Care Home: Court View

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What the care home does well The home has a detailed and well-planned admission process to enable prospective residents to make an informed choice about moving into the home with the assurance that their needs would be met.Clear information and contractual arrangements are in place, this ensures that people have the information they need about the service. There is a well-established staff team at Courtview. During the visit the manager and staff were able to demonstrate a clear understanding and knowledge of the individuals who use the service, and of their role in the home. Staff are recruited appropriately with all required checks being undertaken. The manager was able to demonstrate that she and the staff team have developed good relationships with those who live at the home and have a sound understanding of their needs, wishes and aspirations. These are well recorded in individuals records. Courtview is comfortable, communal areas are well decorated and it is well furnished. Individuals appeared to be settled and `at home`. What has improved since the last inspection? Permanent arrangements have been made for there to be a Registered Manager at the home. The manager has appropriate knowledge and experience to manage a care service and during this visit demonstrated a sound understanding of her role and responsibility. The service made arrangements to clear the front garden of rubbish and this is now safe and accessible for those who live at, work at and who visit the home, as this requirement had been met the home had also complied with the report completed by the Environmental Health Officer in respect of the overgrown front garden area. Training in the Protection of vulnerable adults training has been provided for staff and they are aware of their responsibilities in this area. Furthermore, training for staff in dementia awareness has been provided, this has equipped them with the skills and knowledge to support individuals in this area. What the care home could do better: The registered person shall ensure that unnecessary risks are identified and where possible eliminated, This is to ensure that people are supported and that the likelihood of incidents occurring are reduced. on file was an employment agreement, this outlines the rights and responsibilities of the employee and the employer, this document was dated July 1999, it is recommended that a new, updated employment agreement be obtained in order that clear, accurate information is in place. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Court View 23 Parkfield Road Pucklechurch South Glos BS16 9PN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Odette Coveney     Date: 1 6 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 28 Information about the care home Name of care home: Address: Court View 23 Parkfield Road Pucklechurch South Glos BS16 9PN 01179374021 01179709301 debb@aspectsandmilestones.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Aspects and Milestones Trust Name of registered manager (if applicable) Miss Moira Aston Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: May accommodate up to 5 persons aged 18 - 64 years of age Date of last inspection Brief description of the care home 23 Parkfield Road, Pucklechurch, known as Court View provides accommodation for five service users with learning disabilities aged between 19 and 64 years. It is one of the homes operated by the Aspects & Milestones Trust formally known as Frenchay and Southmead Care Trust. The house is a detached dormer bungalow with a large rear garden. The ample front garden is also used as parking space; there is a large, well-established garden to the rear. The accommodation consists of 5 single bedrooms, 2 bathrooms, dining room, kitchen, and lounge. The house is within walking distance of a public house and local shops. There is a bus service to the centre of Bristol and the house is within easy access of the motorway system. The mission statement of the organisation is: To enable people with learning difficulties, mental health needs and physical disabilities to develop a fulfilling life in the community and to continually seek to improve and be responsive to the changing needs and wishes of the people we Care Homes for Adults (18-65 years) Page 4 of 28 care home 5 Over 65 0 5 Brief description of the care home support. Fees range from #1,027 - #1,174 per week and are based on individuals assessed needs. 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: 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: During this visit we also spoke to the Registered Manager, and, three staff members, and three of the people who use the service. We looked at records and documents, including peoples care plans, daily reports, risk assessments, incident reports and reviewed the care for all of the people who live at Courtview. We also reviewed medication practices within the home. Care Homes for Adults (18-65 years) Page 6 of 28 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 Care Homes for Adults (18-65 years) Page 7 of 28 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 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a detailed and well-planned admission process to enable prospective residents to make an informed choice about moving into the home with the assurance that their needs would be met.Clear information and contractual arrangements are in place, this ensures that people have the information they need about the service. Evidence: Courtview is registered with the Care Quality Commission to provide a residential care service to five adults, all of whom have a learning disability. We reviewed that statement of purpose for the home and saw that this document recorded full information about the skills, knowledge and contact details for the registered responsible individuals, information was given about the services and facilities people can expect should they decide to live at the home, we noted that this document required some minor amendments and suggest that this is reviewed and updated in order that it contained correct information such as; We are no longer known as the Commission for Social Care inspection, with effect from June 1st 2009 Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: we are now known as the Care Quality Commission, the contact details for us should also be updated. Within the statement of purpose the home has recorded some information about the range of needs which are able to be supported at Courtview, however this does not fully reflect the range of needs, which include supporting people with a diagnosis of dementia, furthermore there is no information about the admissions process for the home or details of whether specialist therapeutic techniques are provided for those living at the home. The service users guide has been enhanced by the use of photographs and provides good information about local facilities and services, the staffing arrangements for the home are also included, all of those living at the home are given a copy of both the service users guide and the statement of purpose. Since