Care Home: Edenvale

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What the care home does well We found that the home had excellent standards of person-centred care planning and risk management. People living in the home were supported to be as independent as possible and the care and support provided was based on each person`s wishes and aspirations. The home met people`s cultural needs very well. Chinese-speaking staff had been employed to work with two residents and other staff working in the home had also learned some of the language to enable them to communicate with residents. The home had a well-qualified and committed staff team who worked well together to meet people`s identified care needs. The home provided a good standard of accommodation. Residents` bedrooms were very well individual and all parts of the home were well decorated and comfortable furnished. What has improved since the last inspection? When we last inspected the home in 2007, we made one requirement for the provider to keep a record of weekly tests of the home`s fire alarm system. This requirement was met in 2007. What the care home could do better: Following this inspection we have concluded that the service continues to provide excellent outcomes for people living in the home. We have made 2 requirements in this report. We have asked the provider to make sure that fire doors in the home are not wedged open at any time and to review the hours worked by staff to make sure they have sufficient breaks and days off. We have also made one good practice recommendation to include details of the home`s registration with CQC in the complaints procedure. Key inspection report Care homes for adults (18-65 years) Name: Address: Edenvale 22 River Avenue London N13 5RU     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: Tony Lawrence     Date: 3 0 1 2 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 26 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 26 Information about the care home Name of care home: Address: Edenvale 22 River Avenue London N13 5RU 02088823261 02088867968 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Bee Looi Bennett care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Two specified service users who are over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as either of the specified service users vacates the home. Date of last inspection Brief description of the care home Edenvale is a small care home that provides accommodation and care for seven adults who have a learning disability. The majority of the residents have lived together at the home for a number of years. The home is a large house with three floors. The top floor is for staff accommodation. There are three single rooms and two shared bedrooms for residents. There is a lounge, dining room and a small quiet room downstairs with a small garden at the rear. The home employs some Chinese-speaking staff to meet the cultural and linguistic needs of the two Chinese residents. The home is close to local shops and facilities and public transport. The weekly fee for the service can be obtained from the provider. Edenvale makes inspection reports and other important information about the home available to residents, their families and professionals. A copy of this report can also be found on our website www.cqc.org.uk 7 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: This announced key inspection took place on Wednesday 30th December 2009 from 09:30 - 14:30. Tony Lawrence, CQC Local Area Manager, carried out the inspection. In this report, the words we and us have been used to represent the Commission. During this visit we reviewed outcomes for people living in the home against the National Minimum Standards for care homes for adults. We did this by talking to residents, staff, the manager and provider. We also checked care records kept in the home and one of the residents showed us around the building. The provider sent us the homes Annual Quality Assurance Assessment (AQAA) when we asked for it in November 2009. The AQAA was excellent and gave us useful information about the home that we have used in this report. The AQAA also showed us that the provider was aware of what the home does well and those areas where further improvement was needed. Care Homes for Adults (18-65 years) Page 5 of 26 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 6 of 26 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 7 of 26 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 using the 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 home provides good information for prospective residents. People living in the home are fully involved in the selection and admission of new residents. Evidence: We have an up to date statement of purpose and service user guide that is made available for all prospective service users. The documents set out in detail the aims / vision, objectives / mission and philosophy of the home, the services and facilities we provide and all the required information for the prospective service user, their relatives and representatives to make an informed choice. The people who live at Edenvale are consulted and involved in the invitations for prospective service users to visit the home. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit the homes owner and manager told us that there had been no new admissions to the home since our last inspection in 2007. We were not able to assess Care Homes for Adults (18-65 years) Page 8 of 26 Evidence: how the home managed the referral and admission of new people to the home, but two of the current residents told us that they had visited before they moved in. The owner told us that a programme of visits, overnight stays and trial periods would be tailored to the individual needs of any person referred to the home. We saw that the home had a Statement of Purpose and Service User Guide that clearly detailed the care and support provided in the home. We checked the care plan files for two people living in the home and saw that each included a signed copy of the homes contract / terms and conditions of residence. The contract made very good use of pictures to make information easier for some people to understand. This showed us that the home made every effort to provide information in appropriate formats. Care Homes for Adults (18-65 years) Page 9 of 26 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. People using the 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 to express and record their views and aspirations. Support plans and risk assessments focus on maintaining each persons independence and providing the best possible quality of life. Evidence: I tell the staff what I want to do and they help me. Comment from a resident. Service users are supported to create and have their individual Essential Lifestyle Plans by trained facilitators who are skilled and competent in the application of person centred thinking tools to generate person centred planning. Our service users take pride in the ownership and control of their plans, which is about how they wish to be supported and have their care delivered. Extract from the providers Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: During this visit we spoke to people living in the home about their support plans. We also reviewed the plans for two people. Both people were very positive about their plans and one person was happy to talk about and explain their plan to us. We saw that the plans covered all areas of each persons health and social care needs. We found that the plans were excellent and they were among st the best person centred support plans we have seen. There was clear evidence that people were fully involved in developing and reviewing their own plans. Plans looked at what each person felt was important to them and how they could be supported to achieve their agreed goals and aspirations. It was clear to us that the plans concentrated on how each person wanted to be supported and how this could be balanced against the support they needed. Wherever possible, the plans offered people choices based on their wishes and. The plans we saw were regularly reviewed and we saw clear evidence that people were fully involved in planning their own support plan reviews. Overall, the standards of person centred care and support planning were among st the best we have seen. We also checked the risk assessments that staff had completed for two people living in the home. Again we found that standards of risk management were excellent. Assessments were focused on enabling people to be as independent as possible, while acknowledging possible risks. The assessments clearly explained the potential risks and the benefits for people being able to take part in specific activities. We saw that the assessments included clear guidance for staff on how identified risks should be managed for each person. We also saw that one person had been supported to complete a risk assessment for a planned holiday in September 2009. The assessment was well written and clearly included the views of the person concerned. All of the other risk assessments we saw had been regularly reviewed. All of the support plans and risk assessments we saw during this visit had been produced using pictures and Plain English to make the information easier for people to follow. Care Homes for Adults (18-65 years) Page 11 of 26 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 using the 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 living in the home are supported to make choices about all aspects of their daily lives. They are fully involved in activities they have chosen and they are supported to keep in touch with people who are important to them. Evidence: I go out every day and I go to Gateway Club every week. Comment from a resident. I see my family when I want to and I go out. Comment from a resident. The food is very nice, I like it Comment from a resident. Were here to help people be as independent as possible, if they want to do it, well Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: find a way to enable it. Comment from a member of staff. Some people choose not to go out, so we provide activities at home. Comment from a member of staff. Service users are supported to make changes in relation to what and how they would like their day activities to be planned and how to be supported to access these, in accordance with the changes in their personal circumstances, age, health and interest. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we talked to residents and staff about how people living in the home spent their time. The residents we spoke with were very positive about their day services, local Gateway Club, activities in the home and holidays they had enjoyed. Staff told us that, wherever possible, people were supported to go out every day. For some people this meant formal day services while others took part in activities in the home or the local community. We checked the daily care notes completed by staff and these showed us that each person was supported to take part in activities they chose. Where people chose not to take part in a planned activity, their choice was respected and recorded. We saw evidence that people were supported to go to local day services, the theatre, the local Gateway Club and local shops and cafes. People also took place in activities in the home, including reflexology, manicures and parties. We saw from peoples care plans that the details of their relatives, Friends and other significant people were well recorded. People told us that they visited their families and friends regularly and this was confirmed by the daily care notes. We also saw good evidence that people living in the home were supported to choose the people who would be invited to, and involved in, the review of their support plan. Two of the people who lived in the home were Chinese. The provider had employed some Chinese-speaking staff to make sure that these two people had staff they could communicate with. We also noted that other staff had learned some Chinese to enable them to communicate with these two people. People told us that they enjoyed the food provided in the home. They told us they could choose when and where to eat their meals and that the meals were varied and enjoyable. Care Homes for Adults (18-65 years) Page 13 of 26 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. People using the service experience Excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We found that peoples personal and healthcare needs were very well assessed and recorded. We saw clear evidence of excellent joint work with health care professionals to meet peoples changing care needs. Evidence: The staff help me if I need to see the doctor. Comment from a resident. We monitor all aspects of each persons health care. We work with other people whenever there is a need. Comment from a member of staff. We make sure that our service users are effectively supported in accordance with their personal needs and preferences to have the right level of service and access to all the healthcare support and treatments that they require or are entitled to. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we reviewed the personal and healthcare support given to two people Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: living in the home. We did this by talking to residents and staff and checking care records kept in the home. The care and support plans we saw clearly detailed each persons preferences about the ways they were supported to meet their personal care needs. As with other aspects of their care plans, we saw that there was a clear and consistent emphasis on developing and maintaining each persons independence. We saw that people could go to bed and get up at times they chose and they confirmed this when we spoke to them. During the day we visited, we saw that staff consistently offered people choices about what they wanted to do. We found that the health care records kept by staff were excellent. We saw that the health care needs of people living in the home were well recorded and there was clear evidence that staff worked well together and with other agencies to meet individuals identified care needs. In one case, we saw that staff had worked well with the local psychiatry service and the Occupational Therapist (OT) to investigate one persons increasing health care needs. Assessments had been completed promptly by health care professionals and the OTs excellent report gave staff clear guidance on how to support the resident and manage their increasing needs. We also saw clear evidence that staff working in the home supported one person to manage their diabetes. We saw that staff kept a good record of each persons appointments with their GP, District Nurse, chiropodist or other health care professionals. Staff also weighed each resident every month and a record was kept to monitor any weight gain or loss. We spoke to staff and they demonstrated a good knowledge of prescribed medication needed by people living in the home. We saw that medication was securely stored and records showed us that people living in the home received the medication they needed at all times. One of the support plans we saw included excellent information about the persons wishes as they got older, including their thoughts and preferences about end of life care and their funeral wishes. Talking with staff we found that this information had been gathered and recorded very sensitively. Staff told us that these issues had also been discussed with the second person whose care and support we reviewed, but they had chosen not to discuss them with staff. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the policies and procedures needed to support residents safely. These are known to and used consistently by staff. Evidence: Ive never had any concerns but if I did Id speak to (the owner) or (the manager). Comment from a member of staff. We covered adult abuse as part of my induction. Weve got the policy to refer to if we need it. Comment from a member of staff. Service users, their relatives or representatives are confident that they have no fear in raining concerns or make complaints. We make sure that staff individually and collectively are trained and competent to initiate or support people to initiate the whistle blowing policy. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit staff we spoke with demonstrated a good awareness of the importance of safeguarding people living in the home and the local procedures that they would follow if they had any concerns about a persons welfare or safety. They told us that their induction training included the protection of vulnerable adults and an Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: introduction to the local authoritys safeguarding policy and procedures. The homes owner and the manager told us that there had been no safeguarding referrals or investigations since our last inspection in 2007. We saw that the home had a clear complaints procedure that had been produced using pictures to make the information easier for some residents to follow. Staff and residents told us that most issues were dealt with by staff on duty at the time they happened. There had been no formal complaints in the last 12 months. Following this inspection we have recommended that the provider updates the homes complaints procedure to refer to the Care Quality Commission. Care Homes for Adults (18-65 years) Page 17 of 26 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 using the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides a very good standard of shared and private accommodation. Residents bedrooms are individual, well decorated and furnished. Evidence: I like my room. Comment from a resident. We provide service users with a home environment that reflects their individual and collective contribution to the making of a homely, comfortable and safe environment that they take ownership of with pride. Extract from the providers Annual Quality Assurance Assessment (AQAA). Edenvale is a small care home that provides accommodation and care for seven people who have a learning disability. The majority of the residents have lived together at the home for a number of years. The home is a large house with three floors. The top floor is for staff accommodation. There are three single rooms and two shared bedrooms for residents. There is a lounge, dining room and a small quiet room downstairs with a small garden at the rear. The home is close to local shops and facilities and public transport. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: During this visit one of the residents agreed to show us around the home. We would like to thank this person for her help with this inspection. We saw all communal parts of the home and three residents bedrooms. All parts of the home were well decorated and comfortably furnished. Residents bedrooms were very individual and staff had supported each resident to personalise their room with pictures and their own possessions. During this visit, all parts of the home that we saw were clean, tidy and hygienic. Following this visit we have asked the provider to make sure that fire doors in the home are not wedged open at any time. This is to make sure that residents and other people are safe in the event of a fire. If a door needs to be kept open to enable residents to access the room, it must be fitted with a self closing device that is activated by the homes fire alarm system. Care Homes for Adults (18-65 years) Page 19 of 26 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 using the 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 home has a team of experienced and qualified staff who work well together to meet peoples care needs. Evidence: This is a very good home. Ive worked here a long time, if I didnt enjoy it, Id leave. Comment from a member of staff. When we arrived for this inspection, the registered manager was on duty with two members of staff. The homes owner also came in to help with the inspection. We would like to thank the owner, manager and staff team for their help during our visit. During the day we saw that staff worked very well together to make sure that peoples requests for support were responded to promptly. We saw that the staff consistently treated residents with respect and affection and each member of staff made sure that people were offered choices wherever possible. The staff we spoke with were very positive about their experiences working in the home. They told us that they felt supported and had regular access to training opportunities. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: We checked the staff files for two people working in the home. We saw that each file included an application form, proof of the persons identity, 2 written references, a contract, copies of training certificates and a Criminal Records Bureau check. This showed us that the provider made sure that staff were recruited who were suitable to work with the people living in the care home. Information from the AQAA showed us that all of the staff working in the home had completed their National Vocational Qualification (NVQ) Level 2 training. This was reflected in the staff files we checked and these also showed us that staff completed their induction and essential skills training. Staff told us that they felt well supported and each of the files we checked included copies of regular supervision meetings with the manager and annual appraisals of each persons performance. We checked the homes staff rota and this showed us that there was consistently enough staff on duty, during the day and at night, to meet the care needs of people living in the home. We talked to the owner, manager and staff about the need to review working patterns to make sure that staff had sufficient breaks and days off. This would help to make sure that staff were working effectively at all times. Care Homes for Adults (18-65 years) Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience Excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the qualifications and experience needed to manage the home. Staff know about and follow the homes policies and procedures to deliver excellent standards of care and outcomes for residents. Evidence: The home is run on the principles of openness and positive encouragement and promotion of innovation, creativity, transparency and inclusiveness. The home is managed by a qualified, competent and experienced manager who is committed to quality and the maintenance of a high standard of care and practice. