Care Home: Deer Park Care Centre

What the care home does well There`s a relaxed and friendly atmosphere. The people who live in the Service say and show by their relaxed manner that support workers are kind and attentive. People can do social activities if they want to. People say that they have good meals. People receive the support and assistance they need. Support workers know what they are doing. They have a detailed knowledge of what each person needs and wants. Medication is given safely and people are helped to promote their good health. Sensible steps are taken to reduce the chance of accidents. What has improved since the last inspection? When we last visited the Service we thought that in general things were going okay. However, there were two things that needed to be put right. The first thing was the need to strengthen some of the arrangements used to help support workers to decide when to administer a medicine that can be given as and when it`s needed. This has since been done. The second matter involved the need for the Registered Provider to show us that some repairs have been done to the Service`s electrical wiring installation. The Manager has since looked into this. She assures us that all of the repairs in question have been done. Various improvements have been made to the premises. These include replacing some wooden doors and windows that had rotted in places. Some new bedroom furniture has been provided. New equipment has been provided in the kitchen, laundry and in the wet room. Support workers have attended a number of relevant training courses. What the care home could do better: Some parts of the outside of the building look run down. There are some shortfalls in the training system. Some support workers appear to have not done some of the courses that are intended for them by the Registered Provider. This might result in them not having the opportunity to further develop their ability to effectively support the people who live in the Service. More needs to be done to support people who live in the Service to contribute to the quality assurance system. This is important because they`re the experts on what it`s like to live in the Service. Therefore, they need to have a direct and continuing voice in how things are going. Key inspection report Care homes for adults (18-65 years) Name: Address: Deer Park Care Centre Deer Park Care Centre Detling Avenue Broadstairs Kent CT10 1SR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mark Hemmings     Date: 0 1 0 6 2 0 0 9 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Deer Park Care Centre Deer Park Care Centre Detling Avenue Broadstairs Kent CT10 1SR 01843868666 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: deerpark-manager@btconnect.com Phoenix Care Homes Ltd care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 38 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Thirty eight people who have problems with parts of their mental health can make their home in Deer Park Care Centre (the Service). The premises are a detached purpose built property. The accommodation is on the ground and the first floors. All of the people who live in the Service can have their own bedroom. Each bedroom has as a television point. All of the bedrooms have a private wash hand basin and 24 also have their own toilet. The bedrooms, bathrooms and toilets are connected to a call bell system. Theres a passenger lift that gives step-free access around the building. The gardens are mainly laid to lawn with flowerbeds and shrubs. Theres a patio area Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 38 Brief description of the care home where people can sit out. Theres plenty of off-road car parking. The Service is in a residential area. Theres a bus stop nearby. There are a couple of local shops within walking distance. Ramsgate town centre is about fifteen minutes walk away. The Registered Provider is a private company. It runs another smaller residential service in the area. People who might want to move in can find out things about the Service. Theres a Service Users Guide. This is a brochure that outlines the main things available in the Service. Theres also a document called a Statement of Purpose. This is more detailed than the Guide. The weekly fee for living in Deer Park Care Centre runs from £328.64 to £542.21. The actual amount paid depends upon which organisation is providing the funding. The fee includes all accommodation, laundry, meals taken in the Service and personal care. It doesnt include things like meals out and clothes. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was an unannounced Key Inspection. We arrived at the Service at about half past eight in the morning and we were there for about eight and a half hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since the last inspection. We spoke with five of the people who live in the Service. Also, we spoke with the Manager, the Deputy Manager, four support workers, the cook and one of the housekeepers. We looked at some key records and documents and we had a good look around the accommodation. Care Homes for Adults (18-65 years) Page 6 of 30 Before we went to the Service, we asked 10 of the people who live there and 10 members of staff to fill out a questionnaire for us. We wanted them to tell us what they think of the place. Seven people who live there and nine members of staff kindly returned their questionnaires to us. As we go through our report, well tell you some of the main things that theyre saying in their replies. The Registered Provider also asks the people who live in the Service and members of staff to fill in questionnaires to say how things are going. We randomly picked ten of each to look at in some detail. Again, well tell you the main things that people are saying. When we were in the Service we did a special thing. This involved us sitting in one of the lounges for about one hour and quietly looking at what was going on. We made some detailed notes of what we saw. Later on well tell you more about it. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Some parts of the outside of the building look run down. There are some shortfalls in the training system. Some support workers appear to have not done some of the courses that are intended for them by the Registered Provider. This might result in them not having the opportunity to further develop their ability to effectively support the people who live in the Service. More needs to be done to support people who live in the Service to contribute to the quality assurance system. This is important because theyre the experts on what its like to live in the Service. Therefore, they need to have a direct and continuing voice in how things are going. Care Homes for Adults (18-65 years) Page 8 of 30 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: The Manager asks people who are thinking of moving in about what support they need and want. This is done so that everyone can be confident that moving in to Deer Park Care Centre is the right thing for them. She also talks with family members and with people like doctors from the local mental health services and care managers (social workers). All of this information is collected so that the Manager can build up a really good picture of how the person can best be supported. After shes got all of this information, she can then help the person concerned to decide if the Service can meet their needs. We looked at the information that has been collected for one person who has recently moved into the Service. We wanted to see what sorts of things are being considered. Theres lots of useful information. For example, theres information about their mental health. Also, theres other information about practical everyday things such as the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: help that might be needed in the bathroom. The Manager says that when she gets the information she shares it with the support workers. This is done so that they know in advance about what assistance they will need to provide. We asked two support workers about how all of this works out in practice. They say that they are indeed told about people who are about to move in. They say that as a team they discuss how best to help the person in the first few days, while they get to know them better. The Manager recognises that moving into a residential care setting is a big step. She says that she wants to do everything possible to put the persons mind at rest. We agree that this is really important. She says that as part of the introduction process, people are invited whenever possible to visit Deer Park Care Centre. This is so that they can see what the place is like first hand. During these visits, people can ask any questions they want. One of the support workers says, we recognise that it can be a stressful thing to have to move somewhere new and meet lots of new people. We help people to settle in at their own speed, we dont rush them along and jolly them to be part of things before theyre ready. In our questionnaire we ask people who live in the Service, did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Five people say that yes they did and two people say that they didnt. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are quite detailed individual written plans of support. People are helped to manage their money. Medicines are handled safely. Theres a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. Theres a written individual plan of support for each person. These are important documents. This is because theyre one of the means by which people can decide about the support they need. Also, theyre a way for them to show their agreement with how this is going to be done. The Assessment emphasises the importance to be attached to people having a genuine say in what is put in their individual plans. The plans are a source of information for support workers. This then helps them to provide support in the right way. We looked in some detail at three of these plans. They have information about a number of relevant things. For example, theres information about how to help the people say what they want and about how to support them in managing parts of how they go about things. Theres information about how to help them with practical Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: things such as taking care of how they present themselves. We spoke with three of the support workers about whats in these plans. They know all about it. They also know how to use the information in practice to give people the support they need. In our questionnaire for people who live in the Service we ask, do the support staff and managers listen and act on what you say? Five people reply that they always do, one person says usually and one person says sometimes. The plans are kept up to date so that theyre accurate. This involves support workers making daily notes about how things are going. There are also more organised meetings. These are when family members and care managers are asked to support the person to look ahead to what they want to do in the next year. The Registered Provider doesnt get involved in managing peoples financial affairs such as running bank accounts for them. This is a good idea because it helps to avoid any misunderstandings and conflicts of interest. The Service does hold small amounts of money for some people. This is done to help the people concerned to budget their money so that they always have enough to buy things. Support workers keep a record of the various transactions involved. This is done to make sure that everything is above board. We checked parts of these records to make sure that the system is working okay. For example, we looked to see if there is a record of cash coming into the Service. We also checked to see that there are receipts for things said to have been bought for people. We then looked at the cash balance held for one person to see if it matches what the records say should be there. Everythings in order. Sensible consideration is given to peoples personal safety. Theyre not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, some people are quite okay to go out on their own. The assessments show that support workers have taken sensible precautions. For example theyve made sure that the people concerned are okay to cross the road in safety and that they can find their way home. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can do occupational and social things that interest them. They are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: People are free to do things that interest them. Some of these things involve helping out a bit around the house. Theres an activities coordinator who supports people to do more fun things. For example, she helps some people do various craft activities. If they want to, she takes people out and about in the Services vehicle. In our questionnaire for people who live in the Service we ask, can you do what you want to during the day and in the evening? Six people say that yes they can and one person replies no. The Registered Providers questionnaire also asks about this general subject. Most people say that the activities they can do are very good or good. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: People are helped to keep in touch with members of their families. The Assessment says that family members and friends are welcome to call to the Service whenever they want. Support workers keep in touch with family members so that they know how things are going in the Service. People say that they have good quality meals and that they have enough to eat. Theres a choice of dish at each meal time. We looked at the record of meals served at lunch time that is the main meal of the day. People are having normal things such as shepherds pie, cauliflower cheese and chicken pie. The Manager says that people are encouraged to eat a balanced diet and not have too much instant food. The Registered Providers questionnaire for people who live in the Service asks about the quality of the meals. Most people reply that its very good or good. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are helped in ways that are right for them. Support workers are helpful without crowding people out. Their manner is informal and kind. The people who live in the Service are relaxed in the company of support workers. They dont wait to be spoken with, theyre quite happy to say and indicate if they want something. They show by their manner that they see support workers as being their friends rather than being paid staff as such. In our questionnaire for people who live in the Service we ask, do the support staff and the managers treat you well? Five people say that they always do and two people say that this is usually the case. We also ask, do you make decisions about what you do each day? Three people say that they always do, three people answer that they usually do and one person says sometimes. The Registered Providers questionnaire asks people their views about the quality of the support they get. Most people say that its very good or good. Some people are less able to make conversation than are others. Theres always the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: risk that these people might get overlooked. Therefore, we focused on two of them when we were sitting in the lounge watching how things were going. We were pleased to see that in the course of one hour each of them had regular attention from one of the support workers. This involved the support worker talking with them, reaching out to hand them things they wanted and kindnesses such as smiling at them. Things are orderly without being too much so. When things look like they might be getting a bit too much, support workers gently point people in a different direction. This isnt done in an obvious or bossy way. For example, when we were there one person was getting anxious. They wanted to go in person there and then to their bank to check out their account. Support workers reassured the person that there was no immediate problem with the account. Then they started to make the arrangements necessary for the person to be accompanied to the bank the next day. People are helped to wear neat and clean clothes so that they can look how they want. They are helped to sort out any post they get. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, people have seen their doctors as and when necessary. One person has a special medical need. We looked in detail about how they are being helped to deal with this. They have seen their doctor and they have had various tests done. At the moment, the support workers manage medicines for all of the people who live in the Service. The Manager says that when its safe for them to do so people will be supported to do this for themselves if they want to do. Theres a system to check that the correct medicines are received from the chemist. Once in the Service, theyre stored securely. Theres a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. Theres a record that is completed on each occasion that a medicine is given. We looked at three sets of these records. Theyre being correctly completed. We looked at two medicines in more detail. We wanted to see if the remaining stock matches what should be there and it does. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are free to make a complaint if they want to. People are kept safe. Evidence: Theres a written complaints procedure that tells people how they can make a complaint if they want to. Its best for complaints to be sorted out locally and indeed the Registered Provider has a duty to do this. However, people do have the right to come to us at any time if theyre concerned about something. The procedure explains this option. In our questionnaire for people who live in the Service we ask, do you know how to make a complaint? Six people say that they do know and one person says that they dont. Since our last inspection, the Registered Provider has received one complaint. This was about some items that one person who lives in the Service had lent to another person. This latter person then hadnt returned them all. The records show that the Manager promptly looked into exactly what had happened. She also arranged for the overdue items to be returned to their owner. People say and show by their relaxed manner that they feel safe living in Deer Park Care Centre. The Assessment says that the wellbeing of the people who live in the Service is of paramount importance to the Registered Provider. Related to this, the Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, if someone is not being treated kindly. We spoke with two support workers about this. They know what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. In our questionnaire for staff we ask, do you know what to do if a service user has concerns about the home? Everyone says that yes they do. One person summarises the general mood when they say, Ive never had any concerns about the well being of the service users here. They all get treated with kindness and we recognise that each persons got their own way of doing things and that they need to be supported in a particular way. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable setting that promotes their independence. The kitchen is clean and well equipped. Theres a separate laundry. Evidence: The exterior of the building is in general well kept. However, some of the paintwork near the gutters is peeling away and it looks shabby. Also, the wooden rail on one of the fire escape ramps is beginning to rot away. Inside, the accommodation is comfortable. In general, its like anyones home is. Its got a lived in feeling and things arent too fussy. However, three of the toilets dont have cubicle walls that go up all the way to the ceiling. There are gaps at the top. We think that fully enclosed cubicles would give people much more privacy. People say their home is kept warm enough in winter. The central heating was on when we arrived and it was still on when we left. Various improvements have been made since our last inspection. These include the replacement of some exterior woodwork that had rotted away. Inside, a new shower unit has been installed, various items of bedroom furniture have been bought and some new laundry equipment has been provided. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The building is fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the Kent Fire and Rescue Service say that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. For example, it looks at things such are the exit routes clear? The Manager says that the assessment has been recently updated to make sure that its accurate. Shes now going to send it to the fire brigade people. This is so that they can make sure that Services fire safety system remains up to the national standard. The Managers going to do this by 1 August 2009. The local Department of Environmental Health called to the Service in July 2008. It concluded that the kitchen is, clean and well organised. However, it did find that two of the fridges were not cool enough. The cook says that new equipment has now been installed that has sorted out this problem. We looked at the kitchen too. Its neat and clean. Checks are also done to make sure that things like meat are properly cooked through. Once foods are opened theyre date marked to make sure that they dont get stored for too long. Sensible steps are taken to promote good food hygiene. For example, there are different chopping boards so that uncooked meats are kept separate from other foods. About half of the people who live in the Service are older people and some of them have difficulty getting about. They need varying amounts of help in the bathroom. Theres a hoist to help people get into and out of the bath in safety and comfort. Theres also a wet room where theres a special step-free shower you can walk into. If someone cant manage to stand, theres a mobile hoist that can be used in the lounges and in the bedrooms. There are other things such as assistance poles. These are fitted to the wall so that theres something to hold onto. Along the hallways there are banister rails. The Manager has carefully looked at the help each person needs. This has been done so that support workers know how best to make sure that the person is safe and comfortable. The laundrys got two commercial washing machines and two large dryers. The washing machines have got an extra cycle for any item that needs an especially hot wash. We looked in the laundry. Its neat and clean. Things are well organised so that there isnt any build up of things waiting to be washed. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are support workers around to make sure that people get the help they need. Security checks are completed on staff. Support workers know what they are doing. Evidence: Theres one senior support worker and four support workers on duty from early in the morning until later in the evening. Theres a waking staff presence in the Service at night. They are supported by special security arrangements. During the day there are other members of staff around. They do most of the catering and most of the house keeping. We looked at the roster to see if the various shifts are being filled reliably. We found that they are. In our questionnaire for members of staff we ask, are there enough staff to meet the individual needs of all the people who use the Service? Two people say that there always are enough, four people say that there usually are and three people answer sometimes. The Registered Providers questionnaire for members of staff asks, is your workload reasonable. Most people either agree that it is or dont feel strongly either way. Its very important that all of the support workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: getting references and doing a police check. We looked at the checks that have been completed for two support workers. The necessary checks have been done. New support workers have introductory training before they begin supporting people. In our questionnaire for members of staff we ask, did your introduction cover everything you needed to know to do the job when you started? Three people say that it met their needs very well, five say that it mostly met their needs and one person answers partly. After their introduction to the Service, support workers start completing