Care Home: Creedy Court

What the care home does well Creedy Court is well managed. There are also enough staff who have the skills and knowledge to meet people`s needs. The home is clean and attractive and is situated where people can enjoy the peace of the countryside but travel easily into a nearby town. Good record keeping by staff makes sure that care is delivered properly and that people`s changing needs are noticed and acted upon if people need additional support. The culture in the home is to improve things for people living there. What has improved since the last inspection? Not applicable. This is the first key inspection as Crediton Care and Support Homes Ltd. What the care home could do better: If staff are listening to people when they are in their private room to check they are o.k. then this should be discussed with the person and written down. The new shower room planned for Eastleigh should also have a sink in it for people to wash their hands. Key inspection report Care homes for adults (18-65 years) Name: Address: Creedy Court Shobrooke Crediton Devon EX17 1AD The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Judith McGregor-Harper Date: 3 1 0 3 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 30 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Creedy Court Shobrooke Crediton Devon EX17 1AD Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) James Leslie Moore Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 17 0 care home 17 Crediton Care & Support Homes Limited learning disability Additional conditions: The maximum number of service users who can be accommodated is 17. The registered person may provide the following category of service only: to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD - maximum of 17 places Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Creedy Court is situated near the village of Shobrooke and approximately two miles from Crediton. It is registered to provide care for up to 17 adults who have autism, aspergers syndrome or a learning disability. The home is arranged around a courtyard and there is also a garden to the rear of the home that backs on to open fields. There is off road parking to the side of the building. The home is divided into two separate units (Eastleigh and Westleigh), each with its own lounge, dining area and kitchen. Eastleigh is for people who are less able. People who live in Westleigh are more independent. The fees range from 1200.00 pounds to 3000.00 pounds per week. They vary from person to person as it is based on individual needs and requirements. Please contact the provider for details of additional extra fees. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This is the first key inspection report for Creedy Court as a limited company. The home is an established care home and there have been no changes in registered personnel as a result of the registration change. The service has a previous history of either good or excellent standards of care. As a result of this unannounced inspection the quality rating for this service is 3 stars. This means that the people who use this service experience EXCELLENT quality outcomes. We (the Commission) visited the home and spent time talking to the people who live there. We looked at records and talked with the manager. We observed some social care practices and we spoke with some staff employed at the home. We sent surveys to staff and people who live at Creedy Court, some relatives and social care professionals who have regular contact with people living at the home. Prior to the inspection the home management sent us their Annual Quality Assurance Assessment (AQAA) which gave us a lot of useful information about the home, its management and about the needs of the people who live at Creedy Court. This document asks for evidence in relation to what the home does well and Care Homes for Adults (18-65 years) Page 7 of 30 what they think they can improve on. What the care home does well What has got better from the last inspection Not applicable. This is the first key inspection as Crediton Care and Support Homes Ltd. Care Homes for Adults (18-65 years) Page 8 of 30 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith McGregor-Harper Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 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 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed and clear admission processes minimises the risk of the placement at the home being unsuitable for people who move in. The manager makes sure that people who are considering moving in to the service receive up to date information about Creedy Court. Evidence: This is Creedy Courts first inspection under the parent company of Crediton Care & Support Homes Limited. The home has been open since the year 2000. There have been no new admissions since 2006 and one person moved out in 2009. On the day of the unannounced inspection one person was spending some time at the home getting a feel for the home and deciding whether to move in. We talked to this person who told us that they have had other visits to the service and they also plan some overnight stays. Other people living at the service told us they were aware of the new person who was thinking about moving in, that they had met them and that they felt that their opinion to the suitability of the person moving into the home would be considered by the home management. We talked to the manager about assessment processes for people moving in and we Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: heard an account of a thorough process. Prior to the inspection we sent five surveys to community based health and social care professionals linked to Creedy Court and we received three responses. These responses told us that, in their individual opinions, the management at Creedy Court take appropriate action to ensure that sufficient information is received about the suitability of placement for prospective residents moving into the home. We also sent ten surveys out to people who live at the home. We received nine completed responses. All nine responses said that they had been consulted about moving into the service. Eight people said this included being given enough information about the home for them to decide if the home was right for them. One person did not respond to this question but they also did not express any dissatisfaction with the service in the remainder of their survey answers. The home has recently reviewed and updated its Statement of Purpose. A copy of this document has been forwarded to the Commission. The AQAA completed in February 2010 told us that the Service Users Guide was in the process of being reviewed. This document has now been reviewed and updated/amended and we have been supplied with a copy. Care Homes for Adults (18-65 years) Page 13 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. Each