Care Home: Dinorwic Road, 49

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What the care home does well Service users receive a full assessment of their care needs prior to admission to ensure their needs can be met. Care plans are detailed, drawn up with the involvement of the service user/or representative and provide clear information on how the care is to be delivered. Care plans take into account the wishes and preferences of the service users. Personal care is provided in the way the service users want it to be. Prior to admission prospective service users can visit the home to make a decision should they wish to live there. Service users are involved in making decisions and are incorporated into the daily routines of the home. Service users are encouraged to maintain links with their families and friends, who are also made welcome to visit. Daily routines are flexible to meet the needs of the service users. Service users have access to health care professionals and are supported by staff where needed. Medication is administered safely by trained staff to ensure the service users are safe. Concerns and complaints are listened to and acted upon. Thus ensuring the service have a say in their care. Service users are safeguarded by staff who are recruited correctly and policies and procedures in place. The home is comfortable and safe for the service users to live. There is a qualified, caring staff team in place who care for the service users. The manager is organised, experienced and supportive to the staff. Service users views are listened to and acted upon within their quality assurance process. What has improved since the last inspection? The requirements from the last inspection have been met. A new care planning process has been introduced and involves the service users in all areas of their care and support needs. Improvements have been made to the environment to provide a comfortable place forthe service users to live. The manager has access to the Companies internet system, which enables him to keep up to date with staff training needs and up to date developments. What the care home could do better: The statement of purpose and service user guide should be updated to reflect the new management structure and be provided in an easy read format. The manager should help service users to find appropriate jobs and seek educational training where possible. More support should be provided to enable service users to access individual leisure facilities of their choice. Redecoration and upgrading of some rooms should be undertaken to meet the young client group it supports. The communal bathroom/toilet should be upgraded to improve the standard for the people who live there. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dinorwic Road, 49 49 Dinorwic Road Southport Merseyside PR8 4DL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elaine Stoddart     Date: 0 7 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Dinorwic Road, 49 49 Dinorwic Road Southport Merseyside PR8 4DL 01704550490 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) : Noemail Speciality Care (REIT) Homes Ltd care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Service users to include up to 3 LD 3 The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home 49, Dinorwic Road is a semi detached, converted property, which is located close to the amenities of Birkdale village shops, pubs and cafes. Public transport is available for access. The home is presently registered as a Home for life? and can accommodate up to three residents with a learning disability. The provider is Speciality Care (REIT) Homes Ltd. The Manager is Werner Myburgh who is responsible for the day-to-day running of the service. The weekly fee rate for accommodation ranges from 899.34 pounds to 1,535.00 pounds per week. . Care Homes for Adults (18-65 years) Page 4 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: One inspector conducted the unannounced inspection, which took place over one day. The Key inspection standards and a selection of other standards were assessed as part of the inspection process. The site visit was conducted with Werner Myburgh, who is the Manager for the service. The report has been put together using the information gathered from a number of sources. These include information received for the service since the last inspection and information provided in the AQAA (Annual Quality Assessment). The AQAA comprises of two self questionnaires that focus on the outcomes for the people they care for. The AQAA was completed in detail and provides information on how the Manager and the staff are meeting the needs of people. The data set gives facts and figures about the service including staff numbers and training. Care Homes for Adults (18-65 years) Page 5 of 30 Interviews were conducted with people who use the service, relatives, staff and the Manager. The comments are contained within this report. Have your say surveys were sent to people who use the service and to staff. Comments received are included in this report. As part of the site visit a number of records were examined; these include care files, a selection of policies and procedures and staff files. Two people were case tracked. Case tracking means that the inspector concentrates on the care given and the experiences of one or more people who use the service to get an idea of how their needs are being met. A copy of the last inspection report is available to view in the office. The last inspection for this service was completed on 14th April 2008. For the purpose of this report the people who use the service are referred to as service users. What the care home does well: What has improved since the last inspection? The requirements from the last inspection have been met. A new care planning process has been introduced and involves the service users in all areas of their care and support needs. Improvements have been made to the environment to provide a comfortable place for Care Homes for Adults (18-65 years) Page 7 of 30 the service users to live. The manager has access to the Companies internet system, which enables him to keep up to date with