Care Home: Cranmore

What the care home does well People receive the support they need in ways that are right for them. One person says, `the staff are here to help me do things and I like them. They help me do things like washing and they go out with me to places I like going to. They`re good like I want them to be`. People have the opportunity to undertake a suitable range of occupational and social activities. One person says, `I do things at home like the washing up and I go to friends at the disco and things I like doing. I go (out) lots and do things` People say that they are provided with good quality meals. One support worker says, `we try to make meal times social events. It`s not just about eating food, it`s about sitting down together to chat about things and to plan things to do. It is like a family here and meal times are important`. People are helped to stay in good physical health. This includes being supported to obtain medical assistance as and when it is needed. There are reliable arrangements for handling and dispensing medication. The accommodation is presented to a very good domestic standard. There is a modern automated fire detection system. This gives a high level of fire safety protection. There are reliable arrangements for keeping people safe. These include assisting people to manage their spending money. Security checks are completed on new support workers. This is done to help make sure that they are trustworthy people. Support workers have the skills they need and they receive suitable training. The people who live in the Service are consulted about how their home might be improved in the future. There are suitable health and safety systems that help prevent accidents and other untoward events. What has improved since the last inspection? A number of improvements have been made since our last Random Inspection. These include the following things: People have moved to the new building. As a result of this everyone has a private bathroom. There is more communal space in general. Work has started on making the individuals plans of support more user friendly. This is important because it will enable people to become increasingly involved in making and reviewing decisions that affect them. People have been supported to undertake a wider range of occupational and social activities. All of these things enable the Service to better meet the needs of the people who live there. What the care home could do better: There is no registered manager in post. It is a legal requirement that the Registered Provider addresses this matter. The fire training provided for support workers needs to be strengthened. This is necessary so that more frequent checks are made to ensure that they can reliably operate the fire safety procedure. Key inspection report Care homes for adults (18-65 years) Name: Address: Cranmore Church Road New Romney Kent TN28 8EY     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: Mark Hemmings     Date: 1 3 0 1 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 29 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 29 Information about the care home Name of care home: Address: Cranmore Church Road New Romney Kent TN28 8EY 01797367274 01797367274 info@flarepath-care.co.uk www.flarepath-care.co.uk Flarepath Ltd care home 6 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): 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 who can be accommodated is: 6 The registered person may provide the following category 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 category: Learning disability - LD Date of last inspection Brief description of the care home Up to six people who have a learning disability can make their home in Cranmore (the Service). The premises are a modern detached house. All of the bedrooms are on the first floor and are single occupancy. They are laid out as bed sitting areas. There is a bed, bedside table, wardrobe and comfortable chair. All of them have a private wash hand basin and toilet. All but one also has a private shower. Each bedroom has a television aerial point. The lounge, dining room, kitchen and the laundry are on the ground floor. There are two bathrooms. One has a bath and the other has a Jacuzzi shower. Each of them also Care Homes for Adults (18-65 years) Page 4 of 29 0 6 0 5 2 0 0 9 6 Over 65 0 Brief description of the care home has a toilet and wash hand basin. People can use the Services telephone free of charge. There is an enclosed garden at the back of the property. This has some flower beds and a large central lawn. The Service has its own vehicle. The Registered Provider is a private limited company. The Service is set in a quiet residential street. It is only a very short walk from the centre of New Romney, where there are shops and a bus route. The nearest mainline train station is about six miles away in Ham Street. The nearest large town is Ashford about 20 miles away. The weekly charge for living in the Service runs from £958.00 to £1525.00. Please contact the Manager if you want to find out more details about the charges. Care Homes for Adults (18-65 years) Page 5 of 29 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 this Service is 2 Star. This means that the people who use this Service experience good quality outcomes. We arrived unannounced at the Service at nine oclock in the morning and we there for about six hours hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received this on time. It is very well detailed. Further, we considered any information that we have received about the Service since our last Random Inspection. We completed this on 6 May 2009. Although the Service was registered in 2006 it has only been occupied since 23 November 2009. On this date, all of the people who now live there transferred from another nearby residential service run by the Registered Provider. Because no one lived in the Service before then, we only did very brief Random Inspections where we noted the Service to be dormant. Care Homes for Adults (18-65 years) Page 6 of 29 During the inspection, we spoke with three of the four people who live in the Service. More generally we spent time with all four of them while they relaxed in the lounge and later on while they were busy in the kitchen. We spoke with the Manager and with three support workers. We looked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included things like the individual written plans of support, medication records, the activities plan, the menu, the staff roster, staff training records, financial records, policies and procedures and various health and safety certificates. Before we visited the Service, we asked various people to fill out a questionnaire for us. We wanted them to tell us what they think of Cranmore. All of the people who live there, five support workers, one relative and two health and social care professionals kindly completed them for us. Later in our Report we will tell you some of the main things they are saying in their replies. The Registered Provider has also asked people who live in the Service to complete a questionnaire giving their views about their home. Later in our Report we will tell you some of the replies they have given. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? A number of improvements have been made since our last Random Inspection. These include the following things: People have moved to the new building. As a result of this everyone has a private bathroom. There is more communal space in general. Work has started on making the individuals plans of support more user friendly. This is Care Homes for Adults (18-65 years) Page 8 of 29 important because it will enable people to become increasingly involved in making and reviewing decisions that affect them. People have been supported to undertake a wider range of occupational and social activities. All of these things enable the Service to better meet the needs of the people who live there. 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 29 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 29 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. There is written information about the facilities and services provided in the Service. People who are thinking of moving in will be asked about what support they need and how they want this to be done. They will be encouraged to visit the Service to get a first hand feeling of what it is like. People are told about the rights they will have when they move in and about their responsibilities. Evidence: No one has moved into the Service since it reopened. The Manager says when someone does move in she will meet with them. This is so that she can find out what support they need and want. She will also talk with health and social professionals such as doctors and care managers (social workers). All of this will be done to help her to build up a really good picture of how the person can best be supported. The person will be invited to visit the Service, usually on several occasions. This will be done so that everyone can be confident that moving into Cranmore is the right thing to do. There is quite a lot of written information about the Service. There is a Service Users Guide that briefly describes the main facilities and services someone can expect to Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: have. There is also a contract of residence. This sets out some of the rights and responsibilities people have if they decide to make Cranmore their home. The Manager says that before someone moves in, she shares the information she has learnt with the support workers. One support worker says, we discuss the new person so that we can welcome them and provide the right support for them when they come. Moving somewhere new even after an introduction is unsettling and we want to help the person find their feet. Another support worker says, (the Manager) always shares information with us and we read any paperwork there is about the new person. We know quite a lot about how they need to be supported and what sorts of things they like before they move in. All of the people who live in the Service at the moment are quite settled in their home. The Manager says that if someone wants to move on they will be supported to do this. This may include liaising with family members and with care managers to make sure that the person has the help they need when they leave. Care Homes for Adults (18-65 years) Page 12 of 29 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 receive the support they need in ways that are right for them. People are supported to manage their financial affairs. There is a sensible approach to risk taking. Evidence: Each person has an individual plan of support. These plans help support workers provide the right assistance for people. The plans are kept up to date by the support workers making daily notes. Recently work has started on making the plans more user friendly. This involves using new ways to present information that are more likely to engage the interest of the people who live in the Service. There is a key worker system. This means that each person has a support worker who takes a special interest in their wellbeing. Each person meets with their key worker on a one to one basis. Support workers know how to respond to each person in ways that are helpful for them. In their questionnaire replies everyone who lives in the Service says that they Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: always receive the support they need. One support worker says, we always treat people as we do each other, like adults. Its a bit like a family. We know each person as an individual and we accept them for themselves without wanting to change people into someone else. We know how they like to be treated and have things done. Sensible steps are taken to support people to lead everyday lives of their own choosing. This includes support workers helping people to take reasonable risks and to avoid situations that might be harmful. For example, some people need to be supported so that they are kept safe when they are out and about in the local area. One member of staff says, too often people get babied and talked down to. The people who live here are all adults and they need to be supported to do adult things. So we help people to be active in the kitchen, to do their own laundry and to generally be up and about. At the same time we support people not to take unnecessary risks that everyone would try to avoid. Life is about taking reasonable risks. The Registered Provider does not get directly involved in managing peoples financial affairs. Most people receive help from the local authority or from their families. Everyone has their own bank account to which only they have access. Care Homes for Adults (18-65 years) Page 14 of 29 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. There are interesting occupational and social things for people to do. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is a range of occupational things that people can do if they want to. These include doing college courses and doing household tasks. There are also social things to do. These include indoor activities such as arts and crafts. People also attend regular outside events such as horse riding and social evenings. There was a very lively atmosphere in the Service when we were there. Some people went out horse riding. They then went shopping before returning for lunch. One person was busy doing their laundry and then they did various experiments with a home electronics kit. One person says, I do lots of things and I go out to do things like crafts, horse riding, I go the shops. Ive got lots to do every day. Another person says, I do things at home like the washing up and I go to friends at the disco and things I like doing. I go Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: (out) lots and do things. In their replies to the Registered Providers questionnaire everyone says that they are very satisfied or quite satisfied with the social calendar they have. The Assessment says that the range of things that people can do has been increased since our last Random Inspection. It also says that new and different opportunities will continue to be offered. Each year everyone is supported to go away on holiday. Last year they went camping on the Isle of