Care Home: Donna Claire Venture Short Break Service

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What the care home does well The standard of accommodation offered by this service is of a good standard. The home is well maintained and as a result of effective cleaning routines, guests are accommodated in a clean and hygienic environment. Guests who stay here have the offer of several different easy chairs to relax in, that accommodates their diverse physical disabilities. Many of the people who stay at or visit this service are remembered for their particular talents and skills. The inside walls of the home are decorated with attractive paintings and craftwork, that have been skilfully produced by people who have used the service and friends of the home. These offer an added attraction for people staying at the home, while promoting the skill and abilities of the creators of the work. The gardens that surround the building are well stocked with colourful plants and shrubs that are well maintained. This provides an attractive area for guests to look on to from inside the house and to relax in. Guests comments include, "I just love sitting and looking out on to the gardens." "I go out into the gardens myself and sit in my wheelchair and enjoy everything around me." The friendly interaction of guests and staff create a warm and welcoming atmosphere in the home. Staff comments include, "We aim to make each guest`s stay as enjoyable a possible." "It is a lovely friendly place to work, guests and staff get on very well." Guests comment include, "Staff are very friendly, we are treat like a family here." "It`s like home from home." A message sent by a guest said, "I want to thank you for a great weeks holiday, care and attention, I was made very happy." The staffing ratio at this service is excellent and as a result guests receive a service that meets their aspirations and personal needs. Many activities are organised and visits to local places of interest take place. Guests were recorded to have said, "We were out everyday, plenty of shopping, a visit to the Winter Gardens and Bedes World, I was exhausted after my stay." "I helped staff with the meals and washing up. I also did some baking." The kitchen area includes a dining table that accommodates both guests and staff together and provides a focus where a mixture of serious discussions and light "chatter " combined with positive humour takes place. Here guests are given the appropriate amount of time and support to take part in discussions about the service delivery and any planned activity. It is an opportunity where the equality and diveristy of the guests is positively promoted. Prior to their stay the manager and staff ensure that full information about guests` care needs is received from the guests, their main carers and other professionals involved in their care. This ensures that the appropriate resources can be put in place ready for their arrival and that guests can be supported in their preferred way. One guest commented,"When I arrived my room was set up the way it is at home." Good relationships have developed between the service and the community health services. Nurse specialists in relation to Parkinson`s and Huntington`s disease have delivered talks to staff about the diseases and have equipped staff with important knowledge and advice which has guided them in appropriate and good care practices that benefit guests. What has improved since the last inspection? Last year was an extremely challenging time for this service. Due to financial difficulties the service was faced with a dilemma about its future. The resources needed to keep the established quality of service going, in a way that met the needs of the people who needed and used it, outweighed the income of the service. As a result of a massive fund raising campaign by people who use the service, their families and friends, people in the local community and the media, enough money was raised to ensure the stability of the service and its future. The needed improvements to the service therefore are now being addressed. The outside of the house has been painted, some mattresses and bedding have been replaced, some bedrooms have been redecorated and a new washing machine and hoover have been purchased. There are further plans to put a redecoration and refurbishing plan into place. A training budget has been allocated and plans have been put in place to close the service for one week later in the year, during which time a variety of training courses will be available for all staff to attend. This will mean that staff skills and knowledge will be brought up to date and guests will be supported by staff who are trained to carry out their roles competently and safely. Recently new employed staff have successfully carried out induction training and an established member of staff has achieved NVQ 2. In addition to this the deputy manager, who works closely with the manager, has recently achieved the Registered Manager`s Award (RMA). This has equipped her with the knowledge and skills, which she is now applying to her role, that are needed to support the manager in the running of a service and to keep it is focussed on achieving positive outcomes for the guests who stay there. As a result of the money raised, the manager feels confident that the future of the service is secure and that a committment to deliver a high quality service will continue. What the care home could do better: It is highly recommended that all radiators are fitted with radiator guards so that a low surface temperature is maintained. This will ensure the safety of guests if they come into contact with them. The plans to refurbish the toilet on the ground floor with facilities appropriate to theneeds of people with disabilities is encouraged, while at the same time it is recommended that consideration be given to replacing the windows with obscured glass. This will mean that guests have facilities that they can use without their privacy and dignity being compromised. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Donna Claire Venture Short Break Service Donna Claire House 6 Seaburn Terrace Seaburn Sunderland SR6 8BZ     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: Elsie Allnutt     Date: 2 3 0 6 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: Donna Claire Venture Short Break Service 6 Seaburn Terrace Donna Claire House Seaburn Sunderland SR6 8BZ 01915293171 NOFAX 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) : Miss Geraldine Plunkett care home 6 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: Date of last inspection Brief description of the care home 6 Donna Claire Venture is a short break service operated privately by two people, Geraldine Plunkett and Audrey Turnbull. The service provides planned breaks for both men and women with physical disabilities, between the ages of 18 and 65 years, and who are dependent upon carers for care and support. Donna Claire is situated close to the sea front and within easy reach of a range of shops and other services. The house is a large 2 storey detached building with a bungalow annexe within an area of private housing in Seaburn. It has space and facilities to accommodate people who use wheelchairs and provides 5 single bedrooms. There are adaptations and equipment to meet the needs of people with physical disabilities. The aim of the service is to deliver a service as near to a holiday experience as possible, as well as providing a respite period to their carers. During their stay people are supported, by staff to take part in community based activities. A garden and patio is also available for the people using the service. The home has developed a Service User Guide that informs prospective service users about the service and a copy of the recent inspection report is available Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home in the home for anyone to read. The fees charged by the home are #870:00p per week. 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 people who use this service experience good quality outcomes. Before the visit we looked at Information we had received since the last inspection. How the service dealt with any complaints and concerns since the last inspection. Any changes to how the agency is run. Survey questionnaires that service users and their families returned with comments regarding the service that is recieved. The providers view of how well they care for people. The Visit Care Homes for Adults (18-65 years) Page 6 of 30 An unannounced visit was made to Donna Claire Short Break service on the 23rd June 2009. During the visit we Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure that it was safe, clean and comfortable. After the visit We told the service manager what we found. What the care home does well: The standard of accommodation offered by this service is of a good standard. The home is well maintained and as a result of effective cleaning routines, guests are accommodated in a clean and hygienic environment. Guests who stay here have the offer of several different easy chairs to relax in, that accommodates their diverse physical disabilities. Many of the people who stay at or visit this service are remembered for their particular talents and skills. The inside walls of the home are decorated with attractive paintings and craftwork, that have been skilfully produced by people who have used the service and friends of the home. These offer an added attraction for people staying at the home, while promoting the skill and abilities of the creators of the work. The gardens that surround the building are well stocked with colourful plants and shrubs that are well maintained. This provides an attractive area for guests to look on to from inside the house and to relax in. Guests comments include, I just love sitting and looking out on to the gardens. I go out into the gardens myself and sit in my wheelchair and enjoy everything around me. The friendly interaction of guests and staff create a warm and welcoming atmosphere in the home. Staff comments include, We aim to make each guests stay as enjoyable a possible. It is a lovely friendly place to work, guests and staff get on very well. Guests comment include, Staff are very friendly, we are treat like a family here. Its like home from home. A message sent by a guest said, I want to thank you for a great weeks holiday, care and attention, I was made very happy. The staffing ratio at this service is excellent and as a result guests receive a service that meets their aspirations and personal needs. Many activities are organised and visits to local places of interest take place. Guests were recorded to have said, We were out everyday, plenty of shopping, a visit to the Winter Gardens and Bedes World, I was exhausted after my stay. I helped staff with the meals and washing up. I also did some baking. The kitchen area includes a dining table that accommodates both guests and staff together and provides a focus where a mixture of serious discussions and light chatter combined with positive humour takes place. Here guests are given the appropriate amount of time and support to take part in discussions about the service delivery and any planned activity. It is an opportunity where the equality and diveristy of the guests is positively promoted. Prior to their stay the manager and staff ensure that full information about guests care needs is received from the guests, their main carers and other professionals involved in their care. This ensures that the appropriate resources can be put in place ready for their arrival and that guests can be supported in their preferred way. One guest commented, Care Homes for Adults (18-65 years) Page 8 of 30 When I arrived my room was set up the way it is at home. Good relationships have developed between the service and the community health services. Nurse specialists in relation to Parkinsons and Huntingtons disease have delivered talks to staff about the diseases and have equipped staff with important knowledge and advice which has guided them in appropriate and good care practices that benefit guests. What has improved since the last inspection? What they could do better: It is highly recommended that all radiators are fitted with radiator guards so that a low surface temperature is maintained. This will ensure the safety of guests if they come into contact with them. The plans to refurbish the toilet on the ground floor with facilities appropriate to the Care Homes for Adults (18-65 years) Page 9 of 30 needs of people with disabilities is encouraged, while at the same time it is recommended that consideration be given to replacing the windows with obscured glass. This will mean that guests have facilities that they can use without their privacy and dignity being compromised. 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 10 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 11 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. Assessments received and carried out by the home demonstrate guests needs and aspirations and assists the service to make an informed judgement as to whether they have the capacity to meet them. Evidence: All of the guests staying at Donna Claire were happy to confirm that they chose to stay there. Comments include, Its great here, you get out and about and have a good laugh. I wouldnt go anywhere else. I look forward to coming, the care is superb. Some people have been coming to this service for several years and have regular planned visits throughout the year. Arrangements had been made for two people, who have developed a good friendship, to stay for their breaks at the same time. However the service also ensures that the combination of peoples individual needs is manageable and furthermore, personalities are compatible. The service contracts with a variety of different agencies, many who are from outside Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: the Sunderalnd area. Two of the people staying were from the Scottish borders. People who use the service see their stay as a break for their main carers but also as a holiday for themselves and it is from this premise that the service is delivered. When a person is referred to, or refers themselves, to the service, so that an informed decision, as to whether their needs can be met, can be made, as much information as possible about the person is gathered. Assessments are received from the referring agencies and information from others for example, the guest, their carers, other professionals involved in their care and the persons GP and district nurse. All of the information is recorded and kept appropriately, so that reference can be made to it when needed. Guests felt happy that the service could address their needs well and that they are able to direct their own care. All were involved in the assessment process and felt happy that if their needs change this is addressed appropriately. Before each visit guests needs are reassessed and changes are made to the records where necessary. Care Homes for Adults (18-65 years) Page 13 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. Each guest has a care plan that, is easy to understand, considers all areas of their lives and demonstrates how they are supported to make choices. Guests are supported to maintain their level of independence while at the same time they are supported to take risks safely in order to achieve their aspirations. Evidence: Guests care plans are written in individual notebooks and these are written in enough detail that guides staff to support guests in their preferred way. A copy of the assessed needs, emergency contact details and a copy of the medication taken is kept at the front of the notebook. This provides easy access for staff to quickly refer to when needed. Explicit daily notes are kept for each guest and these are used to adapt care plans, to inform the next shift and to inform carers at home of a guests health or experience while at the service. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Guests discussed their daily routines which were reflected in the care plan. For example for one person details of their daily rest and the order of sequence they like to get dressed were clearly recorded. When supporting guests and assisting them to go out, staff make much effort to promote individual guests dignity, all were dressed smartly and in accordance to their wishes. Guests often bring personal appliances and aids to the short break service to assist them with mobility. Clear guidance in the care plans makes sure such appliances and aids are used correctly and safely. For example the use of different coloured slings, that need to be used for different tasks for one person, are clearly recorded. If guests use motorised scooters outside these are accomodated and risk assessments and instructions how they are to be maintained are recorded. Guests said that having the opportunity to use their scooters outside while at Donna Claire helps them to maintain the level of independence they have at home. Risk assessments and management plans that demonstrate how a risk is safely managed, are in place, for example in relation to moving and handling processes and the safe use of recliner beds and chairs. The risk assessments and care plans are monitored and reviewed appropriately and changed when this process dictates. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the people who use this service often have complex needs, their right to choice and to live a normal and as active life as possible while staying at Donna Claire, is effectively promoted and fully supported. Evidence: People attend this short break service to give their main carers at home a break and for a holiday break themselves. The location of the service and the way the staff support guests, who often have complex needs, to achieve their aspirations, is therefore important. The location of the home meets the image of a holiday type facility and provides a good base to enjoy varied holiday type activities and outings. Daily activities in the home address the diverse and often complex needs of the guests and staff are allocated in sufficient number to address these and guests personal Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: aspirations. At the time of the inspection four guests, all of who were reliant on the use of a wheelchair for mobility, were staying at the respite centre and four staff were allocated to support them. This meant that all guests had 1:1 attention at all times. All guests had requested that they take advantage of the sunshine and go for a walk along the seafront and arrangements were made to meet up for lunch at a named venue. On their return, guests expressed the satisfaction of their day and relaxed with a cup of tea or for some, rested on their beds. Some demonstrated their satisfaction with smiles on their faces, wide open eyes and nods of statisfaction. Others commented, It doesnt matter what we do it is always good here. The staff help you to enjoy yourself. We have lots of laughs. In addition to some people using their own electric scooters to get out and about independently locally, the service also has a bus that is adapted to provide facilities for people who may rely on wheelchairs. This enables people to visit places of interest that are a little further afield. Visits out reflect the interests and aspirations of guests staying at the time and one person said that one of their plans was to go out shopping as this was not always possible when at home. Another, with the support of staff, said that they enjoy going to the theatre and visiting the museum in nearby Sunderland. So that one person, who loves their garden, could receive the support they need to plant out their flower pots, the service organised the pots to be brought from home with them and during their stay they were supported to put in new compost and plants to take home on their return. Meals are organised and served to accommodate individual dietary needs and the care plans reflect this. Guests comments about the food include, It is always good. You get more than enough to eat. It tastes good and you are asked what you like. Meals are taken together around a table in the dining area of the kitchen where many different discussions take place. Staff sit with guests and encourage interesting conversation, that enables them to hear guests feelings about how their stay is going and whether they can do anything to improve their holiday. This provides a positive, friendly venue for the start and finish of each day. Care Homes for Adults (18-65 years) Page 17 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. Service users receive personal support appropriate to their needs and preferences and in a way that enables their privacy and dignity to be promoted and respected. Evidence: People who use this respite care service are temporarily registered with a local GP and district nurse if needed, during their stay. The service supports service users to hospital appointments during their stay, only as a special request and if the home is confident that they have all the necessary information. Close communication is kept with families in relation to health issues of the individual, as well as with the social worker and the community nurse and when there are concerns all parties are informed. Contact details of all healthcare services involved are kept in individual care records. Some of the guests bring with them the appliances that they use at home and for others the service provides what is needed. Clear guidance regarding how to use individual appliances is recorded in the care plans in good detail, for example the use Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: of hoists and slings and reclining beds. Risk assessments and risk management guidance is in place so that they are used safely. Staff interact with guests sensitively and with respect. Before going out for the day the guests were reminded and supported about the use of suncream and staff very gently supported two people to apply it to their face and neck areas. Service users confirmed that they direct their preferred terms of personal care and that their dignity and privacy is always respected. Guests are supported to dress in accordance with their preferred way and style and time is taken to ensure that a persons disability does not compromise their dignity. Comprehensive policies and procedures are in place regarding the safe handling of medication. Only trained staff administer medication and clear records are kept of the medication administered. Individual guests bring their medication in individual dispensing boxes and a list of what is brought and taken home is recorded on receipt and departure. Medication is stored following approprate guidelines. Care Homes for Adults (18-65 years) Page 19 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. Arrangements are in place to help protect guests from abuse and to seriously address complaints and concerns about the service. Evidence: A copy of the services complaints procedure is kept in the home and all guests are made aware of it. Guests feel that their concerns are listened to and action is taken directly to address them. Guests are encouraged to discuss any concerns that they have on a daily basis and again at the end of their stay during a discussion about the outcome of their week, when comments are recorded. Any concerns about their stay are taken seriously and action is taken to ensure that improvements are made at their next stay. Guests commented, If I have a concern I discuss it straight away. I dont think I have had any complaints all the times that I have stayed here. Staff are quick to listen and to put things right. The home follows the local authoritys Safeguarding Adults Procedures and the manager and staff receive training related to these annually. A copy of the procedures is available for all staff to refer to when necessary. Guests keep control of their own money and locked facilities are available in individual rooms for its safe keeping. There are policies and procedures in place for staff to follow when supporting guests with this. Care Homes for Adults (18-65 years) Page 20 of 30 Care Homes for Adults (18-65 years) Page 21 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. As a result of effective maintenance, refurbishing programmes and good cleaning schedules the standard of the environment is good, providing guests with an attractive and homely place to stay. Evidence: The environment, that is kept very clean and tidy, is maintained to a good standard. Over the past twelve months two guests bedrooms have been redecorated, new mattresses and bedding and a new washing machine and hoover have been purchased. In addition to this the outside of the house has been repainted. As a result of the service being in a healthier financial position, a new redecorating programme is to be developed that will include the refurbishment of the downstairs toilet. All areas of the building are attractively decorated and have good quality furnishings. The lounge is an attractive area for guests to sit and relax in, with views for the sea and the gardens, or to watch TV. Four electric recliner chairs are available and all offer different aids to address different mobility needs. The house is accessible for people who rely on wheelchairs for mobility. Guests move around independently in electric or self propelling wheelchairs and easily manage Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: doorways. A passenger lift gives access to the