Care Home: Duckyls Farm Centre

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What the care home does well The students are supported to maintain their independence skills. People have an active lifestyle, and the opportunity to continue their education and follow their leisure interests. The students plan their own activities each day, and are encouraged to develop their communication skills. What has improved since the last inspection? Safer arrangements for the administration of medicines have been put in place. Guidelines for the use of restraint have been clarified. There continues to be an emphasis on staff undertaking National Vocational Qualification (NVQ) training which gives staff skills and knowledge to better support the students. Improvements to the premises have included a new crafts room, redecorating the kitchen, dining room and one bedroom, new flooring in the dining room and new worktops in the kitchen. What the care home could do better: Staff training records have not been kept up to date - this needs to be done to ensure that staff employed are doing the training they are required to do so that people`s needs can be met safely and well. Key inspection report Care homes for adults (18-65 years) Name: Address: Duckyls Farm Centre Selsfield Road West Hoathly West Sussex RH19 4QY     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: Edward McLeod     Date: 1 4 0 4 2 0 1 0 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 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Duckyls Farm Centre Selsfield Road West Hoathly West Sussex RH19 4QY 01342811111 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Brian James Jack care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies 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 categories: Learning disability (LD) Date of last inspection Brief description of the care home Duckyls Farm Centre is a care home registered to provide accommodation and personal care for up to seven people who have learning disabilities. Mr Brian Jack owns the service and is the registered manager for the service. Duckyls Farm Centre is in a rural area, located on the outskirts of the village of West Hoathly in West Sussex. The home has many of the characteristics and features of a traditional farmhouse. Communal rooms are on the ground floor and seven single bedrooms are on the first floor. Staff accommodation for four staff and a sleep-in room is also provided on the site. There are extensive grounds with an organic vegetable garden and livestock. The current fees are 523.19 pounds per week for personal care. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 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 inspection visit was arranged to update our assessment of previous requirements made and of the homes compliance with the key national minimum standards for Care Homes for Adults (18-65). In preparation for our visit we looked at all the information that we have received or asked for since the last key inspection and this has included The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service. The previous key inspection and annual service reviews. Care Homes for Adults (18-65 years) Page 5 of 29 The visit was started at 12.10 p.m. on 14th April 2010, lasted 3 hours and 40 minutes and was attended by one inspector. At the visit we spoke with the provider, two members of staff, and with three people who are receiving a service. We sampled care and health care records and staff recruitment and training records. Records relating to complaints and health and safety were also sampled. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? 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 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 7 of 29 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 8 of 29 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 confident 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. Evidence: We are told in the homes annual quality self-assessment audit (the AQAA) that no new resident is admitted without a full needs assessment. Admission arrangements including visits to the service and trial stays are provided. We sampled the admission assessment for one person recently admitted to the home, and found that the assessment had included a description by the person of how they saw their needs and what they hoped to achieve in the placement. The persons comments had included I like this place and hope to be happy. Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: Assessments sampled indicated that the persons needs had been fully assessed and that the care plan developed took into account the evidence in the assessments. People living in the home are referred to as students by each other and by staff, and so we shall also refer to them as students in this report. The three students who responded to our Care Quality Commission (CQC) survey told us that they had been asked about moving into the home, and that they had received enough information to help them decide if it was the right place for them. The information on the service provided for prospective residents, the Statement of Purpose, has been updated since our previous visit. Care Homes for Adults (18-65 years) Page 10 of 29 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. Peoples 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 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 they are offered opportunities to participate in the day to day running of the home and enable them to influence key decisions. Evidence: We sampled care plans for four of the students accomodated, and found that up to date risk assessments and care plans were in place. Risk assessments and care plans are being regularly updated. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The CQC surveys we received from three of the students told us that they are involved in making day to day decisions about their lives, and that staff always listen to them and act on what they say. Staff we talked to provided examples of how people are supported to stay independent, such as by supporting their literacy and communication skills, and through the experience and responsibilities of living and working in the farm centres community. People are also supported to take responsible risks which can help them maintain their independence by being supported to do cooking, clearing up, and doing their laundry. People also have the opportunity to learn about the risks involved in caring for farm animals and using working tools. We could see from the acitivity plans for the day that two students showed us that people are consulted on how the home is running. Ideas from students taken up by the service - such as redecorating the home and providing a notice board for students drawings and paintings, show that students are consulted on and involved in changes to the service. We discussed with staff how they had been working with one student to assist them in overcoming their fear of crowds, and in adapting to new routines - all this had been taking time, and there had been a period of one to one support to help facilitate this. On one survey form a relative had added a note that the person loves living at Duckyls. Care Homes for Adults (18-65 years) Page 12 of 29 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. 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 adtivities that are appropriate to their age and culture and are part of their local commmunity. The care home supports them 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. People have healthy meals and snacks, and have opportunites to develop thier social, emotional, communication and independent living skills. This is because the home supports their personal development. People choose and participate in suitable leisure activities Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The AQAA tells us that people work in the gardens and on the working farm, and there are other daily activities such as attending college, horse riding and swimming. People are involved in growing vegetables, and looking after cows, sheep and pigs. One person told us in their CQC survey that I like all the animals. I like the way things are managed. We have good outings, swimming, horse riding, once a week we go to a pub. We are told in the AQAA that residents contribute to planning their activities schedule, and that daily routines are based around farm, garden or social activities. Weekends are less formal and residents have a greater choice with regards to activities, rest periods and meal times. Two students showed us the daily schedule they had written up for themselves for that day. The schedules had been individualised to accomodate their different abilities and preferred communication methods. One person wrote in their survey form that we do puzzles and painting here. We play the guitar with others. Regular activities provided as part of the schedule include music, swimming and horse riding. Care records seen included photographs of a boating holiday where some of the students enjoyed the opportunity to handle the boat. Mr Jack told us that one of the ways used to familiarise students with money has been by gradually changing the coins in the pocket money they receive - for example £1 coins at first, then changing this to £1 coins and two 50 p. coins. Students we spoke to said they most often went shopping in East Grinstead, which they said has good shops. Information on things happening in the local community are provided in the home for example there was a leaflet on the notice board for Easter week events at a local church. One of the sets of care records sampled indicated that one student sometimes does readings at the church services they attend. Students also attend a social club in the village. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: People are supported to maintain contact with relatives and friends through visits home, phone calls and letters. People living in the home are involved in setting the menus and helping with the preparation for meals. A rota seen for meal preparation indicated that all the students assist with preparing meals. One person we spoke to said they had been chopping up vegetables for the chilli con carne for that days lunch. We looked at an individual menu plan for one person which is to assist them with losing weight. At lunch staff and students sat around one table and were sharing the same meal. People helped themselves from serving dishes and chose what they wanted to eat for example fruit or dessert. Lunch was unhurried and there was a good atmosphere. People were taking the opportunity to talk about what they had done that morning and other things. Some of the students were talking about the general election and who they would vote for. One person was planning to see a film and have a meal in East Grinstead. The meal provided indicated that students receive a healthy diet and enjoy their meals and mealtimes. Care Homes for Adults (18-65 years) Page 15 of 29 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met. If people take medicine they manage it themsleves if they can. If they cannot manage their medicine the home supports them with it in a safe way. Evidence: Comments received from students in their CQC survey forms, and from talking to them during our visit, indicates that people feel that the service is meeting their needs. Students are mostly independent in their personal care, and it was our observation that the service supports them emotionally by giving each person a sense that they are a valued part of the farm centre community. A member of staff we talked to said they felt that people in the home respect each other, for example they dont go into each others rooms uninvited and have learned to treat their environment with respect. The mutual respect works very well they Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: said. The CQC surveys we received from three people living in the home told us that people believe they are treated well. One person wrote in their survey form that the home does well at cooking, looking after everyone, chatting to everyone and helping the students. A member of staff wrote in their survey form that the home provides a happy and secure environment