Care Home: Daneswood

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What the care home does well The home carries out a full assessment of young people before they move to the home to ensure that their needs can be met appropriately. Information about the home is provided in an accessible format. Young people are encouraged to visit the home before they move there so that they have the opportunity to see the home and meet other young people and staff. Care plans contain a good level of detail so that staff know how to support each young person, promote independence and meet their preferences. Young people who live at the home benefit from a dedicated team of staff. Each young person has key workers who have a good knowledge of how to meet their needs. Key workers support the young people to follow their interests and attend college so that they have a fulfilling lifestyle. One young person was keen to tell us that they like living at the home, the food is good and they enjoy shopping, reading, art and going to college. The home uses fresh, organic produce to ensure that young people have a nutritious diet.Daneswood provides a spacious and homely environment for the young people who live there. The home ensures that specialist equipment is in place to increase young peoples` independence and meet their needs. Bedrooms are decorated and furnished to show young peoples` individual tastes and preferences. What has improved since the last inspection? The home has produced its Service User Guide in a more accessible format with photographs for young people. The home has introduced key worker meetings to review each young person`s care and progress. Medication procedures have been improved to protect young people. The home has made improvements to the environment including an extension with additional bedrooms and shared space, a new kitchen and a sensory room. The complaints procedure has been updated to let people know that they can contact CSCI at any time. Complaints are now being recorded appropriately. The home now has a senior member of staff on duty so that staff are supported to meet young peoples` needs. What the care home could do better: The home currently offers one meal at mealtimes. If the cook knows that a young person doesn`t like the menu they make sure they have an alternative dish available. The home should consider offering a choice of meals on the menu so that the young people can decide what they would like to eat. When staff carry out physiotherapy exercises with young people, they should write the information in the care plan. This is to evidence that exercises that will be of benefit to the young person have been carried out. The home should continue to work with the Speech and Language Therapist to ensure that communication passports and methods are developed and put in place. This is to improve communication and decision making for young people. The home must ensure that creams to be applied to body for health purposes are dated on opening. This is to ensure they are used when they are at their best. The home must develop its staff training programme to ensure that staff know how to meet young peoples` needs and are upto-date with current best practice. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Daneswood Cuck Hill Shipham Somerset BS25 1RD The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Philpott Date: 1 8 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Daneswood Cuck Hill Shipham Somerset BS25 1RD 01934843000 01934843006 Jerry@daneswood.org 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) : Appleford School Ltd care home 17 Number of places (if applicable): Under 65 Over 65 17 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) The maximum number of service users who can be accommodated is 17. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Daneswood is a large detached property located in the village of Shipham, near Cheddar, Somerset. The service was first registered with the Commission for Social Care Inspection (CSCI) on the 14th June 2006. The home has been extended to provide accommodation for 17 young people. The Registered Manager is Mr Jerry Brown and Appleford School, Ltd owns the home. The home is located in an elevated position with outstanding countryside views. There is a steep winding driveway up to the home. All bedrooms are of single occupancy and have full en-suite facilities. The bedrooms are arranged over two floors and there is a passenger lift to access these areas. There are a number of communal areas and conservatory areas that offer lounge, dining and recreational facilities. The home also has an indoor hot tub and sensory room. All areas of the home are maintained and decorated to a high standard. The current fee range is 1990 pounds to 2684 pounds dependent upon individuals needs. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection which took place over 9 hours on 18th February 2009. Throughout the report the term we will be used as it is written on behalf of the Commission. The preferred term for people who live at the home is young people. This is used throughout the report. As part of this inspection we received seven completed surveys from staff and four completed surveys from health professionals. The home sent us their Annual Quality Assurance Assessment (AQAA) in December 2008. During the inspection we observed care practice, and spoke with a relative, management and staff. We viewed the accommodation and facilities at the home. We looked at three individual care plans, and looked at records relating to medication, finance and health & safety. On the day of the inspection, 15 young people were living at the home. The focus of this inspection visit was to inspect the relevant key standards under the CSCI Inspecting for Better Lives 2 framework. This focusses on outcomes for students living at the college. The quality of the service is measured under four ratings. These are excellent, good, adequate