staff training needs and up to date developments. What they could do better: 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 8 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 9 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 are given information about the service. Assessments are made before they decide to move into the the home so they know their needs will be met. Evidence: Information is available to prospective service users and their representatives in the form of a statement of purpose. This enables people to make an informed choice should they they wish to live there. The statement of purpose and the service user guide is to be updated to reflect the new management structure and is to be produced in an easy read format. The AQAA reported the manager arranges to spend time with prospective service users. The manager provides an informal introduction and introduces them to the staff and the other people who live there. Overnight visits/or extended stays are available to enable prospective service users to experience life at the home. All prospective service users are provided with a contract of terms and conditions, Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: which details their rights and and any additional charges. All prospective service users have a personal assessment of their needs, which is carried out prior to admission to the home. The assessments were viewed at the visit to the service and were found to contain detailed information on their care needs. These include personal and health care needs, identified risks, religion, family contacts, communication and behavioural needs. The assessment determines if the service can meet their needs and provide positive outcomes for the service users. Staff were observed to communicate well with the service users during the visit and a pleasant, relaxed atmosphere was present. Care Homes for Adults (18-65 years) Page 11 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. People are supported to take responsible risks and make decisions about their lives. Evidence: Detailed assessments of need viewed are used to form the individual care plans for the service users. Since the last inspection a new care plan format has been introduced, which is person centered to ensure that all areas of care are looked at. These are completed with their individual key workers (A key worker is a member of staff who can communicate with the individual and appreciates his/her cultural, racial needs and is fully involved with their care). The information on all their care needs and is produced in an easy read format with picture aids. The care plan outlines personal care, behaviour, communication, health and independence. Two care plans were viewed and showed that detailed information on individual care needs had been obtained, thus enabling the staff to provide the care and support required. Care plans contained personal information obtained from individuals, such as likes bubbles in bath, My life story, Important people in my life, what makes me happy, dates that Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: are important to me, How staff are to assist me. Care plans evidenced how staff are able to reduce risks and be aware of triggers which can escalate behaviour. Care plans recorded how staff are to keep the service users healthy and safe. This information is important to the service user and ensures the staff are equipped with individual details to enable them to meet their needs and provide positive outcomes for them. Staff spoken with confirmed they have enough information available to them to enable them to provide the care and support required. Staff commented that they are more involved now in the care planning and recording and it is the role of the key worker to keep plans up to date with each service user. The service users are involved in making decisions. Regular meetings are held to discuss their day to day activities and meals preferences. Reviews of their care are held with input from the service users, their families and other professionals involved in their care. Daily decisions are also made to determine what they wish to do on the day. This was observed to take place during the visit as one service user went out for the afternoon with her family, whilst another service user went shopping with staff support. Key workers work with some service users on a one to one supervision basis, when required. Records are made of daily activities, choices made and progress reports completed. Your voice agendas are completed prior to each meeting to ensure that the service users are involved in setting the agenda. These are in a picture format to aid communication. The service users are able to express their views either verbally or with the use of symbols. Care plans are reviewed monthly with their key worker and the service user to assess changing needs. Service users or their families sign their plan of care to agree to the care provided. Risk assessments were seen for two service users and were completed in detail. They outlined all areas of risk, such as going out, in the home and behaviour. These are reviewed and updated regularly to asses changing needs and enable the service users to take responsible risks and lead as independent lifestyles where possible. Service users are supported to manage their own finances where possible. Service users or their family sign an agreement to confirm that staff can manage their finances. Care Homes for Adults (18-65 years) Page 13 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 are provided with activities and a variety of home cooked food, which they help to choose and enjoy. Evidence: The AQAA reported the homes aims and objectives are to promote independence to enable service users to lead a full and enjoyable lifestyle. Two care files viewed showed detailed information on individual care needs. This enables the staff to have the information to meet those needs and provide the care and support required. Discussion with staff, the manager and visiting families confirmed some service users are unable to access employment due to to their high level needs. The manager is pursuing work placements and educational courses for the other service users where this may be possible. A recommendation is made in this report for the manager to pursue this. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Staff support service users to access the community. Activity plans showed that the service users take part in a range of activities in the local community, such as local disco, pubs, YWCA, gym and shopping. Service users are encouraged to maintain links with their families. One service user was taken out by family to a local beauty spot at the time of the visit and was looking forward to her day. Family provided positive comments on the staff. They are brilliant. Care plans showed that service users interests and hobbies are recorded in their care plans when they are drawn up with their key worker. These include information on, My life story, and My relationships. Daily plans showed the activities undertaken each day. Staff spoken with confirmed that these can be changed should the service users choose to do something different. Staff support the service users at all times and some require 1 -1 support by staff. Staff and family spoken commented that this can cause difficulty. Comments include More 1-1 support is needed to provide stimulation (Parent). Sometimes their opportunities are restricted as one service user likes to go swimming and needs personal attention (Staff). Should the three service users wish to access different activities there are only two staff on duty so they can only access individual activities if cover can be sought from staff at other homes or one service user is away staying at relatives. The manager is aware of this putting a case forward for more support to be provided for access activities of their choice. A recommendation is contained within this report. Friends and their families are invited to call at the home at all times and this was observed during the day as visitors called in. The service users often go to stay with their parents for the weekends and this is their choice. The service users enjoyed a holiday in Anglesey last year and the manager confirmed this years holiday is yet to be arranged. All residents have their own rooms, which are lockable, however they choose not to lock them. The residents were seen to spend periods of time in their own rooms for privacy when they wished. Daily routines are flexible and the residents were seen to be involved in the day to day chores. Staff and residents were seen to interact positively together during the visit. Service users have access to all areas of the home and garden. Meals are decided at service user meetings when menus are planned. Service users assist with shopping and were seen to help prepare their breakfast and lunch. Meals Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: were observed to be relaxed and unhurried. Care plans showed their likes and dislikes for food and any allergies and special nutritional needs are recorded. The manager is to develop the use of pictures to aid communication in choosing menus. The manager has his own home budget for the management of food and cleaning supplies and discussion with the manager confirmed this was satisfactory. 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. Peoples health and personal care needs were met in the way that they prefer. Evidence: The AQAA reported that comprehensive care plans are in place detailing information regarding personal care and support needs. Two care plans viewed confirmed this and outlined in detail the personal support required for the service users. Their preferences are recorded in their plan of care, which has been drawn up with the service user and their key worker. Information on How staff are to assist me is recorded in detail in their plan of care. Personal preferences are recorded to enable staff to meet their individual care needs. These include preferences such as, Likes bubble bath Needs supervision at all times. Sleep patterns are recorded on their care plan for those service users who requires checks every hour due to risk of seizures. Routines in the home are flexible and the service users choose times for getting up, going to bed, who to see and what clothes to wear. This was confirmed at the visit as service users were observed to get themselves ready for the day. Staff were supportive at all times when needed. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: All health care needs are detailed in their plan of care and are clearly outlined for the staff to enable them to provide the care and support needed. Health action plans are drawn up with the involvement of the service user and their key worker and detail How to keep me healthy. Health action plans are produced in a picture format and each individual health care need recorded. These include service users general health and family history. Sickness procedures are in place and What to do should I die. All health checks are recorded and seizure management systems are in place to ensure the health and safety of the people they care for. Staff complete follow up reports for all GP and health care appointments. Records are completed to show needs, action taken and the treatment given. This ensures clear monitoring of health care needs. Staff support service users to health care appointments where needed. This was observed to take place during the visit as a service user had a GP appointment. All medication administered is recorded and risk assessments are in place where staff need to take care of the medication for the service users. Consent forms are in place to agree to staff administering medication. Medication audits are conducted every six months by a manager within the company to ensure systems are safe. All staff are trained in medication administration and this was confirmed with the staff interviewed at the visit. All medication is securely stored in a locked cabinet. The medication protocol for staff to adhere to is very clear. and easy for them to understand. Thus ensuring the safety of the people they care for. 