Care Home: East Court

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What the care home does well Those people spoken with said that they were very happy living at East Court and they enjoyed the numerous activities available to them both at home and in the local community. In response to the question "what does the home do well?", one person said "it makes me happy and has what I want. I like living with my friends", another person said "friendly staff and plenty of different activities to do." East Court continues to provide a high standard of personal care and support. Three care plans were examined in detail and each provided a very clear description of what the person could do for themselves, their preferences and how they wished to be supported by staff. This level of detail is very important to ensure that people`s needs are well known by the staff and that all staff support each person in a consistent and safe manner: the home is commended for this. East Court is a large, spacious home set within beautiful grounds. The educational and leisure facilities provided at the home include a pottery, bakery, a weaving studio and a vegetable garden. There are also numerous supported opportunities to access the full range of community based leisure, educational or work pursuits. For example the home as a skittles team in the local pub league and several people attend line dancing lessons and aqua-fit . Bedrooms have been decorated to reflect people`s individual tastes and preferences and all have en suite facilities. The people living in the home participate in all household tasks alongside staff and independence is promoted. It is clear that the people living at East Court are given opportunities and support to express their views on the conduct of the service through regular consultation by the organisation as well as being able to approach staff and management at the home informally. From discussions with the staff team as well as direct observations of their interactions with people living in the home it was evidence that the staff are fully committed in supporting people to live purposeful and fulfilling lives as independently as possible and the home is commended for powering people to make their own informed decisions about how they wish to live their lives. What has improved since the last inspection? Four recommendations were made at the previous inspection in September 2006 relating to reviewing care plans each month; undertaking risk assessments and gaining consent for the use of listening devices in bedrooms over night for health and safety reason; consultating the District Nurse over the competency of staff to administer rectal diazepam and reviewing the format of the reference request from previous employers to include the reason the candidate left their employment. All of these had been satisfactorily resolved. The home continues to be improved and three self-contained flats have been created to allow three people to live semi-independently. Staff continue to receive updated training to ensure they have the skills and confidence to care for people with a learning disability. The home has employed a member of staff with specialist skills in behavioural therapy to support people whose behaviour and/or anxiety and agitation may restrict their involvement in day-to-day activities and social involvement. What the care home could do better: The Trustees, Mrs Reece and her staff team continue to provide excellent opportunities for people to enjoy a fulfilling and enjoyable life at East Court. No requirements or recommendations for improvement have been made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: East Court Doctors Hill Wookey Wells Somerset BA5 1AR     The quality rating for this care home is:   three star excellent 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: Jane Gurnell     Date: 2 1 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: East Court Doctors Hill Wookey Wells Somerset BA5 1AR 01749673122 NA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Orchard Vale Trust care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home East Court is a large listed building located on the edge of Wookey. The house is set in extensive grounds which include a productive vegetable garden. Accommodation is provided in four units. The main house accommodates 11 people; one person lives in each of the self contained Stable Cottage and Coach House and the Garden House offers a quieter environment for four people. All service user rooms are single occupancy and have en suite facilities. People are encouraged to develop and maintain daily living skills and are able to participate in a wide range of activities. East Court is registered with the Care Quality Commission to provide accommodation for up to seventeen people with a learning disability aged 18-65 years. The Registered Provider is Orchard Vale Trust. Weekly fees range from 750 to 950 pounds dependent uppon peoples needs. Items such as personal toiletries, chiropody, hairdressing and transport are not included. Information about the services provided at East Court can be obtained directly from the home. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 17 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: three star excellent 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: East Court was previously inspected on 28th September 2006 when it was judged as providing excellent outcomes to the people who live there. This key unannounced inspection was undertaken on 1st October 2009 between 10am and 4pm. We spent time with the people living in the home and with the staff on duty as well as observing them going about their daily activities and duties. The people living in the home, the deputy manager and staff team assisted the inspector throughout the inspection and contributed to the information gathered to assess the quality of the service. The atmosphere at the home was relaxed and friendly. Staff carried out their duties in a pleasant, unhurried and professional manner. Prior to the inspection the commission forwarded surveys to 10 people living in the home and 10 staff inviting them to comment, anonymously if wished, about the quality of the services and support provided. Six responses were received from people living in Care Homes for Adults (18-65 years) Page 5 of 28 the home and six from staff: all gave positive comments about the service provision. A tour of the main house and cottages was made and people showed us their bedrooms and their pottery and textile work. Records examined during the inspection included a selection of care plans, quality assurance processes, medication management records, staff training and recruitment records, staffing rosters, menus, equipment servicing records, fire safety records and information provided by the home to prospective admissions. Prior to the inspection the home completed and forwarded an Annual Quality Assurance Assessments which informs the commission of the changes and improvements that have been made to the service over the past 12 months. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? Four recommendations were made at the previous inspection in September 2006 relating to reviewing care plans each month; undertaking risk assessments and gaining consent for the use of listening devices in bedrooms over night for health and safety reason; consultating the District Nurse over the competency of staff to administer rectal diazepam and reviewing the format of the reference request from previous employers to include the reason the candidate left their employment. All of these had been satisfactorily resolved. The home continues to be improved and three self-contained flats have been created to allow three people to live semi-independently. Staff continue to receive updated training to ensure they have the skills and confidence to care for people with a learning disability. The home has employed a member of staff with specialist skills in behavioural therapy to support people whose behaviour and/or Care Homes for Adults (18-65 years) Page 7 of 28 anxiety and agitation may restrict their involvement in day-to-day activities and social involvement. 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 8 of 28 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 28 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. Prospective residents and their families are provided with appropriate information to make a decision regarding the suitability of the home. Thorough assessment and transition support ensures peoples needs are well known prior to their admission. Evidence: The home has a Statement of Purpose and Service User Guide that provide details about life in the home and the services and facilities offered at East Court. One person has been admitted to the home since the previous inspection and the deputy manager described the assessment and admission process. The prospective resident had made several one-day visits to the home before staying overnight, and then staying for one week prior to making a decision about the suitability of the home. There was evidence of these visits and the assessment undertaken with social services in the persons care plan. Care Homes for Adults (18-65 years) Page 10 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans describe peoples care and support needs ensuring consistency in care giving. People are encouraged to exercise choice and participate in all aspects of life within the home. Evidence: Those people spoken with said that they were very happy living at East Court and they enjoyed the numerous activities available to them, as well as the support provided by the staff. All six people who returned the survey confirmed staff and managers treat them well and listen and act upon what they say. In response to the question what does the home do well?, one person said it makes me happy and has what I want. I like living with my friends, another person said friendly staff and plenty of different activities to do. Care and support plans are developed for each person living in the home. Information is gained from discussion with the person and their families, from identifying what is important to them and what goals they wish to achieve. A person-centred approach is Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: taken and documents such as My Life, My Plan guide staff to record the care plans from the persons perspective. Three care plans were examined in detail and each provided a very clear description of what the person could do for themselves, their preferences and how they wished to be supported by staff. This level of detail is very important to ensure that peoples needs are well known by the staff team and that all staff support each person in a consistent and safe manner, and the home is commended for this. For example one care plan identified what makes me anxious and there was very detailed information for staff on how to support this person during times of anxiety to prevent escalation in distress as well as to support the person in developing coping strategies. Each care plan contained risk assessments regarding activities such as preparing meals and hot drinks, bathing, swimming, pony trap riding, road safety and vulnerability with strangers to ensure people can undertake activities with support and in safety. The care plans had been reviewed each month with the person and their care coordinator, a member of staff identified as having responsibility to ensure care plans were up to date and reflect peoples needs. Formal care plan reviews with family and social services take place at least every six months, and there was evidence of this in the care plans examined. Health care needs were well recorded and there was evidence that people had regular contact with their GP, dentist, optician and chiropodist as well as referrals to specialist practitioners when necessary. People are able to access their care plans, and may keep these in their bedroom, or the office, as they prefer. At the inspection one person was observed actively consulting their care plans with the staff and a social worker and demonstrated a good awareness of plan contents. Peoples views are sought on a regular basis through day-to-day involvement with activities around the home as well as at regular at the residents meetings. People were seen to be supported by staff in domestic activities and laundry, meal preparation as well as the various leisure activities available. People were seen to be consulted by staff and asked their opinions about the tasks and activities. From discussions with the staff team as well as direct observations of their interactions with people living in the home it was evidence that the staff are fully committed in supporting people to live purposeful and fulfilling lives as independently as possible and the home is commended for empowering people to make their own informed decisions about how they wish to live their lives. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The home supports people to manage their own money but also offers safekeeping for those who are unable to do this themselves. All the people living in the home had their own bank account. Records of day-to-day expenditure were maintained and these were found to be neat and accurate with receipts for all items bought. Two members of staff signed the records as well as the person themselves if they were able: records were audited on a regular basis to ensure there were no discrepancies. Records relating to people living in the home were appropriately maintained and stored to safeguard confidentiality. Care Homes for Adults (18-65 years) Page 13 of 28 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. People are able to participate in a wide range of leisure, social and educational activities, and have regular opportunities to access the local community. Independence is promoted and people are encouraged to develop and maintain daily living skills. Meals provided are of a high standard and offer a nutritious and well balanced diet. Evidence: People participate in a wide