person has a plan of care and risk assessments that reflect current needs. Staff know how to meet peoples assessed needs and they ensure that care records are kept up to date. This means that people receive the care and support they need. Peoples dignity is respected however a potential compromise to a persons privacy was not properly documented in a care plan, as should have been the case. Evidence: We case tracked two people with differing needs. We met them, looked at their care plans, risk assessments, accident and incident records, medication and daily care records. We also talked with duty staff about their care and support needs. We saw that the home had produced detailed and clear plans of care that showed how peoples current needs were being met. We saw that placement officers had been consulted in the review of care plans. Risk assessments were completed echoing information identified in individual care plans. Accident and incident records reflected information recorded in daily care records. Care plans maximised decision making processes that individuals were capable of. One person told us that the home arranged Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: for them to access advocacy services and that they use this service to support their decision making. We saw that due to clinical risk one person had a baby monitor type listening device in their room. We discussed this with the manager as the device was not mentioned in the care plan. We were concerned that the persons privacy could be unduly compromised or that confidential conversations may be overheard. The manager reassured us that the use of the device had been discussed in a multi-disciplinary meeting and that the device was not used covertly in the room, also that there were agreed boundaries for use of the device. We had asked some duty staff to tell us about the device and the answers they provided us gave us confidence that appropriate efforts by staff were taken to respect the persons need for privacy. We told the manager that the care plan should include a clear rationale for the use of the device that explored potential breaches of privacy and how this would be minimised. Care Homes for Adults (18-65 years) Page 15 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 live at Creedy Court are able to take part in activities that suit their needs and wishes and are supported to access the local community and maintain contacts with family and friends. Evidence: In the AQAA we asked the service to tell us how they have improved lifestyle outcomes for people in the last 12 months and they told us. We have encouraged staff to help the service users access community based activities. For instance two of our service users ran a mini marathon last year with a group called ROC based in Exeter. Creedy Court have supported service users in achieving more independent living skills, such as service users obtaining bus passes and utilised them. We have supported service user to move into supported living and less secure environments. We also support service users in budgeting issues, banking and benefits. In survey returns from people who live at the service all nine respondents told us that they can do what they want during the evenings and weekends; one person said that Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: they cannot do what they want during the day. However, this person did say that the home makes me happy and that I like my activities. Survey returns highlighted activities and opportunities for educational or work placements as a strength of the service. We had also sent five surveys to relatives of people living at the service and received three replies. Echoing comments from people living at the service families told us that social events and activities were an area that Creedy Court manages well. One person told us that they wanted a bigger room. We saw during the inspection that action was in progress to offer everyone at the service good sized rooms. One person told us that they wanted Creedy Court to support them to become more independent by moving out and living in the community. We discussed this with the manager with the persons permission and were able to appreciate that the home shares such sentiments and a structured personal goal plan for the person concerned has been instigated. We looked at the main kitchen and the dining rooms at the home. We talked with the chef and observed some people taking lunch. Much of the menu is home cooked and we saw evidence of peoples dietary preferences being catered for with detailed lists of peoples likes and dislikes. Healthy food options are encouraged at the home and monitoring of peoples weights is on-going in order that action commences when people either expectantly put on or lose weight. Outside of set meal times there is the option of purchasing snacks at Georges Bar, which is a room at Creedy Court in a club house style in which to relax and socialise. At lunch we saw one person being assisted to eat their meal. The staff member assisting the person was performing the task in an unhurried and discreet manner. We looked in the kitchen in Westleigh and we looked in the fridge to check if food stored within complied with good food handling practice by being covered, labelled and dated. There was a notice on the fridge door reminding staff that food had to be stored in this way. We saw some plastic boxes of perishable foods that were not labelled nor dated. We asked why this was not so and we were informed that they boxes were staffs own packed lunches. Following the inspection we have been reassured by the management that staff have been asked to label their personal foods in order to prevent further confusion. Care Homes for Adults (18-65 years) Page 17 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. People living at Creedy Court receive appropriate care and support in a way that suits them. Peoples medicines are managed safely. Evidence: During the inspection we spoke with some people living at Creedy Court and observed some staff attending to and responding to peoples social care needs. People told us that staff treat them well; this included respecting ethnicity. All nine survey returns from people living at the home told us that staff treat people well and listen and act on what they say either always or usually. In addition we received a survey return from one community nurse who visits the service regularly. Their responses in our survey indicated they had no concerns about how the service meets peoples health care needs. Prior to the inspection we received one complaint about the service directly, which alleging that a persons health needs were not being met. We raised this as a safeguarding alert with Social Services and the matter was discussed with the home and investigated. The investigation is now concluded and there