Care Home: Copse Lea

What the care home does well People who use the service are provided with information that will enable them to make a choice about living at the home. The needs of prospective residents would be fully assessed to ensure their needs could be met at the home. Residents have care plans that reflect their changing needs and personal goals. Residents are encouraged to make decisions about their lives and to take risks as part of furthering their independence. Staff encourage and support residents to participate in a range of activities. A balanced diet is provided for residents. Personal support provided to residents meets their preferences and their physical and emotional needs are met. People who use the service are protected by the home`s storage and administration of medication procedures. The principles of respect, dignity and privacy are put into practice. Residents and their families have access to a satisfactory complaints system that enables them to raise concerns. Residents are protected from abuse through the home`s provision of staff training and policies and procedures in regard to Safeguarding Adults. The home is safe, well maintained and a comfortable homely environment is provided for residents. The arrangements for staffing are satisfactory, ensuring staff have the qualities and training to meet the needs of the residents. What has improved since the last inspection? Only one requirement was made during the last key inspection that has been complied with. The home now has a manager who is qualified and experienced to manage the home What the care home could do better: The Statement of Purpose and Service User Guide should include the dates they were last reviewed. It is strongly recommended that the organisation look at how to make the garden safe and secure to protect residents and staff from uninvited guests. The apron dispenser in the identified bathroom should be sited away from any form of heat. Written explanation for gaps in employment must be recorded. The registered person must ensure that the person appointed to manage the home apply to the Care Quality Commission to be registered as the manager, in accordance with Section 11 of The Care Standards Act 2000. Key inspection report Care homes for adults (18-65 years) Name: Address: Copse Lea Copse Lea Tringham Close Ottershaw Surrey KT16 0NF     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: Joseph Croft     Date: 0 9 1 0 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: Copse Lea Copse Lea Tringham Close Ottershaw Surrey KT16 0NF 01932873802 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): penny.lamb@surreypct.nhs.uk Welmede Housing Association Ltd The registered provider is responsible for running the service care home 6 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - 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 Date of last inspection Brief description of the care home Copse Lea is a residential home for up to 6 adults who have learning disabilities. Welmede Housing Association manages the service. The service is a detached property and the facilities and accommodation are set on two floors. There is no mechanical means to access the upper floor and none is required for the existing residents. All residents have a single bedroom and access to a separate lounge, dining room and Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 1 1 1 0 2 0 0 8 Brief description of the care home kitchen. There is a large garden to the rear of the house and other garden areas to the front and side. The home is situated in a residential cul-de-sac in Ottershaw, which has a range of local facilities, including shops, post office, pubs and public transport. The fees for the service is £1292 per week. 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for the service is Two stars. This means the people who use this service experience good quality outcomes. The Care Quality Commission (CQC) (us, we) undertook an unannounced site visit to the service on the 9th October 2009 using the Inspecting for Better Lives (IBL) process. The site visit was undertaken by Regulation Inspector Mr Joe Croft and took over five and a half hours, commencing at 09:25 and concluding at 15:15. The manager assisted throughout the site visit. The inspection process included a tour of the premises, direct observation of practice, sampling of medication records, care plans, risk assessments, health action plans, menu and policies and procedures. Discussions took place with the manager and three members of staff during the course of their duties. Discussions also took place with four residents living at the home. Residents told us that they like living at Copse Lea, that they chose the colours for their bedrooms, and that staff look after them well. They also told us that they have activities that they take part in, help with chores around the home and they make choices about what they want to do. Staff were Care Homes for Adults (18-65 years) Page 6 of 30 observed interacting with residents in an appropriate manner, were aware of residents communication needs, and called them by their preferred names. Surveys were sent by us to residents, staff and health care professionals, however, we only received completed surveys from four members of staff. The manager returned the completed Annual Quality Assurance Assessment (AQAA) when we asked it, and this, and the staff surveys, have been used as a source of evidence throughout this report. The inspector would like to thank the manager, staff and residents for their cooperation during the site visit. Weekly fees charged are 1292 pounds. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are provided with information that will enable them to make a choice about living at the home. The needs of prospective residents would be fully assessed to ensure their needs could be met at the home. Evidence: The service has a Statement of Purpose and a Service User Guide that includes the information as required. Both these documents are user friendly and used photographs and symbols to aid the reader. It is recommended that the date these were reviewed should be written on each document. No new residents have moved into the home since the last inspection. Evidence held by the Commission about the service indicated that any prospective new residents would have their needs and aspirations fully assessed prior to a place being offered to ensure that the service could meet their needs. Care plans are produced from the information obtained in these assessments with the involvement of the resident when possible. