Care Home: Dean Park

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What the care home does well There was clear information about the home that was easy to read.Each person had care plans and a person centred plan. These told staff how to meet people`s needs.People see the doctor, nurse, dentist and optician when they need to.Staff help people to take their medicines.People can go out and can do what they want when they are at home.People help to keep the home tidy and help with cooking.They choose their own meals.The shared rooms are nicely decorated. People like their rooms.People know how to make a complaint. Any complaints are looked into and if something is wrong it is put right. Proper checks are done so that new staff are suitable to support people.Staff have the right training to support people.The manager and staff make sure the home is safe for people to live in. What has improved since the last inspection? People have easy to read information about the home in their rooms. Information is also available on video.People know what they have to pay for including meals out.More information is being included in people`s care plans to make sure all their needs are met.People had more opportunities to go out and to have activities.The lounge-dining room has been repainted and there is a new carpet.The manager is getting more support from the owner so that he knows what he needs to do to make the service better.Staff have had more training so they know how to meet everyone`s needs.The owners are checking with people what they would like done to make the service better.The risk assessments, fire safety measures and checks are better and radiators have been covered so that people will be safe. What the care home could do better: More painting needs to be done. The bedrooms and corridors need painting.The records of food must show if you have been getting enough fruit and vegetables.The dates should be recorded when staff checks are received so you can tell when they are ready to start work. Key inspection report Care homes for adults (18-65 years) Name: Address: Dean Park 24 Park Lane Swindon Wiltshire SN1 5EL 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: Elaine Barber Date: 2 9 0 7 2 0 0 9 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 38 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 38 Information about the care home Name of care home: Address: Dean Park 24 Park Lane Swindon Wiltshire SN1 5EL 01793520922 01793520922 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) : Wardsign Limited care home 5 Number of places (if applicable): Under 65 Over 65 5 2 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 5. 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 categories: Learning disability (Code LD) - maximum of 5 places Mental disorder (Code MD) - maximum of 2 places Date of last inspection 1 5 0 7 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 38 Dean Park is a large semi-detached house in the Rodbourne area of Swindon. The house is in keeping with other houses in the street. It is close to local shops including the Designer Outlet Village on the site of the old railway works. Dean Park provides care and support to five adults who have learning disabilities. There is a lounge - dining room, kitchen, shower room and two bedrooms on the ground floor. One of the upstairs bedrooms has an en-suite shower. Care Homes for Adults (18-65 years) Page 5 of 38 There are three single bedrooms and a bathroom upstairs. There are usually two members of staff on duty in the home during the day. One member of staff sleeps in at night. Care Homes for Adults (18-65 years) Page 6 of 38 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 7 of 38 How we did our inspection: This is what the inspector did when they were at the care home We asked the home to complete an Annual Quality Assurance Assessment. This told us about what has happened during the last year, and about their plans for the future. We sent out surveys and we had surveys back from 3 people who lived in the home and 2 staff members. Care Homes for Adults (18-65 years) Page 8 of 38 We visited the home on the 21st and 29th July 2009. We talked to the owner, the manager and two staff. We talked to four people who lived in the home. We looked at some of the records. Care Homes for Adults (18-65 years) Page 9 of 38 What the care home does well There was clear information about the home that was easy to read. Each person had care plans and a person centred plan. These told staff how to meet peoples needs. People see the doctor, nurse, dentist and optician when they need to. Care Homes for Adults (18-65 years) Page 10 of 38 Staff help people to take their medicines. People can go out and can do what they want when they are at home. People help to keep the home tidy and help with cooking. They choose their own meals. Care Homes for Adults (18-65 years) Page 11 of 38 The shared rooms are nicely decorated. People like their rooms. People know how to make a complaint. Any complaints are looked into and if something is wrong it is put right. Proper checks are done so that new staff are suitable to support people. Staff have the right training to support people. Care Homes for Adults (18-65 years) Page 12 of 38 The manager and staff make sure the home is safe for people to live in. What has got better from the last inspection People have easy to read information about the home in their rooms. Information is also available on video. People know what they have to pay for including meals out. Care Homes for Adults (18-65 years) Page 13 of 38 More information is being included in peoples care plans to make sure all their needs are met. People had more opportunities to go out and to have activities. The