have been no required changes to the care practices at the home as a result of the investigation. During the inspection we saw potential for behaviours that challenge and we saw staff diffusing situations calmly and professionally. The service has informed us of incidents at Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: the home via our reporting processes for notifiable events. Individuals records in respect of personal care and health monitoring were maintained well and were sufficiently detailed to track changes. Staff we spoke with had good knowledge of peoples health care needs. We inspected medications held at the home. We saw that medicines were stored appropriately and securely. We checked stock numbers of controlled drugs at random and they were correct. The stock control monitoring for controlled drugs was recorded on loose leaf sheets of paper. We advised the home that this should be recorded in a numbered and bound book. The home made arrangements to receive delivery of a bound hard backed, numbered pages controlled drugs book later the same day. We looked at medicines records and they were generally maintained well. There was an occasion when staff had hand written a prescription on to a medicine chart but the staff had not signed the entry nor was there evidence that a second staff member had checked the hand transcribed entry. This increases the risk of human error. We brought this to the attention of duty staff and two staff immediately checked the accuracy of the hand written entry and signed to acknowledge this. We also saw that someones medicines had not been signed for on one morning. We counted the medicines with the duty staff and medicine numbers indicated that the medicines had been given that morning. We raised this with the homes manager, who has responded to us via email telling us that these matters have now been raised with the staff group responsible for administering and overseeing medicine records. We spoke with staff about what training they had received in administering medicines. The training is delivered by the dispensing pharmacy. Care Homes for Adults (18-65 years) Page 19 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. There is an open culture for raising concerns at Creedy Court; peoples views are heard and acted upon. Procedures are in place to ensure that people are protected from abuse. Evidence: The home has not received any complaints since registering with the Commission. We have received one complaint directly, which has been raised as a Safeguarding Alert, investigated and is now closed. Surveys we received from people living at the service unanimously indicated that people knew whom to raise concerns to at the service. We also received three survey returns from families, all whom expressed satisfaction with the quality of care at the service and satisfaction with communication between the home and family members. We asked people living at the service how they tell someone if they are unhappy with something. They told us that they have people they can speak with, whether staff, advocates or family members. One person told us that emotional support is of utmost importance for them whilst living at the service. They asked us if we would tell the homes manager that they have some unmet emotional needs at times. When Creedy Court registered in October 2009 we asked that the owner, who is the responsible individual for the service, arrange to update their knowledge of local Safeguarding procedures. At the inspection we saw evidence that this training had been undertaken and we were supplied with, on request, a copy of the certificate for this Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: training. During the inspection we spoke with duty staff about training they had received in the protection of vulnerable adults and Whistle Blowing. Staff confirmed training in the last 12 months and were knowledgeable about duties to raise concerns about suspected abuse. We examined incident records and saw that clear and detailed record keeping assists the service in planning to prevent the number of incidents of challenging behaviour at the home. We looked at some records of financial transactions made at the home where monies are held on behalf of people living at the service. We saw that robust accounting processes were in place to prevent financial abuse. Care Homes for Adults (18-65 years) Page 21 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. The buildings and grounds at Creedy Court provide a pleasant and comfortable environment for those living in, working at and visiting the home. Evidence: Creedy Court is a large detached property arranged on two storeys around a pleasant courtyard. There are separate facilities within the courtyard that provide space for activities such as pottery, art and therapy sessions. The home also has a Snoozelen room, which offers people a relaxation area. There is another room that people use for social events, such as discos, called Georges Bar, which has a bar and snack area. We conducted a tour of the premises. The home is accessible to the people currently living at Creedy Court, but it may not be suitable for people with mobility problems due to stairs. There are two units within the home, Eastleigh and Westleigh. Each unit has its own communal space, including lounge and dining areas. The home has an on-going programme of maintenance and refurbishment to ensure the environment remains comfortable and safe. All bedrooms are for single occupancy. Rooms we saw were personalised and comfortable and reflected individual tastes. On Westleigh there is a separate washing machine which individuals are encouraged to use with staff support. There is an additional laundry for all other washing, which is Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: situated in the courtyard away from areas where food is stored, prepared or eaten. The AQAA submitted to us prior to the inspection informed us that. The house keeper has regular infection control and link work training which keeps us in touch with any new legislation, products and information that can support homes in infection control. Individuals rooms are person centred and are personalised with their own furniture and belongings. They also choose the decor and colour. If this is not possible, key worker, multi disciplinary meetings and outside professionals support the individual in choices. The bedrooms are private and most of the service users have their own keys. Individual rooms are specially designed for the needs of the individual, i.e. access for wheelchairs. The AQAA also tells us that in the last 12 months. Creedy Court have set up a garden club for the service users which has seen a massive improvements in the back garden. There is a walled patio area, water feature and seating area. The garden is a welcome place for the birds and this