our last visit to Courtview there has been a new, recent, admission into the home, we reviewed the records for this person including the pre admission care plan and care management assessment. We reviewed the homes records and saw that this person was still being assessed by the home in order to ensure that the home were able to support the individuals and meet their needs. Records were well written and demonstrated that staff were skilled in identifying areas of support and of how to ensure that people retained existing skills. We spoke with two staff members who told us about the admission processes and how the individual had been supported to settle at the home, this person came for short visits and had meals at the home in order for them to settle and get used to the environment. We were informed of how staff have ensured that those people who are already living at the home are supported in order that they were comfortable and had an opportunity to get to know the new person. We saw that each resident is provided with a contract showing the terms and conditions of their stay at the home. These are known as licence agreements, within these documents we saw what people can expect from the home and the organisation, the document outlined individuals rights and responsibilities, information about the fees was included. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals living at Courtview can be assured that their assessed and changing needs and personal goals are known and are reflected within their individual plan of care. Individuals are supported to take risks as part of an independent lifestyle. Evidence: During this visit we reviewed all of the care and associated documents for all of the people living at Courtview, this included the assessments for the individual who had recently been admitted into the home. We saw that recording arrangements for of those living at the home were of a consistent good quality standard. Information had been gathered for some of the individuals living at the home for over a number of years, all records seen were person centered and evidenced that the wishes and choices of the individual had been central to the process and that they had been consulted about their care and aspects which affect their life. we saw that records are kept under review and are updated and amended as required. Within each persons Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: folder there was information about how they had been offered opportunities and supported to make decision about areas of their life which affect them, information was well recorded within review meetings, support plans and records of individuals meeting with their key worker, within minutes of these and day care meetings we saw that people had been assisted in making choices about social, leisure and educational opportunities with options being explored and action plans developed. The home provides the statement of purpose, service users guide, licence agreements and complaints procedure and well as advice about advocacy in a pictorial and written formation, some of these documents have also been enhanced with the use of photographs, making these documents more accessible to those who may have communication difficulties within the home. The home have, for all people living at the home, comprehensive risk assessments in place, these assessments have been devised in order that people can be supported to take risks as part of an independent lifestyle. Risks which have been assessed included: risk of choking, holidays in an unfamiliar environment, leaving the home unaccompanied and responding to fire. We found that the assessments in place were sufficiently detailed and had been kept under review, staff we spoke with during our visit know the people who live at the home well and were able to give clear examples of how people are enabled to take reasonable risks. We did note that one persons risk assessment about their leaving the premises provided information about the security of the exterior of the premises, this information gives incorrect information about gates at the home and this should be amended, furthermore for one person there have been four incidents within the past two weeks whereby they have disturbed another resident in the home during the early hours of the morning, whilst we saw that staff responded promptly to deal with the situation and assist the individuals concerned the implications and risks had not been recorded, this must be in order to ensure that all areas have been explored and resolutions sought, where possible. The home, and Aspects and Milestones Trust have clear information about about confidentiality and data protection, all records are stored in a locked room. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities for personal development and are supported to maintain links with the community, families and friends. Their individual rights are respected whilst providing healthy diets at chosen times Evidence: Information seen on the care files showed that people living at the home are assessed and supported to participate in activities in and outside Courtview based on their abilities and motivations. During our visit we heard staff talking with residents about life at the home and general day to day routines, we found that people have daily opportunities to maintain and develop social, emotional, communication and independent living skills. Whilst we were at the home people were encouraged to get their own breakfast and make their Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: own packed lunch, we saw that people are assisted to prepare for meals at the home such as the preparation of light snacks and preparing vegetables. People go food shopping with staff and make daily choices of what they would like to eat, records of meals evidenced that people are given fresh produce which is home cooked, special dietary requirements are known to staff and are catered for, individuals likes and dislikes are also well recorded, known and action taken as required. There is someone at the home who is in paid employed and appears to enjoy the work that they do. We saw that work arrangements are reviewed in order to ensure that these are still in like with what the person wants to do. We saw minutes of a meeting that took place in March 2009 and saw that this arrangement works well for the individual, we did note that on file was an employment agreement, this outlines the rights and responsibilities of the employee and the employer, this document was dated July 1999, it is recommended that a new, updated employment agreement be obtained in order that clear, accurate information is in place. People are helped by staff and other agencies to take part in activities of their choice, for the person recently admitted into the home we saw that they continue to be supported by the day care service they received prior to their admission into the home. On the day of our visit one person was at work, another two people went out, one for a meal another went shopping. We saw correspondence to evidence that people have accessed, and will be accessing educational