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 using the service are protected by the complaints and safeguarding procedures, which are understood by staff. Evidence: Complaints policies and procedures are in place and available for staff to access to ensure they know what action to take should a complaint be made. The AQAA reported that no complaints have been received since the last inspection and no complaints have been made to the Commission. The complaints record seen showed no complaints recorded. Staff spoken with confirmed they are aware of the action to take should the service users make a complaint. Since the last visit a new complaints and compliments cards have been developed and any complaints or compliments are written and then concealed in an envelope for confidentiality. Service users spoken with confirmed if they had a complaint they would tell staff and their parents who they are in contact with regularly. Family representatives spoken with confirmed If my daughter wasnt happy she would tell us. We would then tell the manager and nip in in the bud. The staff are very approachable. Safeguarding policies and procedures are in place and this was confirmed by staff Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: spoken with at the visit and records viewed. All staff are trained in the Protection of Vulnerable Adults (POVA) thus ensuring the safety of the people they care for. Staff spoken with said they wouldnt hesitate to raise any concerns. The manager has dealt with safeguarding issues in line with the policies and procedures and has contacted the appropriate services to inform of any incidents. All staff are recruited following the correct procedures, which include a Criminal Record Bureau Check (CRB) and two references to ensure the service users are safe. The manager has access to the companies Internet to ensure checks and in place and training is up to date for the staff he is responsible for. Service users monies are managed following the correct procedures and records viewed confirmed this. Consent is obtained from the service users or their representatives for this to take place. 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 clean and safe surroundings. Evidence: The home is a semi-detached house, about two miles from the centre of Southport. It is close to shops, pubs and other community facilities including transport links, such as buses and trains. The AQAA reported the home provides a safe, clean and homely place for the service users to live. The AQAA reported that most rooms need to be decorated and this was confirmed at the visit. A recommendation is made in this report for the redecoration and upgrading of some rooms to be undertaken to meet the young client group it supports. A full tour of the premises was made to assess that the home is suitable for the people who live there. The staff office is secure for the storing of records and medication. There is a communal lounge, which is in need of decorating as the wallpaper ripped. Since the last visit the hall has been re decorated. There is a large garden at the rear and garden furniture available for the service users to use. The kitchen was found to be clean and has seating for residents and staff and is fully equipped. A small dining room is also used for some service users to eat their meals. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The service users have their own rooms and two are in need of decorating and upgrading to a modern standard to meet the needs of the young adults they care for. There is a communal bathroom/toilet, which the manager has requested to be upgraded and estimates where seen to evidence the cost of this improvement. Shared space is sufficient for the service users and staff. Since last visit the requirements of the last inspection have been met and improvements made in the following. A new fire alarm system has been fitted, emergency lighting now in place throughout, the garden wall has been repaired, the exterior has been painted, dining room been painted and new kitchen equipment purchased. The laundry facilities are in the kitchen and infection control policies and procedures in place. Private rooms contain personal items brought to the home by the service users. No adaptations are in place as the service users do not require these at present. The AQAA reported certificates for services are in date and a number of checks were made to confirm this to ensure a safe place for the people to live. The manager has own budget for all repairs needed and he commented this is much better as he is now in control. No radiator covers were found to be in place in some areas. Records showed that risk assessments were in place and purchase records were seen for the ordering of new covers. Weekly radiator surface checks are made and records seen. Thus ensuring the safety of the service users. The manager has ordered a new fire door ordered as recommended by fire service. Monthly checks of shower heads completed and records seen to evidence this. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported by staff who know them well and are trained to meet their needs. Evidence: At the time of the visit there were two care staff were on duty plus the manager who was also responsible for covering another home. Staff rotas viewed confirmed that two staff are on duty per shift daytime and one waking and one sleep in. Support is available from their manager, who is supernumerary and is often available to cover shifts should they need it. Staff were seen to interact very well with the service users and understood their needs. Staff were observed to take them out on activities, involved them in the daily chores and helped them to make choices. The staff on duty also interacted well together as a team. Thus providing a pleasant atmosphere for the service users they cater for. Three care staff were spoken with and their comments include: We need more 1-1 staff to enable residents to access interests of their choice. We have enough Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: information on the care files so that we know what the service users need.. The support is good and supervision and meetings take place every month. All my training is up to date. Service users