has added a new interest to some of the individuals who live at Creedy Court. The Eastleigh dining room has been completely refurbished and with new furniture has made it a more pleasing experience for the service users. In the next 12 months the AQAA informs us that. Creedy Court are going to refurbish [one] bathroom and install a shower to accommodate the needs of the individuals who live there. We discussed the plans to refurbish the Eastleigh shower room with the homes manager and we recommended the addition of a hand washing sink to improve infection control measures in this bathroom. There are also plans to reduce capacity at the unit by increasing room size of two smaller rooms. This will not affect placement availability for people who currently reside at the home. Care Homes for Adults (18-65 years) Page 23 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. Stable staffing from a staff team who receive training relevant to their roles ensures that people receive good care. Staff recruitment practices are robust, which helps to deter people unsuitable for working with vulnerable people gaining employment at the home. Evidence: The home employs 27 care staff, of whom 21 have achieved a care qualification to at least NVQ level 2 (or equivalent). Additionally some care staff are currently working toward this NVQ qualification. The daily staffing levels at the service are 4 care staff during the day and 3 care at night. At night one staff member is on a sleep-in shift. These minimum staffing levels are supported by additional care staff for 1:1 activities, therapist support, managers and ancillary staff. Both male and female staff are employed as carers to enable gender preferences of people at the home to be met in assisting with personal care tasks. Survey returns we received from three social and health care professionals praised the care given by staff in supporting people who live at the home. Health and social care professionals all mentioned the diversity of needs at the service and complex needs of many people living at the service. We received comment from one professional that, in their opinion, the able service users at the home had made some less physically able people more vulnerable, but that this was a problem of the past and had been addressed by the current management of the home by implementing a more person centred Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: approach to care planning and care delivery. No staff have been recruited since registration in October 2009 (staffing remained constant with the re-registration). Recruitment practices were discussed with the manager and we discussed improving record keeping for verbal references. The manager said that a pro-forma would be developed to capture more detailed information to suitability of candidates when sourcing verbal references. We viewed individual staff training records and we saw evidence of continuing staff development and training opportunities suitable to roles and peoples medical conditions at the home. The management monitors staff training to anticipate when staff need training updates and we saw that action is taken to ensure that staff receive required training. Care Homes for Adults (18-65 years) Page 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Creedy Court is a well managed home that has developed helpful and self-critical quality assurance processes in order to continually improve outcomes for people who live there. Evidence: The manager, James Moore, has the necessary experience to manage a care home and is suitably qualified. He is supported in his role by a deputy and an administrative assistant. Surveys received from care professionals indicated that they felt the home was well managed. The AQAA submitted to us prior to this inspection was completed well and gave us the evidence that we asked for. The AQAA was self-critical and told us that in order to improve management at the service the home management needs to, be able to support staff when the office environment is very busy. There needs to be a effective system to archive documentation and other paper work which is easy to access without disruption to the daily workings of the office. Management need to try and streamline paper work more but so it does not to affect the flow of information. The management team can improve links with other care homes that offer the same care so we can support each other and learn from each other. [We need] to work on the information that is in the Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: AQAA form and recognise the importance of the information. During the inspection we saw management and staff reacting in a positive and prompt manner to issues we brought to their attention in order to improve outcomes for people who live at the service. The provider visits the home and has meetings with the manager. We asked for the most recent provider visit report and this was supplied to us. It was detailed and reflected views of people who use the service. Both the AQAA and the provider visit reports focused on listening to suggestions from people who live at the service to how the home could be run better to suit their needs. This is good practice. We looked at how health and safety is managed at the home. We looked at accident records and compared them with daily care and support records. We saw consistency of reporting. We noted that the current accident book lacked RIDDOR reporting prompts. We brought this to the attention of the management and received confirmation via email after the inspection that replacement accidents books had been ordered containing this RIDDOR prompt information. The AQAA provided us with information regarding up to date equipment servicing in the home. On the tour of the building so that the risk of burning from hot surfaces is minimised we saw that radiators within the home have been covered. All windows above ground floor level have been fitted with restrictors, in order to minimise the risk of anyone falling from these windows and all taps have been fitted with thermostats to minimise the risk of people being scalded. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 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 Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 10 When listening devices are used in a persons private room due to the need to monitor clinical symptoms care plans should clearly document potential compromises of privacy and confidentiality from the use of such listening devices. It is recommended that a hand washing sink be included in the re-fit of the shower room in Eastleigh. This will improve the shower room infection control facilities for both people living at the home and staff assisting people with personal care. 2 30 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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