lounge-dining room has been repainted and there is a new carpet. Care Homes for Adults (18-65 years) Page 14 of 38 The manager is getting more support from the owner so that he knows what he needs to do to make the service better. Staff have had more training so they know how to meet everyones needs. The owners are checking with people what they would like done to make the service better. Care Homes for Adults (18-65 years) Page 15 of 38 The risk assessments, fire safety measures and checks are better and radiators have been covered so that people will be safe. What the care home could do better More painting needs to be done. The bedrooms and corridors need painting. Care Homes for Adults (18-65 years) Page 16 of 38 The records of food must show if you have been getting enough fruit and vegetables. The dates should be recorded when staff checks are received so you can tell when they are ready to start work. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 17 of 38 If you want to speak to the inspector please contact Elaine Barber Care Quality Commission CQC South West, Citygate, Newcastle upon Tyne, NE1 4PA. 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 18 of 38 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 19 of 38 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. People had easy to understand information about the service so that they would know what to expect from the service. Peoples needs were assessed before they moved into the home so that their needs could be met. Evidence: We made a requirement at the last inspection that the statement of purpose must clearly detail what people are expected to pay for. Since the last inspection the owner has sent us a copy of the Statement of Purpose which has all the required information including what people are expected to pay for, in particular, meals taken outside the home. We also made a requirement that each person must have a copy of the service user guide. We saw that each person had their own copy of the service user guide in their room. We recommended that the guide should also state what the fees cover and extras people are expected to pay for. This information had been included in the guide. We recommended that the statement of purpose and service user guide should be available in alternative formats and the statement of purpose should be available to people in the home at all times. The service user guide was in simple words and pictures. The owner showed us a video of the home that they were going to develop into a DVD to show to people. A copy of the statement of purpose was available in the home. Care Homes for Adults (18-65 years) Page 20 of 38 Evidence: Three people completed surveys. They all said that they were asked if they wanted to move into the home and they got enough information to decide if it was the right place for them. We looked at the files of three people. Each of these people had had their needs assessed by a social worker before they moved into the home. Each person had a person centred plan, which contained assessment information about their needs. Care Homes for Adults (18-65 years) Page 21 of 38 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. Written information had been reviewed and changed to make sure that peoples needs were met and they could take risks as part of an independent lifestyle. People had opportunities to make choices and decisions. Evidence: We looked at three peoples personal files. The three people had new style plans called support guidance. When we looked at these we found that they contained sections about personal hygiene, activities and work, monies and finance, household, spirituality, communication, food and eating, drinks and drinking, sexuality, behavioural support and emotional support. The sections were completed from the point of view of the person and contained information about their abilities. They clearly showed how the person liked to be supported and how they were able to make choices. Following a recommendation at the last inspection the guidance provided information about the persons diversity needs and promoting their rights to be treated equally and fairly. New person centred plans had been produced for each person. These included information about their communication needs, health, activities and life experiences. Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: There was information in the care plans about how people made choices, for example, choosing how to spend their money. One person told us that they went out independently and made choices about when to go out, where to go and who to see. The other three people needed more support and had less opportunities to make choices. During our visit we saw people choosing how to spend their time. One person chose to spend time in the lounge then later went to their room. People chose to have a cup of tea, then watched a DVD and played a game. One person liked to look at a catalogue. Two people told us in their surveys that they sometimes made decisions about what to do each day and one said that they always made decisions. They all said that they could do what they wanted during the day, evenings and weekends. A member of staff told us that one person went out the previous day and bought some new clothes. We recommended at the last inspection that the risk assessments should be reviewed and developed further to include the individual risks to each person, the reasons why people are taking risks and the benefits of risk taking. We saw that three people had new style risk assessments which were developed in October 2008. The assessments included the hazard, the benefits to the person of taking the risk, the likelihood of harm and the steps taken to minimise the