and poor. The following is a summary of the Care Homes for Adults (18-65 years) Page 7 of 31 inspection findings and should be read in conjunction with the whole of the report. What the care home does well The home carries out a full assessment of young people before they move to the home to ensure that their needs can be met appropriately. Information about the home is provided in an accessible format. Young people are encouraged to visit the home before they move there so that they have the opportunity to see the home and meet other young people and staff. Care plans contain a good level of detail so that staff know how to support each young person, promote independence and meet their preferences. Young people who live at the home benefit from a dedicated team of staff. Each young person has key workers who have a good knowledge of how to meet their needs. Key workers support the young people to follow their interests and attend college so that they have a fulfilling lifestyle. One young person was keen to tell us that they like living at the home, the food is good and they enjoy shopping, reading, art and going to college. The home uses fresh, organic produce to ensure that young people have a nutritious diet. Care Homes for Adults (18-65 years) Page 8 of 31 Daneswood provides a spacious and homely environment for the young people who live there. The home ensures that specialist equipment is in place to increase young peoples independence and meet their needs. Bedrooms are decorated and furnished to show young peoples individual tastes and preferences. What has got better from the last inspection The home has produced its Service User Guide in a more accessible format with photographs for young people. The home has introduced key worker meetings to review each young persons care and progress. Medication procedures have been improved to protect young people. The home has made improvements to the environment including an extension with additional bedrooms and shared space, a new kitchen and a sensory room. The complaints procedure has been updated to let people know that they can contact CSCI at any time. Complaints are now being recorded appropriately. The home now has a senior member of staff on duty so that staff are supported to meet young peoples needs. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home could do better The home currently offers one meal at mealtimes. If the cook knows that a young person doesnt like the menu they make sure they have an alternative dish available. The home should consider offering a choice of meals on the menu so that the young people can decide what they would like to eat. When staff carry out physiotherapy exercises with young people, they should write the information in the care plan. This is to evidence that exercises that will be of benefit to the young person have been carried out. The home should continue to work with the Speech and Language Therapist to ensure that communication passports and methods are developed and put in place. This is to improve communication and decision making for young people. The home must ensure that creams to be applied to body for health purposes are dated on opening. This is to ensure they are used when they are at their best. The home must develop its staff training programme to ensure that staff know how to meet young peoples needs and are upto-date with current best practice. Care Homes for Adults (18-65 years) Page 10 of 31 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 Alison Philpott 33 Greycoat Street London SW1P 2QF 02079792000 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. 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 11 of 31 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 12 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home carries out a full needs assessment to ensure that it can meet the needs and aspirations of young people who move to the home. Evidence: We viewed the homes Statement of Purpose and Service Users Guide. This gives detailed information about the facilities at Daneswood. The home has produced its service users guide in an alternative format which includes photographs for people who may be considering using the service and for young people who live at the home. Young people who are considering moving to the home usually visit the home on three occasions and have the opportunity to stay for a meal. A month before the young person moves into the home, staff visit and work alongside the staff who are currently supporting them. The staff from Daneswood shadow the staff initially and then start to take over the care. The home takes part in transition meetings to ensure they will be able to meet the young persons needs and to plan the move. A detailed transition plan was obtained. The home carries out initial assessments to ensure they have up-to-date information. We looked at three initial assessments that had been carried out by the home. Two of the assessments were comprehensive and detailed. One of the initial Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: assessments we viewed had limited detail and was not signed or dated. The home should ensure that initial assessments are fully completed and signed and dated to evidence that the home has fully assessed young peoples needs. Care Homes for Adults (18-65 years) Page 14 of 31 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 . Care plans are person centred and contain a good level of detail. The home supports young people to take responsible risks. Evidence: We looked at three care plans. These were person centred and contained a good level of detail. Key workers are involved in developing care plans and keeping them up-todate. The home has a pen picture for each young person. This provides a good summary of the young person and any individual healthcare needs, for example how to manage Epilepsy. Staff told us that they are always given up-to-date information about the needs of the