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The manager told us that the service would follow the organisations Moving in policy when they receive enquires from prospective residents. The service would obtain an assessment of need from the placing care manager. The manager of the home would undertake an assessment of the prospective resident at their current placement, and they would be invited to visit the home for meals and overnight stays so they could meet the residents and staff. New residents would only be admitted on the basis that their assessed needs could be met by the service, and that they are compatible with the current residents living at the home. New placements would be reviewed after one, three and six month intervals. The Annual Quality Assurance Assessment (AQAA) informs that the Statement of Purpose and Service User Guide are available in paper and audio formats. There was no information in regard to the assessment process of prospective residents. The information provided in the AQAA is further reported under the Conduct and Management of the Home part of this report. Care Homes for Adults (18-65 years) Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have care plans that reflect their changing needs and personal goals. Residents are encouraged to make decisions about their lives and to take risks as part of furthering their independence. Evidence: Two care files were sampled during the site visit. Each file had a Service User Plan (SUP) for each individual. The manager told us that they had recently commenced using this type of care plan. Each included information in regard to the personal and health care needs, personal hygiene, dressing, eating and drinking, social behaviour, privacy, cultural and health and safety. Each included goals and objectives and was signed by the key worker. The reason why the resident was unable to sign the care plan was not recorded. This was discussed with the manager who told us that this would be attended to. From the viewing of the past care plans, and the new care plans for one resident, it was noted that there was a gap in between reviews. There had been a review in July 2008 and an annual review in April 2009, which was a gap of nine months. However, both care plans had been reviewed September 2009. This was Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: discussed with the manager who told us that the reason for the gap in reviews was due to there not being a manager in post. The manager told us the new care plans are to be reviewed on a three monthly basis by key workers. This was confirmed during discussions with staff. Staff surveys informed that they are always given up to date information about the needs of residents, and this is reflected in the care plans. Daily notes are maintained that relate to the Service User Plans, and entries were made for each morning, afternoon shift and night time. The care files sampled had a personal information sheet that included the residents next of kin, GP details and other personal information pertaining to the resident. During discussions residents told us that they were aware of their care plans. We were told each resident also has a Person Centred Plan that they keep in their bedrooms. One resident showed us their PCP. The PCPs are written by the residents, with staff support, and specifies their likes and dislikes, the activities they like to do, their families, religion and other information pertaining to them. The manager told us that they are curently reviewing all the PCPs that would be completed by the 29th October 2009. All but two staff have completed their training in regard to the Person Centred Plans. During discussions the manager and staff told us that staff support residents to make decisions for themselves such as the choice of menu, clothes they wish to wear and activities and they want to partake in. The emphasis is to enable residents to be as independent as they can. Risk assessments were viewed for the three residents. Risk assessments viewed were clear and had been regularly reviewed. The manager told us that risk assessments are put in place when a risk has been identified. The Annual Quality Assurance Assessment (AQAA) informs that residents are encouraged to make choices. Up to date care plans and risk assessments are in place. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged by staff to participate in a range of activities. A balanced diet is provided for residents. Evidence: Residents are supported to participate in a range of activities according to their needs, preferences and wishes. Activities include attending day centre, shopping trips, pubs, spiritual places of worship and annual holidays. Each resident has a copy of their weekly activities in their care plans. During discussions residents told us that they attend day centres and some evening clubs, and like going out to the local pub, theatre and cinema. On the morning of the site visit three residents attended an external activity of bowling. Residents told us that they like the activities they do, and they can choose what they want to do during the evenings and at the weekends. One resident showed us all the model aeroplanes Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: they had made, which were on display in their bedroom. This resident told us that they had been to air shows and museums, and had photographs of these visits on their bedroom walls. During the afternoon of the site visit an external musician attended to provide musical entertainment to all residents. We were told that this person attends every two weeks. Staff told us that residents regularly go on holidays. Recently residents had been on holidays to a renowned holiday resort and had a short break in Derbyshire. Residents are supported to maintain important relationships with friends and families. Care plans contain details of important contacts with addresses and telephone numbers. During discussions the manager and staff told us that there are no restrictions on visitors to the home, and some residents go to their parents homes for weekends. One resident has a girlfriend who lives at another of the organisations care homes, and they visit each other at weekends. Daily routines are flexible with bedtimes and mealtimes arranged to meet individual needs and timetables. Residents are encouraged and supported by staff to undertake