risk. Care Homes for Adults (18-65 years) Page 23 of 38 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 had opportunities to be part of the community and to take part in appropriate day time and leisure activities. People maintained relationships with their family and friends. Peoples rights were respected and their responsibilities were recognised in their every day lives. People were offered a varied diet and chose their meals. Evidence: We made a recommendation at the last inspection that a current activities programme should be developed and available to people. When we looked at the personal support plans we saw that each person had an individual activities programme for the week. This included a range of activities and there was something each morning and afternoon. The owner told us that they were trying different activities with one person to find new things they liked to do. The owner also said that it was easier to find activities for the other people who lived in the home because it was clear what they enjoyed. We recommended that a greater selection of activities should be offered both internally and externally. When we looked at the activity sheets we saw that a wider range of activities was being offered. We also recommended that a format for evaluating the success or failure of an Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: activity should be developed. We saw that there was also space on the activity sheets to record whether the person had enjoyed the activity or not wanted to join in. We looked at three peoples personal notes for the past month. These showed that people had opportunities to go out into the community. One persons notes showed that they visited the pub and cafes and used the bus independently. This person told us that they went out regularly on their own. The two peoples notes showed that they went to the local shops, superstores, and the designer village. They went out for lunch and personal shopping. The daily notes showed that people also had varied leisure activities. People had been to Butlins for a holiday in June. Activities in the last month included, watching TV, playing skittles, watching DVDs, dancing at home, light exercises, throwing and catching, listening to music, singing, manicures, food shopping, a birthday party and shopping for clothes. One person, who went out independently, went to Oxford and Chippenham. We saw that the support guidelines included how to support people with activities. A record was made in the daily notes when people had contact with their family and friends. These showed that one person had contact with their sister and brother-in-law. One person told us that they had contact with their brother and friends. The owner was trying to trace the family of one person who had lost contact with their brothers and sisters. We saw information in the support guidelines about how people were supported to be involved in household tasks such as cleaning, washing, food shopping and meal preparation. The notes showed that one person was involved in making toast, laying the table, drying the dishes, making a pot of tea, helping with the laundry, making sandwiches and preparing lunch. Another person helped set and clear the table and butter the bread. Information in the support plans showed that people got up and went to bed at different times. As already stated people were involved in food preparation and shopping. When we looked at the menu we saw that a variety of meals was served. A record was kept of who chose the main meal of the day. This showed that people took turns to choose the meal. There were pictures on the menu so that people could see what meals were being served. A member of staff told us that they showed two people pictures of meals to help them to choose what they wanted. They said that the other two people could choose their meals by talking about alternatives. We saw that the record of food usually stated that mixed vegetables were served rather than which particular vegetables. This made it difficult to tell whether people were having the recommended five portions of fruit and vegetables each day. One person who had support with eating had a more detailed record of meals they had eaten. During our visit we saw people being offered and eating fruit for snacks. Care Homes for Adults (18-65 years) Page 25 of 38 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 received support in ways that they preferred. Peoples health care needs were being met. People were protected by the medication practices. Evidence: We looked at three peoples files. We saw that the ways in which people liked to be supported were recorded in their support plans. Personal care took place in the privacy of the bedrooms and bathrooms. We made a requirement at the last inspection that the registered person must ensure that peoples privacy and dignity are upheld and the practice of a person using another persons en-suite shower must cease. The owner told us that this practice had been stopped straight away. Each person was registered with a GP. There was information in each persons file about any health needs and action taken to meet these needs for example appointments for different health checks. Appointments with health professionals were recorded. We saw that people had appointments with their GP, the community nurse, speech therapist, dietitian, podiatrist, optician and dentist. Each person had had a flu vaccination. There were records in the person centred plans of peoples consent to take medication. Medication was stored in a locked cupboard in the office and was not easily accessible to people. We recommended at the last inspection that a cupboard is installed that meets Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: the requirements for the storage of controlled drugs. A controlled drugs cupboard had been installed in the home next door. Staff could access this quite easily if anyone was prescribed controlled drugs. Alternatively the manager said he would move it to Dean Park if needed. A local pharmacist provided the medication and also some printed medication administration record (MAR) sheets. Medication received was recorded on these sheets. There were also separate records of the weekly audit of medication received into the home, administered and returned to the pharmacy. We looked at the MAR sheets and saw that they were appropriately recorded. The owner told us that staff received training about medication from the pharmacist and we saw records that confirmed this. We made a recommendation at the last inspection about keeping a record when one person was given their medicines which they took themselves. The owner told us that this person no longer took their own medicines and staff supported them to take their medication. We saw records that confirmed this. Care Homes for Adults (18-65 years) Page 27 of 38 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 were systems for recording any complaints or concerns and peoples complaints were listened to and acted upon. People were safeguarded from abuse and harm. Evidence: There was a copy of the complaints procedure within the statement of purpose. This had been updated since the last inspection. We recommended at the last inspection that a complaints log should be developed. However, there had been no complaints to record since the last inspection. Two out of three people who completed surveys said that they knew how to make a complaint and that they knew who to talk to if they were not happy. The third person did not answer those questions. We saw that there was information about No Secrets, the guidance about safeguarding adults, in the office. Staff confirmed that they understood the contents of the guidance and the whistle blowing policy. They also said that they had attended training in safeguarding people. When we looked at the training records we saw that staff had training about safeguarding adults and this was refreshed. During the inspection the owner booked two newer staff on to safeguarding training for the following Thursday. Two staff who completed surveys said that they knew what to do if someone had concerns about the home. Staff helped people to manage their money and records were kept of transactions with receipts. We made a requirement at the last inspection that the practice of people purchasing meals must cease unless the person specifically wishes to do so. This practice had stopped. Since the last inspection clearer information had been provided in the statement of purpose and service user guide so that people knew what they were Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: expected to pay for, including meals out. Care Homes for Adults (18-65 years) Page 29 of 38 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 was clean, fresh and hygienic. Improvements had been made to the decor and the lighting. The owners had plans for further improvements to peoples environment. Evidence: The home was a large mid terraced house situated on a main road close to Swindon town centre. It was in keeping with other houses in the street. We looked at all the living areas, including the lounge-dining room and the bedrooms. There were three peoples bedrooms on the first floor and two bedrooms on the ground floor. One of the upstairs bedrooms had an en-suite toilet and shower and one of the ground floor bedrooms had an en-suite toilet. The home was clean, tidy and free from any offensive odour. Three people said in their surveys that the home is always fresh and clean. We made a recommendation that consideration should be given to re-decorating and refurbishing areas in need of attention. We saw that the lounge-dining room had been redecorated and people told us that they thought it was a big improvement. The lounge area had been rearranged so that it was easier to see the television and it looked more comfortable and homely. The kitchen cupboards had also been repainted and a new cooker, flooring and lighting had been provided. There were new carpets in the loungedining room. The owner told us that they planned to repaint the corridor and stairs, the bedrooms and the utility room. They were in the process of installing a stairlift for the benefit of one person. Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: There was a separate laundry room. This contained a new combined washing machine and tumble drier and there were hand wash facilities for staff. There were infection control guidelines. Care Homes for Adults (18-65 years) Page 31 of 38 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. People were benefiting from support from staff who were properly recruited, inducted, qualified and trained. Evidence: We looked at the rota, which showed that there were usually two members of staff on duty during the day. The manager also worked during the day in both Dean Park and the home next door. There was one member of staff sleeping in at night for both homes. A member of staff told us that there was sometimes only one member of staff on duty when a staff member was on holiday. The owner told us that she takes people out when she visits. She said that she liked to provide double cover so that staff can support people with activities. We looked at the files of two staff who had been recruited by the new owners since they were registered. The staff had both completed an application form including a declaration that they had no convictions. One member of staff had a gap in their employment record and there was a record of the explanation for this. Copies of their passports were being kept as proof of identity. Two written references and a protection of vulnerable adults (POVA) first check had been received for each member of staff before they started work. Their criminal records bureau (CRB) checks were received after they started work. Following a recommendation at the last inspection each member of staff had a risk assessment and control measures for starting work before their CRB was received. We Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: also recommended that a checklist should be used to record when all recruitment checks are received and when a new staff member starts work. A checklist was being used to record what checks had been received. We saw that these checklists recorded yes when a check was received and some dates were recorded. It would be easier to tell if all checks were received before a member of staff starts work if the date was recorded when a check was received. The statement of purpose said that staff were given in house training up to National Vocational Qualification (NVQ) level 2. We looked at the training matrix which the owner had produced. This showed that there were seven staff. Four of the staff had NVQ level 2 and one had NVQ level 3. The training matrix showed that staff received training in health and safety, food hygiene, manual handling, first aid, protection of vulnerable adults, medication and equality and diversity. One staff member had also had training about the Mental Capacity Act and introducing infection control. We recommended at the last inspection that staff would benefit from equality and diversity training so that they can recognise and record how to meet these needs. This had been addressed and five staff had received this training and the two new staff were going to attend the training. We also recommended that new staff should receive Learning Disability Award Training as underpinning knowledge for NVQs. The two new staff had started Learning Disability Award Induction training. Care Homes for Adults (18-65 years) Page 33 of 38 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. People benefited from a home run by a manager who was appropriately qualified, experienced and supported. Systems had been developed to capture the views of the people who live in the home and their representatives so that the home is run in peoples best interests. Peoples health and safety were promoted within the home and improvements had been made to the environment to make sure people were kept safe. Evidence: The registered manager is qualified and has many years experience within the care sector. Since the last inspection he had shown that he was aware of the areas in need of development and had been working towards achieving this. We made a recommendation at the last inspection that the manager should receive regular supervision from the owner. The manager and the owner told us that he was now receiving regular supervision and we saw records to confirm this. We made a requirement at our last inspection that the registered person must ensure quality assurance and quality monitoring systems are in place to take account of the views of the people using the service and their representatives. Questionnaires had been sent to the people who lived in the home to obtain their views about the service provided. Care Homes for Adults (18-65 years) Page 34 of 38 Evidence: The owner had produced a development plan based on these views. We saw that many of the improvements in the plan had already been actioned, for example the redecoration and new carpets. There was a new health and safety policy and this was very detailed. Overall health and safety checks were regularly carried out to ensure the safety of staff and the people who live in the home. We saw that there was a gas safety certificate and portable appliance testing took place once a year. Checks of the fire safety measures were also taking place regularly. At the last inspection we made a requirement that the registered person must ensure a fire risk assessment is completed and kept under review. We saw that there was a fire risk assessment completed for each room in the house and this was due for review in September 2009. We made another requirement that all risks from hot surfaces are assessed and minimised where possible. All the radiators had been covered so that they no longer posed a risk. An environmental risk assessment had been produced. We made another requirement at the last inspection that data for all toxic materials must be available for staff reference. The owner told us that they had eliminated all toxic materials from the building. We saw that there were Control of Substances Hazardous to Health (COSHH) data sheets for all cleaning products so that staff would know what to do if anyone came into contact with a cleaning product. Care Homes for Adults (18-65 years) Page 35 of 38 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 36 of 38 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 17 17 The records of food must be recorded in more detail. 28/08/2009 So that it is possible to tell whether people are having recommended nutrients, for example, five portions of fruit and vegetables a day. 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 1. Refer to Standard 34 Good Practice Recommendations The date when recruitment checks are received should be recorded on the recruitment checklist to make it easier to see that all the required checks have been received before a member of staff starts work. Care Homes for Adults (18-65 years) Page 37 of 38 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. 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