with a homely, warm atmosphere. Regular medical checks are being recorded, and care records we sampled indicated that students are receiving the medical support they are in need of. For example, on the day of our visit a chiropodist was providing treatment for people who needed this. Care plans sampled included Essential information for hospital records which would go with the person if they were attending or being admitted to hospital. We sampled medication records and found that records are being held for medication ordered and the date received. Staff we talked to advised us of the arrangements for disposal of out of date medicines and that one member of staff takes responsibility for ensuring that medication arrangements are working properly. We sampled medication administration sheets over a two week period for two of the students, and found that records were being fullly completed. At our previous visit a requirement was made concerning storage facilities for medication. At this visit we found that prescribed medications and homely remedies are now stored in seperate, lockable, wall-mounted cupboards. The previous requirement concerning medication storage was found to have been met. Care Homes for Adults (18-65 years) Page 17 of 29 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. If people have concerns about their care they or people close to them know how to complain. Their concern is look 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. Evidence: The CQC surveys we received from three of the students told us that they know who to speak to if they are not happy. Two of them wrote on their form that they knew how to make a complaint. One person wrote in their survey form that I am always able to talk to someone and be listened to. We sampled the complaints record, and found that no complaints had been recorded since our previous visit. Mr Jack said that this was probably because of the very interactive nature of activities in the home, and people are able to quicikly raise concerns and have them dealt with there and then. A member of staff we spoke said that because it was like living in a family home that people feel they can speak to each other and therefore issues are dealt with before they become problems. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The three staff who completed CQC survey forms wrote in them that they knew what to do if someone had concerns about the home. At our previous visit a requirement was made that multi-disciplinary agreement on the acceptable use of restraint be obtained. We are told in the AQAA that restraint is rarely used, and that staff are receiving training in a range of behaviour management techniques. We sampled the homes policy and proceedure for the management of aggression, which advises that restraint should only be used to prevent inflicting damage to other residents, staff or themselves. We read the report of the one incident recorded of use of restraint since our previous visit, and discussed this with Mr Jack. We sampled the risk assessment for the person involved, which included an assessment of the signs to indicate an incident may happen and the calming techniques which were known to be effective at those times. Mr Jack said that restraint used with the student had been discussed at a multidiscplinary review of their care, and that there had been general agreement on the approach taken. The previous requirement was found to have been met. At our visit we found that where the need for a Mental Capacity Act assessment had been identified, this had been arranged. We found that where there was a need for a safeguarding alert identified, the service was advising the local authority and CQC of the alert and providing reports on these where requested. Talking to staff and observiing the interactions between students, we noted that students have a respect for each other and feel a responsibility towards each other. This may contribute to the relatively few untoward incidents between students which are being recorded at the service. Care Homes for Adults (18-65 years) Page 19 of 29 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 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. Evidence: We are told in the AQAA that improvements to the premises since our previous visit have included the construction of a new crafts room, the redecoration of the kitchen, dining room and one bedroom. New worktops have been provided in the kitchen, and new flooring has been provided in the dining room. At our visit we found the premises are being well maintained, and that maintenance staff are in place to carry out ongoing repairs and maintenance. We talked with the handyman employed at the service, who told us that recent repairs had included repairing door closings, changing locks on bathrooms which had suffered wear and tear, and preparing a replacement window frame. The main communal area is a dining room and sitting room, where people have meals Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: together and can sit around and watch T.V. There is a second sitting room which is used for activities, and both sitting room areas are comfortably furnished and homely. Furnishings and decoration are of a good standard. Each person has their own bedroom, and the three bedrooms we visited indicated that people have personalised their bedrooms and have their bedrooms arranged the way they like them. All areas of the home visited were found to be clean and free from odours. Three of the students told us in their CQC survey forms that the home is always fresh and clean. Care Homes for Adults (18-65 years) Page 21 of 29 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 have safe and appropriate support as there are enough competent and trained staff on duty at all times. They have confidence in the staff because checks have been done to make sure that they are suitable. There is a need for staff training to be fully recorded in order to evidence that peoples needs are met by appropriately trained staff. Evidence: Three staff who completed the CQC survey form told us that there are usually enough staff to meet the individual