Care Home: Curtis Street (87)

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What the care home does well The home told us in the Annual Quality Assurance Assessment that the service is very good at meeting individual needs. The home ensures that residents are involved with the review process and that their Care Plans are kept up to date. Appropriate risk assessments are in place to enable the individuals to live as independent a life as possible. The home has a dedicated staff team, with various skills and are trained to a high level and are well supported by the Senior management to support the residents. The Policies and Procedures provide clear guidelines to staff and are well developed. Tenants have excellent opportunities for personal development and access to the local community facilities in order to participate in leisure activities. Tenants are well supported to maintain good contacts with their families, friends and personal relationships. The home has a robust complaints procedure that is written in appropriate format to ensure that the tenants are comfortable with raising concerns and complaints with the assurance that they will be listened to and their views acted on. It was evident from staff interaction with the tenants and the records seen that there is a warm relationship between the staff and the tenants, a great deal of respect is reflected while supporting the tenantss to maintain their independence. One staff member stated in the response card returned to us " It caters for each service user`s individual needs. It monitors them daily and reviews them regularly. It offers a safe and caring environment". What has improved since the last inspection? The Home told us in the AQAA that they have reviewed the contingency plan for a person who`s health needs have changed. Staff have been provided with more training. Policies have been updated where required and the home has also produced documents in various formats. The home has used the Dept of Health guide "Essential Steps" to assess the infection control management. What the care home could do better: The home manager told us that the present environment could be improved by having a new home and that a new property that will meet the tenants needs has been found. However the sale has not been finalised. We have issued a requirement for the present environment to be refurbished should the purchase of the new property fall through.We have made a recommendation for two staff members to undertake regular fire drills so they are up to date with action to be taken in the event of fire emergency. Key inspection report Care homes for adults (18-65 years) Name: Address: Curtis Street (87) 87 Curtis Street Swindon Wiltshire SN1 5LR     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: Grace Agu     Date: 0 7 0 4 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 32 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Curtis Street (87) 87 Curtis Street Swindon Wiltshire SN1 5LR 01793420314 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): canswindon@aol.com Community Access Network Limited Name of registered manager (if applicable) Mrs Tracey Lynne Parker Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered manager must work a minimum of 64 hours per 4 weeks in this home except on those occasions when they are absent due to sickness, training and annual leave. Date of last inspection Brief description of the care home It should be noticed that it is the custom and practise in this service to refer to service users or residents as tenants but in doing so the home recognises that those living at the home do not have full tenancy rights. Tenant is the preferred term of the people living and working at the home as it is seen as more empowering and respectful. 87 Curtis Road is a care home that provides care and accommodation for up to 3 people aged between 18 years and 65 years who have a learning disability and need support. Community Care Network known as C.A.N. run the home. The house is a small terraced house located within a 5 minute walk of the centre of Swindon. It provides each service user with their own bedroom. Additionally there is a shared Care Homes for Adults (18-65 years) Page 4 of 32 3 Over 65 0 Brief description of the care home lounge, dining area, conservatory/orangery, kitchen and bathroom. One bedroom is on the ground floor the other two are on the first floor. There is a rear courtyard with a small garden and car parking for two cars at the rear. The service replicates principles of ordinary living being a two storey terraced house similar to others in the road. It is typically staffed with one person on duty with additional staff at busy times. At night there is no awake staff presence. Instead staff undertake to sleep at the home in rotation and are expected to meet any night time needs as they arise. Fees are subject to means testing and are typically between £990 and £1091 per week. Care Homes for Adults (18-65 years) Page 5 of 32 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: This visit took place over seven hours and was carried out following an unannounced inspection on 17th and 18th May 2007 to review the requirement made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the Home. The Home was operating within the required conditions of registration set down by the Commission. The conditions of registration detail the type of care and the needs of residents, and the numbers of residents who may stay at the Home. It was pleasing to note that the requirement including the recommendation made at the last inspection had been met. We met with the Home manager Mrs Tracey Lynne Parker and one staff member. We also spoke informally with two tenants before one went out as a part of daily activity, Care Homes for Adults (18-65 years) Page 6 of 32 and one tenant when they returned in the afternoon before the inspection was concluded. A number of records were reviewed. A cross section of the comments made by staff and residents on the surveys received before the visit will be reflected in the body of the report. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: The home manager told us that the present environment could be improved by having a new home and that a new property that will meet the tenants needs has been found. However the sale has not been finalised. We have issued a requirement for the present environment to be refurbished should the purchase of the new property fall through. Care Homes for Adults (18-65 years) Page 8 of 32 We have made a recommendation for two staff members to undertake regular fire drills so they are up to date with action to be taken in the event of fire emergency. 