opportunities, people living at the home have engaged with art and drama at college. When saw reviewed daily diary notes and care plans we saw that within the past few weeks people have visited places of local interest such as Bath and Willsbridge Mill, other people have gone further afield and one person has recently returned from a holiday in Rhodes which they appear to have enjoyed very much. People have gone to the theatre, hydrotherapy, musical bingo, discos and local social clubs. People regularly access local community facilities such as the local pug and shops, clear information about the local amenities is included within the homes services users guide, a copy of which is given to all individuals. Daily house routines promote independence, individual choice and freedom of movement Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home support people who live at Courtview as required and ensures that the emotional and physical health needs are met; it protects those living at the home from potential harm through satisfactory medication practices. Evidence: We reviewed the way in which individuals are assisted with their personal care. We saw that staff provide a sensitive and flexible support to people in order that they maximize individuals privacy, dignity and independence over their lives. Personal care is provided in private and bathroom areas have locks on doors. We saw in care documentation that people are encouraged to manage their personal care and are supported in a respectful manner with areas they require assistance. When talking with staff about the people living at the home and the assistance they require, staff spoke with warmth and demonstrated a sound understanding of the individual needs and personalities of people living at the home. Staff spoke respectfully and showed that the rights and needs of people living at the home come first. People living at the home have Health Action Plans in place, these record what Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: healthcare services people require, tailored to their specific needs and preferences and records how these will be met, both with support from the home and other professionals. By examining these documents we saw that staff monitor the physical and emotional health of people who live at the home, potential complications and problems are identified and dealt with at an early stage. All of the people who live at the home are registered with a local general practitioner and are supported to visit, we saw that people had accessed primary care services such as dentist, opticians and chiropodist. These records also showed that people has accessed specialist services, these include; occupational therapist, the community learning difficulties, speech and language therapist and special dietary advice. We saw on a staff notice board information about swine flu and actions required should their be a influenza pandemic, evidencing that the home are keeping up to date with health matters and current good practice guidance which may effect those who live at the home. During this visited we reviewed medication practices at the home, this included recording, storage and staff training. We found that a monitored dosage system is in place at the home and is supplied by the dispensing pharmacist. we spoke with the member of staff who is responsible for the reordering and monitoring of medication at the home, they informed us of the measures, audits and safeguards in place to ensure safe administration. Of the records we reviewed we found no errors, medication that we checked in stock corresponded with records at the home. Staff informed us about their role and responsibility in respect of medication and provided details about the training they had undertaken. Medication practices within the home are sound, there are clear policies and procedures in place to underpin these. The registered manager and staff deal with the aging, illnesses and death of those who live at the home with sensitivity and respect. Since our last visit to the home there have been two deaths of people who lived at Courtview, one of these people had moved to another home and had died at the new home, staff from Courtview stayed in touch and provided information to other other home in order to facilitate a smooth transition for this individual. We found that staff from Courtview had attended this persons funeral and had supported people who were friends of this individual to attend also. We saw that this difficult subject has been discussed with people who live at Courtview and their wishes in respect of their end of life wishes had been recorded. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Those living at the home are protected from abuse and harm through robust policies, the home provides detailed information to enable those living at the home to raise concerns. Evidence: he home has in each persons room a copy of the procedure on how they can raise complaints at the home, these are in pictorial format, staff also ask people within key worker review meetings if they have any concerns and remind individuals of how they can raise issues in a supportive, safe manner. We were informed that there were no current complaints being dealt with at the home, we viewed the complaints log book record, there had been no recorded issues or complaints since our last visit. No complaints were raised to us during this visit. Records of recently employed staff members were viewed and contained personal information and record of identity. Other information seen included, record of previous employment, references, protection of vulnerable adults checks and satisfactory Criminal Record Bureau disclosures. We saw that staff had attended training about how to protect vulnerable people and this is also covered within the National Vocational Qualification undertaken by staff at the home. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We saw in staff files that staff have completed training in the protection of vulnerable adults, we also saw that this is an ongoing area of training. There are clear policies and procedures at the home which inform and guide staff practice should a complaint, concern or allegation be raised. 