needs of all the people who use the service. On the day of our visit there were sufficient staff for the supervision of activities and for the provision of outings. There were also sufficient staff to ensure people received support with completing their activities plan, and to ensure that a good lunch was provided at 12.30 p.m. when people had gathered for lunch. We sampled three sets of staff recruitment records. Discussion with Mr Jack indicated that although there have been problems with the length of time ISA/CRB staff checks are taking, staff are not being employed until satisfactory CRB checks have been obtained for the person. We advised Mr Jack that there was advice on our website Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: concerning checks and the employment of staff. While no new staff have been employed since our previous visit, we sampled two sets of recruitment records for persons who have applied to work in the home. We also sampled the recruitment records for two of the staff employed in the home. Discussion with Mr Jack indicated the type of person and kinds of experience they would be looking for. The discussion indicated that peoples job applications are being fully assessed, and gaps in employment likely to be taken up at interview. The previous requirement concerning this was therefore assessed as met. We are told in the AQAA that staff training so far this year has included fire prevention, abuse awareness, induction training, challenging behaviour, safe handling of medicines, food hygiene, and first aid. Three staff told us in their CQC survey form that they are being given relevant training which helps them understand peoples needs and gives them enough knowlege about health care and medication. They also told us that their induction training covered everything they needed to know to do the job when they started. We sampled the workbook records for two staff who had undertaken the Nescott training in administering medicine. There is also a system in place for staff to sign when they have refreshed their video training - for example fire and safeguarding training. We noted on the staff records we sampled that a new template has been put in place to evidence what training staff have undertaken, and when they would next be due to refresh that training. We noted that these new templates had not been completed, and that staff training certificates were not available to be viewed - Mr Jack said that at present staff held the copies of their training certificates. There was therefore a lack of staff records to evidence that staff had undertaken all required training. A requirement has been made concerning this. The AQAA tells us that six staff hold the national vocational qualification (NVQ) in care at level 2 or above, and that four staff are presently doing NVQ training, including two staff undertaking the NVQ4 in management training. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: We are told in the AQAA that staff are receiving one to one supervision once per month. Staff we talked to confirmed that staff supervision is in place, and that the supervision provided supports them in meeting the needs of the students. Mr Jack advised us that the staff meetings book records when staff supervision has taken place, and that it is expected that more formal supervision records will be recorded when the deputy manager has completed updating the system for staff records. As we accepted the providers undertaking that formal supervision records would be put in place, no requirement was made concerning this at this visit. We were told by staff that supervision is provided by the registered manager and deputy manager, sometimes both together. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because is is run and managed appropriately. Peoples opinions are central to how the home develops so that the home has appropriate ways of making sure they continue to get things right. The environment is safe for people because health and safety practices are carried out. Evidence: The manager Mr Jack has extensive management experience and is supporting two of the staff team to complete the National Vocational Qualification 4 (NVQ4) in management. Mr Jack continues to update his knowledge and experience - for example by familiarising himself with the NVQ4 in Management so that he can assist staff in completing their training. Mr Jack is also involved with a number of committees and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: groups where he has continued to develop his knowledge of disabilities. Comments received from staff and students indicated that there is a good atmosphere in the home, and that students are benefiting from taking on responsibilities and developing their independence skills. Staff we spoke to provided examples of how students ideas for the improvement of the service have been put into action - for example, choosing the decor to the dining room, the development of the garden, and having a notice board put up for their drawings and paintings. We are told in the AQAA of the dates when the most recent services and tests have been carried out on electrical systems and equipment, and that fire safety records and fire drills are being regularly maintained. We spoke with the handyman and found that he has extensive training in health and safety issues, and that he is assessing the safety of the premises and attending to maintenance issues on a daily basis. We found that arrangements are in place for staff to undertake training in health and safety matters such as food hygiene and infection control. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 35 17 The provider must ensure that a record of all staff training undertaken, including induction training, is held. Present training records held do not evidence that staff have undertaken all required training. Staff who have not undertaken all required training may present a risk to people receiving a service. 30/07/2010 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 28 of 29 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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