daily household tasks. On the day of the site visit one resident was doing their laundry. They told us that they do other household chores, and they also have a vegetable patch in the garden where they have grown fresh vegetables. The menus were viewed during this site visit. The manager told us that the menus are produced with the residents, and that Speech and Language Therapists also view and advise on the menus on a three monthly basis, particularly with one ageing resident who has some difficulties with their eating. Meals provided include fresh meat, fish, pasta, fresh vegetables and fruit. Staff told us that residents are supported to make choices about the menu every Saturday. Photographs of different foods are used to help residents make decisions. The food is bought fresh every week. Fresh fruit was freely available on the day of the site visit. Lunch time was observed during the site visit. This was a relaxed occasion with staff sitting and eating with residents, therefore available to provide support as and when required. During discussions residents told us they can make hot drinks and have snacks whenever they choose. This practice was observed throughout the site visit. Records confirmed that fridge and freezer temperature checks are undertaken and Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: food is temperature probed regularly before serving. The AQAA informs that residents take part in meaningful activities of their choice, and they are supported to pursue their chosen hobbies and interests. Evidence found during the site visit supported the evidence provided in the AQAA. Care Homes for Adults (18-65 years) Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support provided to residents meets their preferences and their physical and emotional needs are met. The arrangements for medication are robust and protect residents. The principles of respect, dignity and privacy are put into practice. Evidence: The two care plans viewed provided information in regard to the level of support each resident required with their personal care needs. It was evident through discussions that staff were knowledgeable of the personal care needs of residents. Staff told us that they attend to the personal care in the privacy of bedrooms and bathrooms. We observed staff always knocking on bedroom doors before entering, and calling each resident by their preferred names. From discussions with the manager and staff, and the viewing of care plans for two residents, it was clear that residents have access to all health care professionals as required. Each resident had a health care action plan that included information in regard to appointments with the GP, dentist, Psychiatrist, opticians and other specialist health care professionals. The manager has since developed records for each separate health care appointment that would make it easier to follow an audit trail in Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: regard to each residents health care. Care plans included detailed information about the specific medication residents were prescribed, and also included information and guidelines in regard to PRN medication that had been signed by the residents GP. Staff at the home follow the organisations Medication Policy and Procedure that was last reviewed in October 2007. The home uses printed Medication Administration Record sheets (MARs) from the local pharmacy. The Medication Administration Records for three residents were viewed. Medication was appropriately stored in a locked metal cabinet. The MARs sheets included the quantity of medication received, and were accurately maintained with no omissions. The home has a book for recording medication that has been returned, and this had been signed by the pharmacist. The manager told us that no resident is taking a controlled drug or self-medicating. Evidence was viewed that residents who were part of the case tracking process had had an annual medical review with their GP. The sampling of the staff training files provided evidence that staff had received training in regard to medication. The manager told us that only staff that had received this training administer medication. The manager and senior staff undertake monthly audits of the MARs sheets and medication to ensure they are accurately maintained. The AQAA informs that all residents have an annual health check, medication is reviewed by the GP and personal care is provided according to residents individual care plans. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to a satisfactory complaints system that enables residents and their families to raise concerns. Residents are protected from abuse through the homes provision of staff training and policies and procedures in regard to Safeguarding Adults. Evidence: The Care Quality Commission has not received any concerns, complaints or allegations in regard to the home since the last key inspection. The home follows the organisations Complaints Policy that was last reviewed in April 2008. The complaints policy included the timescales for responding to complainants. Residents have a copy of this document in the Person Centred Support Plan. It was noted that this document had the incorrect contact details for the Care Quality Commission (CQC), and there were no copies available throughout the home. The manager told us that this is currently being reviewed by the organisation, and this updated document would be displayed throughout the home. A summary of this document is included in the Statement of Purpose and the correct contact details for the CQC was also included in the Statement of Purpose. The AQAA informs that the home has not received any complaints since the last key inspection. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: During discussions staff told us that residents would talk to them if they were unhappy, and for two residents who have communication difficulties, they are able to tell by their body language, facial expressions and moods if they are unhappy. We did observe staff engaging with one resident and they were able to communicate and understand this persons response through their facial expressions and eye movement. We were also told that there are regular in-house resident meetings, and a monthly meeting organised by Welmede Housing Association Ltd for all residents within the organisation, where they are encouraged to voice their views and opinions. Residents told us that they would talk to staff, but they had not needed to make a complaint. All staff surveys informed that they know what to do if some has concerns about the home. Staff told us that they would inform the manager and/or the service manager. The home has a copy of the recent Surrey Safeguarding Procedures, and staff follow the organisations Abuse Policy that was last reviewed in May 2008. The sampling of five staff training files provided evidence that staff had attended training in regard to Safeguarding Adults, and refresher training dates had been booked for November and December 2009. The manager told us that new staff receive this training during their induction training. Different scenarios in regard to abuse were discussed with the manager and staff. They were knowledgeable about the procedures to be followed and were aware that the safeguarding issues must be reported to the local Safeguarding Team. The home has had one Safeguarding Adults investigation that has been concluded. The manager told us that staff do not have power of attorney for residents finances. Each resident has a building society account and the home holds money for residents that are kept secure in a locked cabinet. Staff check residents money at every handover meeting. Records of residents monies were not viewed during this site visit. The AQAA informs that all staff have training in regard to Safeguarding Adults and have awareness of the Surrey Multi-Agency procedure. All new staff receive a Protection Of Vulnerable Adults (POVA) check before employment is offered. Carers and families are provided with a copy of the complaints policy. The user friendly complaints policy is provided to all residents. Advocates are available if required. 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 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 in the service live in a safe, well maintained and comfortable homely environment. Evidence: A tour of the premises was undertaken and bedrooms were viewed. The home is a detached property and the facilities and accommodation are set on two floors. All residents have a single bedroom that have a sink and the appropriate furniture as required. There is a separate lounge, dining room and kitchen. There is a large garden to the rear of the house and other garden areas to the front and side. The lounge had appropriate seating for residents, and included a television, DVD and stereo player. There is a bathroom and toilet on each floor. The ground floor bathroom has an adapted bath and a bath lift that had recently been serviced. Communal bathrooms and toilets had liquid soap dispensers and paper towels. It was noted in one bathroom that the plastic apron dispenser was fixed to a wall above a radiator. This was discussed with the manager and a recommendation has been made that this dispenser should be sited away from any form of heat. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Bedrooms viewed were appropriately decorated, and residents had their personal belongings that included photographs, televisions and stereo players. During discussions residents told us that they like their bedrooms and they chose the decor for them. Residents are able to have a key for their bedrooms if they so wished. The home has a laundry that includes a washing machine and a tumble drier. Control of Substances Hazardous to Health (COSHH) were kept secure in locked cabinets. The manager and staff told us that risk assessments in regard to the COSHH are in place, and are reviewed on a regular basis. Staff and residents told us that they attend to the cleaning duties in the home. One resident told us that they enjoy helping to keep the home clean, and like to use the vacuum cleaner to keep the carpets clean. It was noted that the heat rising from the central heating radiators had began to stain some walls. The manager told us that there is a redecoration programme and these issues would be addressed. The kitchen had recently been refurbished and was very clean. Food was appropriately stored in the fridge, and fridge/freezer temperatures were being maintained on a daily basis. There is a large garden to the rear and the front of the property that is appropriately maintained. Residents are able to access this at their leisure. It was noted that the rear garden is very accessible, and members of the public could easily walk around to the rear of the garden. This was discussed with the manager who told us that this had been a problem in the past. It is strongly recommended that the organisation look at how to make this safe and secure to protect residents and staff from uninvited guests. The sampling of staff training files provided evidence that staff had attended training in regard to Infection Control, and evidence of further training in this area was viewed during the site visit. On the day of the site visit the home was very clean, tidy and free from offensive odour. The AQAA informs that the home has been decorated with the choice and involvement of residents, it is clean and safe, and the garden is well maintained. Evidence found during the site visit supports the information provided in the AQAA. 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 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 are satisfactory, ensuring staff have the qualities and training to meet the needs of the residents. People who use the service are protected by the organisations recruitment policy and procedures, however, one identified issue in regard to recruitment must be addressed. Evidence: Residents living at the care home are all White British, and they are supported by a multi-cultural team of male and female staff. Staffing at the home consists of the manager, deputy manager, five senior support workers and two support workers. We were told that agency staff are not used at the home. There are currently six residents living at the home. The duty rota viewed during this site visit provided evidence that there are three members of staff on duty during the morning shift, two in the afternoon and one waking night staff. The manager told us that he is confident there are enough staff on duty during the morning shift, but, due to the changing needs of residents, he is hoping to increase the staffing levels for the afternoon shift to three. Two staff surveys informed there are always enough staff on duty to meet the needs of residents and two informed that there are usually enough Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: staff on duty. The AQAA informs, and the manager