young people they support. The home told us that they are arranging more key worker meetings to further improve communication. We spoke with a relative who said that the key workers are very good and know their young person really well. During the inspection, staff were observed supporting young Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: people and encouraging independence wherever possible. Staff spoken with had a good knowledge of the young people they support. Where young people have limited verbal communication, staff were observed looking for facial expressions when there were choices being offered and decisions to be made. The home keeps small amounts of money for some of the young people. These are stored securely in individual wallets. We checked the records and monies for one young person. These were found to be correct. The home obtains two signatures to protect the young peoples monies. We looked at individual risk assessments for bathing, showering, travelling in vehicles, mobility, moving and handling, using the hydropool, and swimming. These contained a good level of detail. Care Homes for Adults (18-65 years) Page 16 of 31 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 . The home offers a range of opportunities for young people to maintain a fulfilling lifestyle. Young people benefit from a nutritious diet. Evidence: Some young people are supported to attend Weston College and City of Bristol College. Courses include DIY, music and self awareness. Certificates were displayed on young peoples bedroom walls. The home has five vehicles to take young people out. On the day of the inspection, young people were going shopping, and to Weston super Mare for a walk. A music therapist visits the home one day a week. The home holds arts and crafts sessions. One young person was keen to show us their artwork and life book they are Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: working on with the support of their key worker. We spoke with a relative who was visiting the home on the day of inspection. They were very happy with the support provided at the home and said they are always made to feel welcome. They said their relative who lives at the home goes swimming, to the cinema, to National Trust properties, the zoo, @Bristol, and was soon going rock climbing with the Calvert Trust. The home uses fresh, organic food to provide a nutritious diet to young people. We spoke with the chef who displayed a good knowledge of individuals special dietary needs. We viewed the menu. The home does not offer a choice on the menu. The home told us that if someone doesnt like the menu, they make sure they have an alternative available. The chef knew what the young peoples preferences are. The home should consider offering a choice on the menu so that the young people can decide what they would like to eat. The home provides two sittings at meal times so that young people who need assistance are not hurried and benefit from a quieter environment. We observed breakfast and lunch being served. Staff were interacting well with the young people they were supporting. Care Homes for Adults (18-65 years) Page 18 of 31 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 . Staff at the home provide support to ensure the needs of the young people are met. Young people are supported to access healthcare professionals. The homes medication policies and procedures protect the young people who live at the home. Evidence: Each young person has a dedicated team of staff to support them with personal care. Staff spoken with had a good knowledge of the young person they support. On the day of the inspection, a number of young people had got up later than usual because they didnt have to go to college as it was the half term holiday. The home has access to healthcare professionals including GPs, Neurologist, Speech & Language Therapist, Physiotherapist, Occupational Therapist. Health professionals who completed surveys told us if they have any queries they will always contact me if necessary and have taken on board any advice given, there should be a professional nurse/matron on site, the home always strives to offer good care and communication. The home told us that when a young person goes to the GP, they Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: always try to send a key worker who has a good knowledge of the young person. We spoke with a key worker who had received training from the Physiotherapist to carry out exercises with their young person. The staff member had a good knowledge of how and when to do the exercises. This was not documented in the care plan and there was no record of when the exercises had been carried out. The home should ensure that they write the information in the care plan to evidence that they have undertaken the exercises that will be of benefit to the young person. A key worker told us how they are able to communicate with their young person. The young person had a file in their bedroom that contains facts about me - how I communicate; how you can help me; eating & drinking. Not all of the young people have this type of file. This information is useful if a different member of staff needs to support the young person. The home should continue to work with the Speech and Language Therapist to ensure that communication passports and methods are developed and put in place to improve communication and choice making for the young people. We looked at protocols for young people who have Epilepsy. These contained a good description of the seizures, treatment and information on when staff should take further action. One of the protocols in use had been transferred with a young person from their last home. This made reference to the homes nurse. Daneswood does not employ a nurse and we discussed the need to update the protocol so that staff know what to do. The home told us that they are waiting for a consultant to review the young persons Epilepsy so that the protocol