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 32 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 32 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 policy and procedure for admission of a prospective tenant is robust to ensure that the individual makes a positive choice of moving to the home with assurance that their needs will be met. Evidence: There have been no addition to the tenants numbers since the last inspection. The individuals have lived together in the home for several years. The homes policy on admission states that potential tenants must be referred and assessed by Social Services. The individual is encouraged to visit the house informally to meet the other tenants and to see the house. If they like it individual would stay overnight to ensure that they are able to live with the existing residents. Existing tenants are asked their opinion about the individual moving in. All three tenants care plans viewed evidenced measures in place to highly support and meet specific complex and assessed needs of the individuals living in the home. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: The manager and the staff member that we spoke with on the day showed in dept knowledge of the needs of the tenants and how to support them in variable situations. The home has a Statement of Purpose, that has information about the services provided, for example, how to make a complaint and any support that would be given in relation to the individuals health. The manager told us that these documents are kept updated. Each individual had a contract/terms and conditions of residency in the care file. There is also evidence that the terms and conditions and general expectations are discussed and explained to the tenants. We noted that the documents were signed by the residents. Care Homes for Adults (18-65 years) Page 12 of 32 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. Tenants are supported with individualised care plan and are supported to participate in running the home. Risk assessments are in place to enable them to live independent lives. Information about them is kept confidential. Evidence: We looked at the care files of the three people living in the home. These care files contained person centred plans to reflect the changing needs of people using the service. There was personal information to include next of kin, social and other health care support. The care files also contained comprehensive information focused on the specific requirement of the individual. Each care file has a range of information which include likes and dislikes, choices they make, care plan details arising from; communication, domestic arrangements, faith and culture, family life,finance,health care, personal hygiene, personal support,social life, specialist support and work. The care plan also Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: reflects the individuals views, fears and aspirations. These care plans were signed and dated by the tenants and were regularly reviewed. We noted that the language used in these documents was clear and easy for the individuals to understand. The manager told us that the plan is aimed at promoting independence and focuses on the positives for the individual. Problems are talked about and any difficult areas are discussed and worked through with the individual. The Home maintains an individual daily diary for each individual. We noted that the tenants are encouraged to write the entries in the dairies weekly focusing on the activities that they had participated in using a special software programme on the computer. For example in one individuals diary the person describes how they felt about their week. I have done my chores. I have been to town and looked round the shops. I went to my music therapy group where I did some recording and played drums. I am very excited about my holiday in Spain next month and about the move to the new house. From discussion with residents and staff we gained the impression that everything that occurred in the home was done with the involvement of the people who use the service. Records show that the people living in the home are supported to attend regular house meetings and the notes of the last two meetings were seen to include discussion about holidays, security and house rules. The care files viewed contained detailed risk assessments, which had been developed from using the individual care plan.The manager told us at a discussion that restrictions are negotiated rather than imposed to ensure that consideration is given to the persons needs. Examples of risk assessment include, at home unsupported, going out supported, self administration of medication, managing money, radiators and window safety. There is evidence that risk to self and others are also assessed. Records seen indicate that risk factors are discussed and explained to the residents and any relevant health and social care staff. For example on the day of the visit the manager made us aware on one individuals behaviour. These risk assessments were recently reviewed. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: Staff spoken with on the day demonstrated knowledge of the tenants needs and understanding of their roles and responsibilities in relation to confidential information about the tenants. We observed staff obtain permission from one tenant before passing on information about them. The Home has a confidentiality policy. Care Homes for Adults (18-65 years) Page 15 of 32 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. Tenants have opportunities for personal development and are supported to maintain links with the community, family and friends. Their individual rights are respected whilst providing healthy diets at chosen times. Evidence: Based upon the needs of the tenants the home ensures that tenants engage in leisure activities outside and within the home based on individual risk assessments and capabilities. Each person follows their own programme. There is a good communication system in place which supports the ongoing management of such programmes. One strong advantage of the service is the nearness to the town centre and all the resources it offers. It is good to note that the home has used this to its advantage in the way it supports the tenants to access the town as much as possible, both Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: independently and with support. Another strength of the service is that its size allows for each person to be seen and treated as a unique individual. We noted that the notice board in the office and the communication books are used regularly to update any changes such as medical appointments or rescheduled day activities. Review of the activity records and discussion with the registered manager and staff showed that residents are encouraged to live an active life based on their choices. One individual is supported to attend fitness club on Fridays and music therapy on Tuesdays. Another individual is supported to undertake voluntary employment at an office as well as to do some house work such as cleaning their room when not working. The manager told us that the individual has made many friends in the work place many of which are people without disabilities. The person told us that they enjoy their work very much. Support is also offered to manage finances and budgets including benefits. Tenants are also supported to access specialist staff should the need arise. Evidence showed that tenants are supported with managing friendships and