. The Proprietor carries out regular audits of the medication system and records. Errors are rarely found and, if they are, then action is immediately taken to address them and to reduce the risks of them occurring again. Staff receive training prior to them administering medication. Care Homes for Adults (18-65 years) Page 18 of 28 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. The residents are protected from abuse and neglect through rigorous training and monitoring of standards. Residents and staff are encouraged to raise any issues and action is taken to address these Evidence: The Home has a complaints procedure which is available in alternative formats. Residents told us that they can always speak to the Proprietors or any of the staff. There are many opportunities for residents to raise any concerns and staff work hard to ensure that communication is as effective as it can be. Minutes from the residents meetings and staff meetings as well as the monthly proprietors reports show that action is quickly taken in response to any issues and suggestions made by staff or residents. Staff receive training about Safeguarding and are clear about the need to raise any concerns they may have. Two of the senior staff are due to attend the advanced Safeguarding training shortly. Discussions with staff show that the Proprietors clearly communicate the high standards expected of staff. Care Homes for Adults (18-65 years) Page 19 of 28 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. The accommodation meets the needs of the residents. Evidence: Several of the residents showed us their rooms and around the communal areas. Residents are encouraged to personalise their bedrooms. One of the residents told us that when they had first moved into the Home they had been able to go shopping for new bedroom furniture and bedding. They have also recently been to buy a sofa for their bedroom. The Proprietor had paid for this but had given the resident the money so that they could go shopping with a relative as this was what they wished to do. The Home provides a good standard of accommodation for the residents but there are plans to provide additional ensuite shower rooms and to decorate the whole Home. There are several communal lounges that the residents can use as well as their own rooms. The Home also provides accommodation in a four bedroom bungalow which is attached to the main house. This provides semi-independent living for four ladies. All of the bedrooms in this area are ensuite. Residents are encouraged to take part in the household tasks within the Home. The Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: standard of cleanliness of the Home is high. The Home is set in large grounds. Last year some of the residents spent a lot of time working in the garden to ensure that there were a lot of flowers. The residents are able to have pets if they wish to. Care Homes for Adults (18-65 years) Page 21 of 28 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. The residents are involved in the recruitment of new staff. The residents continue to be supported by staff who are well trained and well supported in their roles. Evidence: One of the residents told us about their role in the recruitment of new staff. They said that they feel that this is important since the staff are there to support them. We did not look at recruitment files during our visit but discussions with the Proprietors indicate that appropriate checks are being carried out. Staff told us that they received good induction and support from more experienced staff when they first started work at the Home. They were given time to get to know the residents and to read and understand the care plans. Staff said that they receive ongoing support from the Proprietors and senior staff through seeing them on a daily basis and in more formal situations such as supervision. Staff told us about training that they have received and we confirmed this through looking at the training matrix. Staff receive training about mandatory subjects such as health and safety and Safeguarding as well as training about issues that are relevant to individual residents. Training and ongoing staff support is given a high priority by the Proprietors. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Responses with the staff surveys that we received are all positive about the training provided. Additional comments were made such as - we have excellent training to meet the requirements for the job, we have access to any training we feel we need, training opportunities are readily available. There is a low turnover of staff at the Home and the staff who spoke to us said that they really enjoy working there. They said that there is good communication amongst the staff team and they include the Proprietors as part of that team. Residents told us that they really like the staff and that staff always help them if they need it. We observed staff and residents during our visit and noticed the positive way in which they all related to each other. There is a relaxed atmosphere in the Home and friendly conversation between staff and residents. There was a lot of laughter and chatting taking place. Care Homes for Adults (18-65 years) Page 23 of 28 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. The Home continues to be run in the best interests of the residents with their views being sought about issues that affect them. The health and safety of the residents and staff is taken seriously. Evidence: The Proprietors jointly manage the Home and have recently been joined by their daughter, Amy Taylor, as part of the management team. All three have a clear vision of the quality of the service that should be provided to the residents and are able to convey that successfully to the staff team. Staff said that they feel well supported by the management team and that they are in the Home every day. They said that they are very approachable and are good at communicating. The minutes of the staff meetings show that staff are kept informed of issues and that their views are sought and discussed. Staff feel that they are an important part of the team. The responses within the staff surveys were all positive about the management of the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Home. Additional comments were made, such as - as a staff team we are supported by management that are committed to make sure the staff team have the skills to support the residents to make decisions...., the management are always approachable...., The management team clearly know the residents very well. We observed the residents seeking them out to speak to them and to tell them about their day. Residents told us about the time that the management team spend with them, assisting them with day to day tasks and in going out with them. The Home has a well developed quality assurance process which includes a variety of informal ways of obtaining the views of residents, staff and relatives but also includes more formal ways, such as monthly audits and reports. Action is clearly taken in response to gathering the views of others. The AQAA was completed in a very detailed way and clearly shows the improvements that have taken place and those which are planned for the forthcoming months. The management team are always seeking to provide a better service. Regular health and safety checks are carried out and risk assessments are carried out and regularly reviewed and updated. We saw a selection of these which include a certificate from the Environmental Health Officer in recognition of the high standards of food safety and hygiene. There is also a certificate confirming achievement of the Safer Workplace, Better Business issued by the EHO. We also saw evidence of regular maintenance and servicing of equipment relating to fire safety. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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