will be up-to-date and accurate. We viewed the homes medication. The home has recently obtained a medication trolley to make more room in the medication cupboard. The trolley was secured to the wall when not in use. Oxygen cylinders were stored appropriately and signage was in place. The home told us on their AQAA that staff who administer medication have been provided with appropriate training, and an assessment of competency is completed prior to them giving medication. We looked at the Medication Administration Record Sheets. These were fully completed. We checked the balance of some of the medicines and these were found to be correct. Creams viewed in young peoples bedrooms were not all dated on opening. The home must ensure that creams are dated so that they are used when at their best. Care Homes for Adults (18-65 years) Page 20 of 31 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 . The home has an effective complaints procedure and system in place. Young people are protected from the risk of abuse. Evidence: The home has updated its complaints policy and procedure since the last inspection. This now includes information on how to contact CSCI. The Service Users Guide contains an accessible version of the complaints procedure. The home had received three complaints since the last inspection. The home had documented their investigation, the action they had taken, and detailed responses to the complaints. Each complaint and paperwork relating to it is contained in an individual file to promote confidentiality. The home has whistleblowing and abuse policies in place. Staff spoken with knew what to do if they suspected or witnessed abuse. The home ensures that new staff do not start work until the appropriate checks have been carried out. Care Homes for Adults (18-65 years) Page 21 of 31 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 home provides a comfortable and spacious environment for the young people who live there. The home has plans to make further improvements. Most areas of the home are clean and hygienic. Evidence: The home has extended since the last inspection and can now accommodate 17 young adults. All bedrooms have en suite facilities. A sensory room has been added for young people to access. We viewed the premises including a number of bedrooms, bathrooms and communal areas. The home is well maintained. The communal areas provide spacious living. Lounges provide comfortable furnishing and have radios and music available. There are no televisions as the home wishes to promote a social environment. Young people can have a television in their bedroom if they wish to. Bedrooms were personalised to show young peoples individual interests and tastes. Some young people had chosen to have a fish tank in their room. The home has specialist equipment including electrically adjustable beds and pressure monitors for people with Epilepsy. We viewed symbols being used in bedrooms to assist young people. In one bedroom we viewed a board that staff are planning and Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: developing to plan the young persons day with them. There is a hydrotherapy pool on the ground floor. We viewed the main bathroom which has an assisted bath. The home told us that they plan to redecorate the room to create a more pleasant bathing experience for young people. On the day of inspection, some building work was being carried out at the home to provide further storage. The staff and management were trying to ensure that this did not impact on the young people who live at the home. The home has upgraded the main kitchen since the last inspection. The small kitchen is in need of refurbishment. The home told us that this is planned for later this year. The home has a large conservatory which is used for arts & crafts. Young peoples artwork is on display. The home employs contract cleaners. Most areas of the home were observed to be fresh and clean. We pointed out one area which had some cobwebs and some dirt on the laundry floor. The home told us these had been attended to by the end of the inspeciton. We viewed liquid soap and hand towels throughout the home. Care Homes for Adults (18-65 years) Page 23 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The homes recruitment policies and procedures protect young people. The home is aware that there are some gaps in the training programme and plans to deal with this. The home is working towards increasing the number of staff supervision meetings that take place to ensure that staff are well supported and supervised. Evidence: Staff photographs are placed on the noticeboard so that young people know who is supporting them each day. On the day of inspection, there appeared to be sufficient staff on duty to meet young peoples needs. Each young person receives one to one support from staff during the day. Since the last inspection, the home has employed four Senior Support Workers. This means that staff have access to a senior member of staff on shift who can provide guidance. We looked at four staff recruitment files. These contained all of the required information to ensure that young people are protected. We viewed paperwork confirming that staff had undertaken an in-house induction/orientation. The home told us that on the first day of employment, they Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: discuss the role of a care worker, the homes handbook and the code of practice. There was no evidence that staff had undertaken an induction course which fully meets the Skills for Care criteria. We spoke with one member of staff who had been in post for approximately one year. They had not yet undertaken any training in safeguarding adults, although they knew what to do if they witnessed or suspected abuse. The home told us that they are trying to develop their staff training and that they are aiming for new staff to completed the Learning Disability Qualification (LDQ) Induction Award. This award will