are involved in planning menus and have your voice meetings to discuss activities. The staff are great. Staff files viewed confirmed that all staff are recruited following the correct procedures. A record of all training is maintained and certificates to confirm this were seen. All mandatory training was found to be up to date, thus ensuring the service users are cared for safely. Other training provided in equality and diversity, violence and aggression, person centered planning and autism. This provides the staff with appropriate training for the client group they care for. Training in food hygiene is booked April 2009 to keep staff updated. The manager has all the training details on a computer system and has access to the Craegmore web site for up to date CRB information and training needs. Thus ensuring staff are kept up to date with training needs. The manager is involved in staff recruitment and induction. Key worker system in place (who is a person who communicates with individual residents and is involved in their care planning and reviews and keeping information up to date). Key workers have weekly meetings with the service users to discuss any issues they may have. There is a new induction programme in place and the manager is presently working with two staff who are undertaking this process. The induction is over a period of three months and the outcome is sent to an National Vocational Qualifications (NVQ) assessor for approval. All mandatory training is completed during their induction programme during a weeks residential course. Staff are enrolled on NVQ level 2 at the time of their induction. New staff spoken with confirmed that the induction process was taking place and provided positive comments on the process. The AQAA showed that three permanent staff have the following NVQ qualifications. One has NVQ 2 and two are working towards this. Three bank staff have the following, two have NVQ 2 and one working towards this. NVQ provides the staff with qualifications they need to carry out their roles to meet the needs of the service users. The staff are supported in their roles through regular supervision with their manager and attend monthly meetings to discuss issues relating to the care and support they provide. A recommendation has been made in section three of this report for the staffing levels to be improved to enable service users to access activities of their choice. Discussion with staff and their families confirmed that this could be improved to enable the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: service users to have more choice and 1-1 support to meet their needs. The manager confirmed that he has completed an application to obtain this. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience 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 well run in the interest of the people they care for. Evidence: The AQAA reported the manager Werner Myburgh is skilled and experienced to enable him and the team to meet the service users needs. The visit to the home showed the records and systems in place to be accessible and organised and staff provided positive comments on the support received. The manager is to apply to the Commission to become the registered manager of the home. He is registered for another service in the Craegmore network as he manages two services. The manager is supernumerary, however he often covers shifts if there are staff shortages. The manager is involved in the recruitment and induction of staff . He manages his own budget for staffing, repairs and shopping. The manager is undertaking his Registered Managers Award. The home is looking to appoint a deputy to assist the manager in his role. The manager commented that his area manager is very supportive to him and monthly manager meetings take place to keep him up to date with progress. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The companies quality assurance programme ensures that regular audits are completed to involve the people who use the service and to obtain their feedback on the care provided. Audits include: medication, finances and health and safety. Thus ensuring the management and running of the home is monitored to ensure the people who live their are safe and cared for. The provider visits the home monthly to speak to the staff, the people who live there, look at records and tour the building. A report is then completed of the findings and recommendations made. Regular meetings take place with the service users to discuss menus and activities. Key worker meetings, staff meetings, annual surveys, reviews with all professionals are also regularly conducted to assess the quality of the service provided. Family spoken with confirmed they are involved in reviews and are able to talk to all the staff should they have any issues. All certificates for services, such as electric supply, are up to date and were confirmed in AQAA. Fire, emergency lighting, fridge and water temperatures checks are made and recorded to ensure the home is run safely for the people people and staff. Records are made of all incidents and accidents and evidence was seen to support this. The manager works well with the Commission and informs us of all incidents following the correct procedures. Policies and procedures are available to staff, updated annually and ensure safe systems of working. All staff training is up to date to ensure the staff are equipped to care for the service users safely.The manager has access to Companies intranet to enable him to monitor this. 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 1 1 The statement of purpose and service user guide should be updated to reflect the new management structure and be provided in an easy read format. The manager should help service users to find appropriate jobs and seek educational training where possible. More support should be provided to enable service users to access individual leisure facilities of their choice. The manager should apply to the Commission to become approved as the registered manager. 2 3 4 12 14 37 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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