range of activities and have full weekly schedules that include evening commitments. The facilities provided at East Court include a large vegetable garden, a pottery, a bakery where people learn about healthy eating and meal preparation and a weaving studio where people make tapestries, cushions and soft furnishings as well as fabric painted pictures. People said that they could make choices about what activities they took part in and had developed their own weekly Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: activity timetables: these included activities at the home and also in the local community. Timetables were either written or pictorial with photographs and symbols dependent upon each persons ability. People are also provided with regular opportunities to access the local community, to attend a number of clubs and activities, including at weekends and evenings. For example the home as a skittles team in the local pub league and several people attend line dancing lessons and aqua-fit . The home has an Activities Co-ordinator, who is a member of the care team with the additional responsibility of facilitating community activities. She works with the people living at the home to ensure that the range of opportunities offered continues to meet their interests and needs. An Activities Week is held each year, where people try out a wide range of activities. This years activities included visits to museums, ten pin bowling, zoos-2-you visit, dog walking, dance classes, open top bus ride, ice skating, obstacle course, human table football, gladiator jousting, visits to National Trust properties and a barbeque and singer. People said they had also participated in the regions Art Week in September displaying and selling arts and crafts made at East Court. Everyone living in the home is offered the opportunity to go on holiday once a year and a home provides £300 towards this. People go away individually or in small groups and are involved in choosing and planning the holidays. This years holidays have included stays in Brittany, Cornwall, Torquay and a barge holiday. Several people attend a local college for a drama course and a building maintenance course. People are encouraged to develop and maintain their independence and several people live semi-independently at the home in their own self-contained accommodation. Two people at the home are in employment: one person has received a long service award from a local older persons care home. Relationships with family and friends are encouraged and supported in the home provides a guest-room for overnight or longer stays. One person said she was supported to maintain a relationship with her boyfriend who lived in another care home. People are fully involved in the growing, preparation and cooking of food and people are supported by the staff to prepare all the meals at home. Some staff and people at the home belong to the Healthy Living Club with the emphasis on understanding the importance of following a well-balanced nutritious diet as well as undertaking exercise. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: Meals are seen as an opportunity to meet up and enjoy social interaction and people spoke highly of the meals provided. Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports people in accessing healthcare services and plans ahead in consultation with them for continuing health care needs. Medication practices are safe. People are provided with appropriate assistance to meet their personal care needs. Evidence: People are provided with support to undertake personal care tasks as necessary. Each care plan gave a very clear description of what the person could do for themselves and how staff should offer them support in a manner that protects their privacy and dignity. Health care services are accessed appropriately and it was evidence that people had regular contact with their GP, a dentist, and optician and a chiropodist as well as specialist support from the local hospital. Written records demonstrated where specialist advice is sought and on-going dialogue between the person, their family, care manager and the home is maintained. A record is maintained of all professional visits. The home employs a member of staff with specialist behavioural therapy knowledge and she supports people to manage periods of anxiety and agitation and contributes to the care and support plans. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: People are supported to maintain responsibility for their own medication if they are able to do so. One person was seen in consultation with senior member of staff with regards to preparing her medicine for the forthcoming week. For those people who are unable to manage their medication themselves safe storage was provided in the home and all staff and responsibility of medication administration had received training. Medication records were inspected and found to be neat and accurate. A signature had been recorded for all medications given and medication stock was audited each month. Specialist advice and training is sought from the District Nurse with regard to invasive medicines or those to be given in an emergency such as diazepam or medazolam for seizures. Care Homes for Adults (18-65 years) Page 18 of 28 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 living in the home and their relatives can be confident that concerns and complaints will be taken seriously and dealt with promptly. The home provides people with regular opportunities to provide feedback on the service provided. There appropriate policies relating to the Protection of Vulnerable Adults and whistleblowing. Evidence: The home holds monthly meetings where people may express their views. Those people spoken with said they enjoyed these meetings and felt that their views were listened to. One person said that they are supported by staff to resolve any irritations or concerns. All six people returning a survey said they knew how to make a complaint and they felt staff listened to them and acted on what they said. The home has a complaints procedure, which includes details of external agencies that may be contacted, including CQC. This is displayed on the noticeboard in the hallway and has been discussed at the regular meetings. Neither the home nor the commission have received any complaints since the last inspection. The home has policies relating to the Protection of Vulnerable Adults and Whistleblowing and staff have received appropriate training ensuring they know their responsibilities should they suspect someone is at risk of abuse. Care Homes for Adults (18-65 years) Page 19 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. East Court provides a comfortable and spacious home to the people who live there. The home has been decorated and furnished to a high standard. Evidence: East Court is a large Georgian listed building, situated within spacious grounds, with beautiful views towards the church and countryside. The home has been upgraded since the previous inspection with three self-contained flats being created. The home is commended for the quality of the accommodation provided. Eleven people live in the main house, one person in a self-contained flat; one person lives in Stable Cottage, one person lives in the Coach House and the Garden House offers a quieter environment for four people who may have additional physical care needs. Staffing levels are provided for each unit in accordance with peoples needs and enabling some people to live with greater independence. Bedrooms have been decorated and furnished to a high standard and reflect each persons preferences and personality. Bedrooms were seen to be individualised with photographs, pictures and personal belongings. All rooms had door locks to provide privacy and security and people were seen to be using their own keys to enter their rooms. Each room is for single occupancy and all have en suite facilities. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: There are communal lounge and dining areas within the house and cottages and an additional games room within the main house. The home is set in large grounds that are accessible to people. The home also has a guest room that is available for visitors. There is an on-going programme of re-decoration and refurbishment within the home and the home employs a full time member of staff with the responsibility of undertaking day-to-day repairs and redecoration with the assistance of the people living in the home. The home was found to have a high standard of cleanliness, and follows good practice with regard to infection control. Care Homes for Adults (18-65 years) Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by competent and well-trained staff who are employed in sufficient numbers to meet the needs of those currently living in the home. Evidence: The home employs care staff and workgroup leaders. Care staff are responsible for assisting people with their personal care and also supporting people during the day with domestic, leisure and social activities. Activity group leaders have specialist knowledge in the chosen activity and assist people to complete the activity with a sense of achievement and pride. There are generally four care staff on duty during the day and two sleeping-in members of staff at night. The deputy manager and registered manager also work alongside the staff to maintain their relationship with the people living in the home and to supervise and support the staff team. The high level of staffing has ensured that people are provided with regular opportunities to participate in hobbies and social activities and have access the local community, and the home is commended for this. Newly appointed staff receive a recognised national induction programme which introduces them to good care principles and provides them with information about supporting people with a leaning disability. Staff are provided with regular updates in mandatory training, and there is a good annual staff appraisal and training plan that is Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: matched to identified individual staff training requirements. Staff spoken with stated that it was a good place to work and that they received appropriate support: this was further confirmed by the six staff returning a survey. Staff receive regular formal and informal supervision from a nominated member of staff within the management team, however from discussion with the deputy manager and examination of the records it was clear that the formal supervision is not always recorded. The deputy manager confirmed that due to the size of the staff team, approximately 30 people, it was proving problematic to provide everybody with regular formal supervision in a timely manner. The management team within the home and the senior managers of the Trust had met recently to discuss this and it was agreed that a review of the management structure within the home was necessary to be able to address this. The recruitment files were examined for a selection of staff employed since the last inspection. A member of staff within the administration team supports the home manager with the recruitment processes and ensures that the necessary preemployment checks , such as a criminal record bureau check and to written references are received prior to the member of staff starting work and this was evident within the staff files examined. Care Homes for Adults (18-65 years) Page 23 of 28 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. East Court is a well run. The management and staff team strive to provide a safe and stimulating environment for people to live a fulfilling life. Formal quality assurance processes ensure people and their families are consulted over the services provided and their comments and suggestions are listened to. There is a relaxed and open atmosphere within the home. Evidence: Lesley Reece is the registered manager at East Court. She has a good knowledge of peoples needs and has many years experience in managing the care home. Robert Freebury, the former manager has become the Responsible Individual and regularly visits all of the homes owned by the Orchard Vale Trust: he was present on the day of the inspection. All the managers and senior staff within the home operator an open door policy and were seen to be engaged with people and staff throughout the day. Those staff spoken with all confirmed they viewed the purpose of their role was to support the people in the home to live as fulfilling lives as possible, to learn new skills and to most of all be happy. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: People living in the home and their families are encouraged to provide feedback on the service provided. Residents meetings are held each month and family meetings every three months. In addition nominated staff members meet individually with people each month to review their care and support plans and formal care plan reviews with family and social services occur every six months. The families of people living in the homes owned by the Orchard Vale Trust also choose a Families Representative to liaise with the Trustees, who themselves are parents of people in the homes. The home has appropriate policies and procedures in place to safeguard vulnerable people. All records are stored securely in accordance with the Data Protection Act 1998. The home displays appropriate Employers Liability Insurance. One member of staff has taken lead responsibility for health and safety within the home. Fire records were examined demonstrated regular checking of equipment to ensure it is maintained in a safe working order. Staff are provided with regular fire safety training and the people living in the home are included in fire drills. Health and safety records have been appropriately maintained. All accidents are well recorded and have been reported to family, the GP, district nurse and the commission as necessary. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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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