rooms on the first floor. The gardens have attractive shrubs and flower pots and at this time of the year the guests are supplied with an abundance of colour provided by the many species of flowers. There are also garden benches, one in memory of a former guest, to be used by guests and staff. One guest independently accessed the garden at different intervals during the day using a wheelchair. The bathroom facilities that include a specialised bath and a separate shower facility, addresses guests diverse needs. The bathing aids are regularly maintained so that they are safe for use. There are plans in place to refurbish the ground floor toilet and to replace it with new facilities. Over past inspections it has been recommended that the window, which is currently clear glass obscured by a net curtain, is replaced with obsured glass, so that the dignity of anyone using the facility is not compromised. The home has carried out risk assessments for each person who uses the service regarding the unguarded radiators and in the event of a risk being identified the radiator(s) in question are covered with soft protection. It remains a recommendation of this report that radiator covers are fitted to all radiators. Care Homes for Adults (18-65 years) Page 23 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. Excellent staffing ratios and appropriate training opportunities ensures that guests are appropriately supported and protected by a competent and qualified staff team. Evidence: The ratio of staff on duty at this service is excellent. This both reflects the needs of the guests who stay here and the sort of lives they wish to enjoy. To reflect the needs of the guests staying this week there is a 1:1 ratio. This means that guests, all who use a wheelchair for mobility, receive individual attention and are able to take part in the activity of their choice within the community. Four new staff members have been recruited over the past few months, all who have worked in care previously and some who are qualified in NVQ 2. One person described their induction process and said, My induction period helped me to get to know how the service works, the different routines and how tasks are carried out. It also informed me of the fire procedures that you need to follow. Any new member of staff without any care qualifications follows the Skills for Care Induction Standards and then register to work towards the NVQ standards. The manager works directly with the staff team and is available for advice and guidance directly. Staff are encouraged to keep a diary of the advice given during any supervision period and of any issues they want Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: addressed or clarified. There is an open relationship between the staff team and the manager. The staff team is diverse in experience and skill, some staff having worked at the service for many years and some are new. All staff demonstrate enthusiasm about their roles and have a good understanding of guests needs. One member of staff said, Everything you need to know about a guest is written down in their care book and we are encouraged to write everything down that we support them with. One guest said, The staff are good they listen to how I want them to support me. A good training programme is in place and staff feel confident that they acquire the skills needed from the training courses offered. The way staff interact with guests and carry out care practices reflect this. So that all staff have the opportunity to attend training sessions plans are in place to close the service for one week in October. During this time various training courses that will cover all mandatory trainingwill be available. This will include Safeguarding training. Records reflect the robust recruitment procedures that are in place. A fully completed application form where a clear work history can be identified, two appropriate references and CRB (Criminal Records Bureau) checks are in place for the most recently recruited staff. 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 manager who works closely with and who is well supported by her management team, provides a service that is well run, safe, and focussed on the best interests of the guests. Evidence: The service is well run by a management team that is competent, well qualified and consistent. The management team consists of the registered manager who is a qualified teacher and who has been registered to manage this home for sixteen years. She has a wealth of experience shared with her business partner, who for many years prior to retirement was a qualified nurse. The deputy manager is the third member of the team who has also worked at the service for many years and who has recently qualified in the Registered Managers Award (RMA). All are focussed in providing a good quality service by supporting and leading a focussed competent staff team. The manager keeps up to date with new legislation and attends talks and training related to it. The most recent being training regarding the Deprivation of Liberty. The Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: deputy manager is now applying her new found knowledge to her role as part of the management team. All plan to up date their mandatory training during the training week in October. Procedures are in place to ensure that the services policies and procedures are followed appropriately and that the service is run in the best interests of the guests. The services procedures are monitored daily and recorded in the service diary and in addition to this the guests satisfaction of the service provided is recorded and used in developing the service further. Care plans are monitored and reviewed from one visit to the next and modified if needed. Health and safety procedures are appropriately followed and recorded and staff work reflecting these. A recent visit from the fire service confirmed that the fire procedures and appliances in place are appropriate. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 37 9(2)(i) So that the manager gains the recognised qualification she must register for the Registered Managers Award and NVQ 4 in Care or another relevant qualification. (Timescale of 31/10/06 not met) 31/12/2007 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 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. 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