enable staff to show that they have met the requirements of the Common Induction Standards in a learning disability context. The home must ensure that they have an appropriate induction training programme that meets the Learning Disabilities Award Framework (LDAF)/Skills for Care guidelines so that staff know how to meet young peoples needs appropriately and are up-to-date with current best practice. The home has a staff training matrix which shows the training that staff have completed. It includes the following areas; role of the care worker, abuse, raising concerns and whistleblowing, fire, moving and handling, first aid, health & safety, person centred care, effective communication, Epilepsy, infection control, food hygiene, safe handling of medicines, Mental Capacity Act, physical intervention, signing, Learning Disabilities, Autism, care practice and behaviour management. The home has made efforts to provide training since the last inspection. There are still a lot of gaps in the training completed by staff. The home must ensure that staff undertake training so that they know how to meet the needs of the young people and are up-todate with current best practice. A health professional told us that they had recently visited the home to provide training. Staff had been booked on the course but on the day very few turned up. The home told us that they are working on improving attendance at training. The Registered Manager has attended a course in Equality & Diversity. The home told us they will be putting this into their in house training for staff. Twenty five staff have completed an NVQ. Twelve staff are currently working towards an NVQ. The home has a resource library available for staff. This included books about epilepsy, person centred planning, and autism. Out of the staff that completed surveys, four staff confirmed that their manager meets with them and gives support and discusses how they are working on a regular basis, two staff said often and one staff member said sometimes. Staff spoken with told us that they receive regular supervision and feel well supported. We viewed records of supervision sessions and a supervision planner. The home told us that they are currently working to improve the number of supervision sessions taking place. Care Homes for Adults (18-65 years) Page 25 of 31 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 manager has the required qualifications and experience to run the home. The home has quality assurance systems in place to ensure that the home continues to develop and improve. The health, safety and welfare of young people and staff are promoted and protected. Evidence: Jerry Brown is the Registered Manager at the home. He has more than twenty five years experience of providing care and support to people with learning disabilities and complex needs. He is a qualified Social Worker and holds an NVQ 4 in Management. Staff spoken with told us that they find the management at the home to be open and approachable. As part of its quality assurance, the home sent out surveys to interested parties in May 2008. There was evidence that the home had taken action on comments to improve the service. The provider carries out monthly visits to the home to speak to people and Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: monitor quality. We viewed reports that were written after the visits which included action that needed to be taken. We viewed health & safety records. The home has a fire risk assessment in place. The fire alarm system was serviced in November 2008. The fire extinguishers were serviced in February 2009. Electrical installation was checked in August 2008. Portable appliance testing was carried out in March 2008. Gas safety was checked in January 2009. The call bell system, hoist and lift was serviced in January 2009. Accident and incident records are maintained and followed up by the manager, as required. Food in the fridge was covered and dated. The home maintains daily temperature records. Cleaning products are locked in a cupboard in accordance with COSHH (Control of Substances Hazardous to Health) regulations. Care Homes for Adults (18-65 years) Page 27 of 31 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 31 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 1 20 13 The home must ensure that creams are dated on opening. 31/03/2009 This is to ensure that they are used when at their best. 2 35 18 18/05/2009 Staff require updates in mandatory training such as fire safety, manual handling, first aid and health and safety. (The previous timescale of 11/04/08 has not been met). This is to ensure that staff know how to meet young peoples needs appropriately and are up-to-date with current best practice. 3 35 18 The home must ensure that they have an appropriate staff induction training programme that meets the 18/05/2009 Care Homes for Adults (18-65 years) Page 29 of 31 Learning Disabilities Award Framework (LDAF)/Skills for Care guidelines. This is to ensure that staff know how to meet young peoples needs appropriately and are up-to-date with current best practice. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 The home should ensure that initial assessments are fully completed and signed and dated to evidence that the home has fully assessed young peoples needs. The home should consider offering a choice on the menu so that young people can decide what they would like to eat. The home should ensure that they write information relating to physiotherapy exercises carried out in the care plan to evidence that they have undertaken the exercises that will be of benefit to the young person. The home should continue to work with the Speech and Language Therapist to ensure that communication passports and methods are developed and put in place to improve communication and choice making for the young people. 2 3 17 18 4 18 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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