contact with families to ensure that communication is promoted at all times. For example one individual told us that they visit mum and gran on weekends. Records show that one individual goes to see his brother on Sundays. One Individual stated that they are planning to go on holiday to Spain in summer. I am really excited, I cant wait, I have been before. Tenants are provided with a healthy and balanced diet. The manager and staff confirmed that all tenants devise the menu weekly. One tenant told us that they take it in turns to devise the menu and do the shopping for the week. The person showed us the recipe from where the menu is developed when it is their turn. The menu is then displayed in the kitchen afterwards. One other tenants spoken with told us that they liked their food and the opportunity to help in cooking the food. The homes kitchen, was found to be clean and tidy.The laundry facility is located in the kitchen however the manager told us that no laundry is carried out when meals Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: are being prepared. The home has a written policy that provides staff with information on what to do should a tenant be found to be missing. The information includes the contact details of the Care Quality Commission. Care Homes for Adults (18-65 years) Page 18 of 32 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. Tenants receive preferred personal support as required, their emotional and physical health needs are met, respect is given to their wishes in the event of death. Medication administration practices at the home protect the tenants. Evidence: The Care file reviewed showed evidence of the level of support the individual tenant needs and this is dependent on the specific assessed need for the person. We believe that the individuals living in the home have a choice of when to go to bed and when to rise because of the support given to them to have control over their lifestyles and the ability to manage their personal care. Records show that all personal care is undertaken in private either in bedrooms or bathrooms. Tenants are able to choose what to wear daily. The care file reviewed showed the tenants are supported to access a full range of health care services. There is evidence that each individual is registered with a local General Practitioner and consultant and medication reviews are undertaken when Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: necessary. The home also accesses support from the Community Team for People with Learning Disabilies (CTPLD) for managing tenants challenging behavior. Records show that each person has a health action plan which enables staff to have good knowledge of the residents health care needs. The health action plan is developed with the input from the resident and staff. Records noted in the action plan include weight chart, appointments, dentist, opticians, continence nurse and challenging behavior monitoring. There was appropriate risk assessment in relation to those residents who are able to self administer their medication. Records show that medication received at the home is recorded and stored securely. The home has a policy in relation to drug administration. The impact about death and dying was not discussed at this visit however the home has a death and dying policy which staff are expected to follow in the event of death of any of the individuals living in the home. Care Homes for Adults (18-65 years) Page 20 of 32 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. Tenants are supported and encouraged to complain with the confidence that their views will be listened to and acted upon. Staff training, policies and procedures protect residents from harm and abuse. Evidence: The home provides each tenant with a copy of how to complain. We noted that this document is presented in a picture format which also includes symbols and text to enable the tenants to understand how they can make a complaint. The complaint procedure includes the contact details of the Care Quality Commission to ensure that the tenants are aware of their rights to complain directly to the Commission at any stage if they are not satisfied with the outcome of their complaint to the organisation. The home stated in the Annual Quality Assurance Assessment (AQAA) that this document is issued annually to remind the residents of its purpose. We noted that there has been no recorded complaint since the last inspection. We looked at the measures the service has in place to protect the residents from harm and abuse. We noted that the home has policies on physical intervention, staff recruitment, staff supervision and whistle blowing. We also noted that the home has a local No Secrets ( Safeguarding Adults In Swindon) guidance displayed on the notice Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: board in the office to enable staff to contact appropriate organisations if any allegation or disclosure of abuse is made to them. The manager and staff member we spoke with on the day had clear undestanding and awareness on how to protect the tenants from abuse and avoidable harm. Staff training records showed that all staff have received training on Protection of Vulnerable Adults from abuse and Non-Violent Crisis Intervention. Care Homes for Adults (18-65 years) Page 22 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The present home needs urgent refurbishment if the organisation fails to find a new home for the tenants. Evidence: These standards were not fully inspected due to plans to find a new home for the tenants. The manager told us that the house is ideal in meeting the needs of the tenants in terms of the location and all community services are within walkable distance. The home is a terrace property which could be improved upon by providing additional bathrooms, repairs and updating. The manager told us that it is not possible due to limited funding. Community Access Network (CAN) the registered provider for 87 Curtis Street have decided that it would be better to purchase a more appropriate property to provide a better environment for the tenants. The manager stated that the organisation has identified a property not too far from the present one and tenantss have been fully involved and are happy with the potential new home. One individual confirmed that they had visited the new place and is very excited about moving in. Care Homes for Adults (18-65 years) Page 23 of 32 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 tenants enjoy a good and warm relationship with competent staff. The homes recruitment procedures offer protection to the tenants 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 and staff member we met on the day showed clear understanding of their role and accountabilities. The staff member demonstrated understanding of the need for, and the importance of having polices and procedures in place to both protect the tenants and ensure that work discipline is maintained. The person gave an impression that the home has a confident and disciplined work team that has respect for each other and for the tenants that they