a more detailed training programme. This involves them completing various courses on subjects such as first aid, how to keep people safe and how to support people who have limited mobility. The records show that most of the support workers have done quite a lot of training. However, there are some gaps. Its not clear if theyre just an administrative oversight or whether the support workers in question have missed out on particular bits of training. The Manager says that shes going to check this out. She says that if there are any gaps then additional training will be provided to fill them. In our questionnaire for members of staff we ask, are you being given training which helps you to understand and meet the individual needs of service users? Everyone says that yes they are. The Registered Providers questionnaire for members of staff asks, is your training and development sufficient to enable you to effectively carry out your job? Most people think that it is. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to help members of staff to support people in ways that are right for them. At the moment, 10 of the 25 support workers employed in the Service have obtained the qualification. Another five people are currently studying for it. When we spoke with support workers we asked them about points of detail to do with their work. They have a sound understanding of important things. Such as about how people prefer to express themselves, what sorts of activities they like to do and what they like to do for themselves. Throughout our time in the Service we saw them using this knowledge so they were supporting people in an appropriate way. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service is reliably managed. People are asked what they think about how things are going, but this could be a bit more developed. Peoples health and safety is promoted. Evidence: The Manager has a good knowledge of how things are going in the Service. Support workers like the way that shes hands on and is quite happy to work alongside them. The Manager has both of the formal qualifications she needs. These qualifications are important. This is because theyre intended to help managers ensure that people receive high quality residential care services. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there is a system where each support worker meets with someone senior to look at how their work is going. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: when. Also, they plan their work in advance so that they use their time to the best effect. For example, they know who needs the most support when they go out and they organise themselves accordingly. In our questionnaire for members of staff we ask, do you feel you have the right support, experience and knowledge to meet the different needs of the people who use the Service? Three people say that they always do and the remainder say that they usually do. We also ask, do the ways you pass information about people who use the Service between staff (including the manager) work well? Three people say always and the remainder answer usually. One of the support workers summarises the general mood in the staff team when they say, (the Manager) is very kind and you can always chat with her and she really cares about you. Although shes the manager you think of her as someone you can talk to and wholl help you in your work. Theres no us and them in the staff team between the managers and the seniors and the rest of us. The Assessment stresses how important it is that the people who live in the Service are actively consulted about their home. It says that various things are done to ask people how well they think things are going. These include informal everyday discussions. There are also house meetings every month or so. We looked at the records of the last one to see what was talked about. They are interesting everyday things such as proposed changes to the menu and suggested social activities. Weve already mentioned the questionnaires from the Registered Provider that people who live in the Service and members of staff are invited to complete. Although theyre useful, theres no organised system to examine what people are saying in their replies so that any suggested improvements can be acted upon. Also, theres no clear system to tell the people who live in the Service whats been said and what changes are going to be made in response. The Manager says that shes now going to look into this so that the system can be strengthened. Support workers are regularly checking that the fire safety equipment is in good working order. Also, there are more detailed checks of the system that are done by a contractor. There are unannounced fire drills. Theres also a system for each member of staff to have regular fire safety training. These things are very important. This is because the level of fire safety protection in the Service largely depends on members of staff doing the right thing at the right time. An engineer has had a look at the gas appliances in the Service and has said that theyre in a good condition. The same applies to the mobile hoist and the passenger lift. When the electrical wiring installation was last examined a number of repairs were recommended. The Assessment says that these have all been done and the Manager Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: confirms this account. We looked at the record of accidents and other untoward events that have occurred in the Service this year. There is nothing out of the ordinary in the sense that we need to make further enquiries. The Deputy Manager says that he checks the place over to make sure that theres nothing broken that needs fixing. Also, he looks out for hazards that might cause someone to have an accident. He hasnt noticed anything so far. We kept our eyes open while we were walking around. We didnt see any obvious hazards either. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 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 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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