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 relationships between staff and those living at the home are good, and this creates a warm, supportive, homely environment, which promotes a good quality of life for the individuals living at Courtview Evidence: Courtview is located within the semi rural, residential area of Pucklechurch. It has local facilities nearby which include shops, cafe, churches, pubs and community centres. The home has sufficient toileting and bathing and showering areas for individuals use. These areas are close to peoples rooms. The temperature in the home at the time of our visit was warm and comfortable. The home is appropriately adapted to meet the needs of the current group of people who live in the home. Specialist equipment has been obtained for individuals following identified need, examples of these include bathing aids and sensory aids. There has been a requirement in respect of the external land, to the front of the property, this had been outstanding since December 2006. The requirement was that the service must make arrangements to clear the front garden of rubbish and make Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: this a safe accessible for service users. When we visited the home previously we were accompanied by and Environmental Health officer from South Gloucestershire Council, they had also reported that the home must deal with this area. A further requirement was made by us that the home must comply with the report completed by the Environmental Health Officer in respect of the overgrown front garden area. Upon arrival at the home it was clearly evident that both of these requirements had been met. The area had been cleared of overgrown trees, bushes and shrubs and new gravel had been laid and had transformed the area. We also saw that another exit out of the front driveway had been implemented, we were informed that planning permission had been requested in order that this exit may be used. At this visit all areas seen were clean, tidy and odour free. We saw evidence that the home is well maintained 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Courtview enjoy a good and warm relationship with competent staff. The homes recruitment procedures offer protection to the people living in the home. Evidence: There is a well-established skilled and experienced staff team at the home to meet the needs of the individuals living in the home. The manager told us that staff are able to demonstrate understanding and knowledge of the care needs of individual residents. We viewed rotas for the forthcoming week and saw that staffing provision appeared to be consistent with levels and skills needed due to assessed care needs of the individuals. Staff confirmed to us that the home had a full complement of staff. During our last key visit to the service two requirements were made in respect of staff training, these were; that training in the protection of vulnerable adults training must be provided for staff in order that they are aware of their responsibilities in this area and also that training in dementia awareness must be provided for staff in order to equip them with the skills and knowledge to support individuals in this area. Staff on Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: duty, and the manager of the service confired that training in both of these areas had been completed. We saw evidence that this training had been undertaken in staff files. Staff told us that this training had been valuable and provided necessary information on order to understand the complexities of dementia and their individual and joint rols in respect of safeguarding vulnerable people, both of these requirements had been met. Staff files reviewed informed us that staff have undertaken training in areas such as dealing with behaviour which challenges, dementia awareness, hand hygiene, mental capacity act training, health and safety and manual handling. The manager told us of forthcoming training events for staff such as 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent manager who safeguards the interests of people who live at Courtview and also protects them through policies and procedures. Individuals records are securely locked away. Evidence: The home is operated and managed by Aspects and Milestones Trust, Western Challenge own the building and are responsible for any major works or refurbishments of the home. At our previous two visits to the home we recorded that the previous manager was managing two services and was not able to spend enough time at Court View and therefore a requirement was made by us that permanent arrangements must be made for there to be a Registered Manager at the home. (The service was notified of this and this has been outstanding since September 2007). Ms Aston was asked by Aspects and Milestones Trust to go to Court View for three months and then was interviewed and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: successfully appointed to the post. Ms Aston underwent her fit persons interview with us on April 21st 2009 and was registered as the manager of this service. Ms Aston has been working at Court View since August 2008. The previous manager moved on to another Aspects and Milestones Service. Ms Aston is a qualified positive response assessor and is therefore skilled in responding to behaviors which may at times be challenging, Ms Aston has a National Vocational Qualification (NVQ) at level 3 in care practice and is also an internal assessor and verifier for this award. Ms Ashton is currently in the process of undertaking an NVQ at level care in Management and a Registered Managers award. Staff files also contained evidence of supervision and positive comments were noted in the feedback to staff. Frequency of supervision was generally good and staff had received the required sessions. Areas of discussion included guidelines and policies of the home, individuals expectations and an evaluation of their performance and how this can be developed. We saw that the home has in place a detailed emergency fire plan, this plan was completed in and covers what the procedure is at night and outlines individuals responsibility in the event of a fire emergency. The home also had in place a comprehensive fire risk assessment, this assessment identified potential hazards, assessed those who were at risk, methods of control and also recorded were further controls that are necessary. We viewed the fire logbook for the home. The home was completing the appropriate checks on the fire equipment and the recording of fire drills and the testing of equipment were satisfactory. We saw the fire panel in working order. We did note that emergency lighting had not been checked on a consistent monthly basis Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R 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 1 28 16 The service must make 22/09/2008 arrangements to clear the front garden of rubbish and make this a safe accessible for service users. The service was notified of this in December 2006). 2 35 13 (6) Training in the Protection of 22/10/2008 vulnerable adults training must be provided for staff in order that they are aware of their responsibilities in this area. Permanent arrangements 22/09/2008 must be made for there to be a Registered Manager at the home. (The service was notified of this since September 2007) 3 37 8 4 42 13 The home must comply with 22/09/2008 the report completed by the Environmental Health Officer in respect of the overgrown front garden area. 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 1 9 13 The registered person shall ensure that unnecessary risks are identified and where possible eliminated. This is to ensure that people are supported and that the likelihood of incidents occurring are reduced. 24/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 It is recommended that a new, updated employment agreement be obtained in order that clear, accurate information is in place. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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