confirmed, that of the nine permanent staff employed at the home, fifty five percent hold the minimum of an NVQ level 2 and above. Each member of staff has a training and development file. The sampling of five of these files provided evidence that staff are receiving training to help them fulfil their roles. Training undertaken included Dementia, Deprivation of Liberties, Control of Substances Hazardous to Health, Equality and Diversity and Epilepsy. The home follows the organisations Recruitment Policy and Procedure that was last reviewed in April 2005. The recruitment file of the most recently recruited member of staff was viewed. This included an application form, two referees, full employment history, health declaration and proof of identity and a photograph of the members of staff. A Protection of Vulnerable Adults (POVA) first and Criminal Record Bureau checks reference numbers were also maintained. Two other staff recruitment files were viewed. These included the information as required, however, for one staff member the second page of each of the two references were missing. The manager told as that he would follow this up. There was a gap in employment for one identified member of staff with no explanation. A requirement has been made in regard this. Staff surveys inform that the organisation carried out all the checks as required before they commenced their work with the organisation. The manager told us that all new staff attend the organisations induction training programme that is in-line with the Skills for Care Council. This was also confirmed in the four staff surveys that we recieved. During discussions staff told us that they receive formal supervision every two months. Evidence of supervision records were viewed. The AQAA informs that all staff have had CRB and POVA checks undertaken and each member of staff has an individual training file with evidence of training undertaken 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well managed home and their views influence the running of the service. The health, safety and welfare of residents are promoted and protected. Evidence: The home now has a manager who is qualified and experienced to manage the home. This was in compliance with a requirement made during the key inspection of October 2008. The current manager has been in post since the 20th March 2009. He is a qualified Registered Mental Health Nurse and holds the registered managers Award (RMA). The manager told us that he has over thirty four years experience of working with adults and children with a Learning Disability (LD). He was the manager of another of the organisations care homes for adults with LD for fifteen years prior to taking up his current role at Copse Lea. The manager has not submitted an application to register with the Care Quality Commission and a requirement has been made in regard to this. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: During discussions staff told us that the manager is supportive, has an open door style of management and has made positive changes for the benefit of the residents and staff since commencing their duties Quality assurance is undertaken through two monthly meetings with residents and staff meetings. The minutes of these meetings were sampled during the site visit. Monthly Regulation 26 visits are undertaken by representatives of the organisation, and copies of these reports were available at the home. The manager told us that the last annual survey of residents, their families and other associated stakeholders was last undertaken in June 2007. We are aware that the new manager has not completed a year in his position, however, the organisation should have ensured that annual quality surveys are undertaken to ascertain the views of the quality of care provided by the service to people using the service. The manager told us that surveys would be sent within the next four weeks. The manager returned the Annual Quality Assurance Assessment when we asked for it. Discussions took place with the manager in regard to the contents of this document. The manager was advised to provide as much information as possible in regard to what the home does well, as some of this information was very limited in the document. A good practice recommendation has been made that the manager should view the guidelines in regard to completing the AQAA that are available on the Care Quality Commission website. The sampling of five staff training files provided evidence that staff are receiving the mandatory training as required. The organisation provides regular refresher training to all staff. Information provided in the AQAA informs that the health and Safety maintenance checks of equipment used at the care home are reviewed in accordance with the manufactures recommendations. We did view evidence that the fire extinguishers and Portable Electrical Installations (PAT) had been undertaken The manager told us that there are general risk assessments in place. We evidenced the fire risk assessments. Weekly testing of fire safety equipment used at the home is undertaken and records of these were viewed. The AQAA informs that there is an experienced manager in post and policies and procedures are adhered to. Care Homes for Adults (18-65 years) Page 26 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 27 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 34 19 The registered person shall 09/11/2009 not allow a person to who applies to work at the care home unless the employer has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. Written explanation for gaps in employment must be recorded. 2 37 9 The registered person must ensure that the person appointed to manage the home apply to the Care Quality Commission to be registered as the manager, in accordance with Section 11 of The Care Standards Act 2000. To ensure that residents are safeguarded by an appropriate person to manage the care home. 09/12/2009 Care Homes for Adults (18-65 years) Page 28 of 30 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 1 24 The Statement of Purpose and Service User Guide should include the dates they were last reviewed. It is strongly recommended that the organisation look at how to make the garden safe and secure to protect residents and staff from uninvited guests. The apron dispenser in the identified bathroom should be sited away from any form of heat. 3 24 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. 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