Wight. People are helped to keep in touch with members of their families. This includes using e-mails. Family members and friends are welcome to call to the Service at any reasonable time. People are encouraged to make their bedrooms their own private space. The bedroom doors have locks on them so people can keep their possessions secure if they want to. The records show that people are provided with a normal menu of meals in which there is sufficient choice and variety. In their replies to the Registered Providers questionnaire everyone says that they are very satisfied or quite satisfied with their meals. One person says, we have really good meals that we all choose. I like the food, I dont really have a favourite thing to eat, we have all sorts. Im never hungry, theres always plenty. Another person says, the food is good. I have things to eat I like. One support worker says, we try to make meal times social events. Its not just about eating food, its about sitting down together to chat about things and to plan things to do. It is like a family here and meal times are important. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: The support workers are relaxed and informal in how they are. They help people to organise themselves without being intrusive. People are helped to wear neat and clean clothes so that they can look how they want. In their questionnaire replies everyone says that support workers listen to them and act on what they say. One person says, the staff are here to help me do things and I like them. They help me do things like washing and they go out with me to places I like going to. Theyre good like I want them to be. People are helped to keep healthy. The records show that support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. People are supported to attend medical appointments and they are supported to follow any treatment regimes that might then be necessary. In their questionnaire replies everyone says that they are satisfied with the medical attention they receive. Two people are supported to manage some of their own medication. The Manager Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: says that more people will be supported to do this as and when it is safe for them to do so. Support workers manage medication for the other people. There is a system to check that the correct medicines are received from the chemist. Once in the Service, medicines are stored securely. The Assessment says that all members of staff who give out medication have been trained so that they know what they are doing. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is filled out on each occasion that a medicine is given. These are being completed correctly. Care Homes for Adults (18-65 years) Page 18 of 29 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. There is a complaints procedure and there are arrangements to make sure that complaints are dealt with properly. People are kept safe. Evidence: There is a complaints procedure. In their questionnaire replies people say that they know how to make a complaint and who to speak with if they are not happy about something. One person says, if I wasnt happy about something Id talk with one of the staff whod help me or with (the Manager). I dont have anything to say, Im quite okay at home and thats that really. Another person says, Im okay and dont have any worries. If I want something I can say it and people help me have what I want. The Registered Provider has a detailed policy and procedure that explains how it will investigate and resolve complaints. The Manager says that all complaints will be promptly investigated so that they can be resolved as quickly as possible. Since our last Random Inspection neither we nor the Registered Provider have received any complaints about the Service. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. In their questionnaire replies everyone says that they are treated well. The support workers are confident that people are being kept safe. One support worker says, all of the people are treated really well here. This is their home and they Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: most definitely are safe here. They hopefully know that we understand their needs and genuinely take care of them. We wont always agree if they want to do something that might cause them harm, but whatever we do we always have their best interests at heart. Another support worker says, the residents are very well cared for. Ive never worried about that at all since Ive been here. Ive only ever seen people been treated as adults and with kindness. The people who live in the Service are helped to manage their personal spending money. This involves support workers retaining funds on their behalf and then disbursing them when requested. The records show that this is being done in a reliable and transparent manner. The Assessment says that the Registered Provider is committed to promoting diversity in the Service. By this it means respecting each person who lives there as an individual who is inherently valuable in their own right. The Assessment says, We actively encourage our residents to live as full and active lives as they are able and to be supported to achieve their full potential. In each support plan we record, where possible residents wishes regarding their attendance at religious services, any cultural needs they may have, and their wishes should they become ill or in the event of their death. The records show that as part of their training support workers receive guidance about the need to guard against any form of prejudice or discrimination. New obligations have been placed on all registered providers for managing situations in which it may be necessary to deprive someone of some of their liberties. The Registered Providers responsibility is to make sure that any limitations will only be done in the best interest of the person. The Manager says that the necessary systems to deliver the additional safeguards are in place. At the moment, there are no particular restrictions being used in the Service. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is very well presented. There are suitable fire safety arrangements. The kitchen is well equipped. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. This is a legal document that the Registered Provider has to have to describe the Service. Copies of the document can be obtained from the Registered Provider. The building is very well maintained on the outside. The garden is neat and orderly. On the inside, the accommodation is decorated and furnished to a very high standard. There is a light and airy atmosphere. In their replies to the Registered Providers questionnaire, people say that they like the new building to which they have recently moved. There are some unnecessary health and safety posters and no smoking signs pinned on the walls. These do detract a little from the lived in feeling that is otherwise achieved. There is a modern automatic fire detection system. This is being checked to make sure that it continues to operate in the right way. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The local Department of Environmental Health has not yet inspected the kitchen. We examined the kitchen and it is clean and well organised. The records show that the refrigerator and the freezers keep foods cold enough. There is also a system to make sure that foods are used promptly once they are opened. Support workers know about the importance of good food hygiene and they follow the correct procedures. People say that the accommodation is kept comfortably warm. The radiators are fitted with guards. This has been done to reduce the chance that someone will be burnt if they fall against them. The hot water system is temperature controlled. This has been done so that the water does not get hot enough to scald someone. There are an adequate number of bathrooms and toilets. There is also an adequate amount of communal space. The laundry is in a side building. It is clean and well organized. There is a washing machine and a dryer. Care Homes for Adults (18-65 years) Page 22 of 29 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. There are enough support workers on duty. Support workers have the necessary skills to support people in ways that are right for them. Security checks are completed on new support workers. Evidence: The records show that there are two or three support workers on duty from early in the morning until later in the evening. There is a staff presence at night. In their questionnaire replies support workers say that there are enough members of staff on duty. One support worker says, there are enough staff to make sure that everyone gets the support they need. We work together well as a team and in general things go well. When we were in the Service, we kept a look out for things that might give us a clue about how well the place is being staffed in practice. We noticed that two support workers accompanied the three people who went out in the morning. This left one support worker at home who then assisted someone to tidy their room. Later on the person was supported to set up their home electronics kit. The records show that the Registered Provider completes a number of security checks on new support workers. These include things such as confirming their identity, taking Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: up references and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. In their questionnaire replies, support workers say that security checks were completed on them in the manner described in the records. Support workers say that they received sufficient introductory training when they first started working in the Service. One support worker says, I got lots of training when I started and it was useful. There was no attempt to rush me and I was able to get into the swing of things and get my confidence. Theres a lot to learn and you need to have a good start. The Registered Provider wants all support workers to receive ongoing training. The subjects include first aid, food hygiene and how to respond to people who are expressing themselves through difficult conduct. The records show that this training is being delivered in a reliable way. All of the support workers have completed a relevant National Vocational Qualification (NVQ). This Award is designed to further develop their ability to provide people with the assistance they need. Care Homes for Adults (18-65 years) Page 24 of 29 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. There is no registered manager. The Service is well managed. There is a quality assurance system. There are suitable health and safety arrangements. Evidence: The Manager is not registered with us. It is a legal requirement that the Registered Provider has a suitably qualified registered manager in post to oversee the day to day running of the Service. There is a requirement about this matter at the end of this Report. The Manager has been in post for several years. She ran the residential care service from which the people have recently moved. She has a good understanding of how to ensure that people reliably receive support that is right for them. She does not have either of the formal qualifications that are recommended by the National Minimum Standards. She says that she is keen to start studying for both of them as soon as possible. Support workers say that there is good team work between them. There are handover Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: meetings at the beginning and end of each shift. One support worker says, we all get on quite well and organise ourselves so that on each shift the residents get the help they need. We know what each person likes to do and their routine so we can organise ourselves accordingly. Things work pretty smoothly in general. Each support worker meets regularly with the Manager to review their work and to discuss their professional development. In their questionnaire replies support workers say that they receive all the support they need. People who live in the Service are regularly asked what they think about their home as part of everyday life. Also, there is a system of monthly house meetings. These are where people who live in the Service can review how things are going and can suggest improvements. The records of the most recent meeting show that people are happy with the move to their new home. Each year the Registered Provider asks people who live in the Service, their relatives and health and social care professionals to complete a questionnaire saying what they think about Cranmore. We have already noted some of the replies that have been given. A representative of the Registered Provider calls to the Service once a month to check how things are going. In addition to this one of the Directors also visits regularly. The records show that there are regular fire drills. There is also a system that makes sure that all members of staff know how to operate the fire safety procedure. The Manager is going to strengthen this arrangement further. This is so that support workers are given more frequent updates about using the procedure. The new system is going to be introduced by 1 March 2010. The records show that all items of equipment used in the Service remain in good working order. The records show that there have not been any accidents or other adverse events in the Service since our last Random Inspection. The Manager says that she will review any future events. This will be done so that steps can be taken to prevent a recurrence. The Manager says that she is about to start completing organised health and safety audits of the building. These will be done to help make sure that there are no hazards that might result in someone having an accident. The Manager says that there are no particular hazards that need to be addressed at the moment. We did not notice any either. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 37 8 The Registered Provider must appoint a registered manager to run the Service. This is so that we can give suitable consideration to the fitness of the manager proposed to us for registration. 01/03/2010 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 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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