support. In one of the surveys returned to us one staff member stated The staff work well together to support the residents. Tenants told us on the day that they have good relationships with staff and this was demonstrated in the interaction between one tenant and the staff member on duty on Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: the day of our visit. One individual stated on the comment card returned to us Staff help me to do things I want with my money. Review of the rota on the day of the visit evidenced that the home had satisfactory numbers of staff competent to meet the needs of the people living in the home. Rotas show that at busy times, for example going out with tenants for shopping and appointments there are two staff on duty and at other times, including the night time there is typically one staff member on duty. However, in one of the surveys we received from a staff member (in the section of what the home could do better) the individual expressed concern about the numbers of staff on duty sometimes. This is what the person told us More staff would be ideal as usually one member of staff is on and if the resident want to go out there is no one to stay home with those who dont want to go so it can be a bit restrictive. In care files of the these individuals we noted that there are risk assessments that cover this situation which states that the maximum time that any of the service users can be left on their own unsupported is one hour. We recommend that the manager should consider the above concern and review the rotas for those times, with staff and residents, if appropriate. From discussion with the manager, one staff member and review of staff training records we are led to believe that staff have attended training in ares of fire safety, protection of Vulnerable Adults from Abuse, First Aid, Safe Handling of Medication, Disability Equality, Hand Hygiene, Team Building and Food Hygiene. Through observation of staff interaction with residents we are able to conclude that they have good listening skills, seem approachable and are able to communicate effectively with tenants in that category. There is also evidence that each staff member has an annual appraisal. Each staff member has a personal development file. There is good and on going staff supervision at the home which a staff member stated took place every four to six weeks. The manager told us that the supervision is tenant focused as well as giving staff the opportunity to discuss training needs. The home has regular staff meetings and good handover system in place to ensure that communication remains consistent. The organisation has robust recruitment and employment policies and procedures in the home. The manager told us that the last staff recruitment was three years ago. One staff record viewed contained satisfactory recruitment documentation which Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: reflects the policy of the home. Understanding issues about equality and disability are included in the induction programme for newly recruited staff members. Care Homes for Adults (18-65 years) Page 26 of 32 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 leader who safeguards the interests of tenants and also protects them through policies and procedures.Tenants records are securely locked away. Evidence: The Home Manager, Mrs Tracey Lynne Parker is competent and well qualified. Mrs Parker has a Registered Managers Award qualification along with National Vocational Qualification (NVQ) at level 4 in Care management and is a member of The Crisis Prevention Intervention Institute. The manager has many years experience in working with people with Learning Disabilities and has managed 87 Curtis Street for over 10 years. Other training attended included all mandatory training to include Protection of Vulnerable Adults from Abuse, First Aid and Hand Hygiene training. We noted, through observation of interaction between the manager and her staff member and the tenants, that lines of communication are good and effective which Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: gives an indication that the home is well run. We believe from our discussions with the manager that she is a good role model for her staff. The staff member we spoke with on the day told us that the manager is very approachable, very supportive and flexible and would listen to any concerns that staff may have. The individual told us that they are happy with the way the home is being managed. Staff work as a team, there are regular staff and resident meetings. The manager demonstrated a clear undertaking of the role she has within the home and showed a comprehensive understanding of the tenants needs. Evidence of measures used to monitor the quality of service provided at the home includes providers statutory monthly visits, Care Plan reviews from the Care Management Team, managers meetings, staff and residents meetings. The homes has robust policies and procedures that cover relevant areas written under Appendix 3 of the National Minimum Standards aimed to support the home in promoting good practice. We noted that the policies have been reviewed to ensure that information provided is current in relation to providing good outcomes to the people living in the home. Policies noted included Confidentiality, Missing persons, Whistle Blowing, Finances for Tenants and Infection Control. The Accident Book showed that accidents are recorded and reviewed and risk assessments updated if necessary. The manager is aware that a Statutory Notification should be sent to the Care Quality Commission in the event of any serious injury to a resident. The fire logbook is up to date and in order. Records show that the inspection of fire fighting and fire alarm systems and fire safety training for staff has been carried out. There is evidence that staff have undertaken regular fire drills. However we noted that two staff members have not undertaken regular fire drills. We discussed this with the manager and we believe that this will be addressed. There was evidence of fire risk assessment. There was evidence of generic risk assessment of various areas of the home. It was agreed that the risk assessment should include the stairs to prevent falls to residents staff and visitors. Other areas that need to be risk assessed include the kitchen, lounge, laundry and dining area. This risk assessment was completed before the inspection was concluded. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: Other health and safety measures including the homes Liability Insurance were in place. We selected at random the account of one of the residents held by the home. Records showed that the amount recorded balanced with the amount available. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 24 23 Renovate present environment or find a new home for the residents To provide a better and more comfortable home for the residents. 16/07/2010 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 31 of 32 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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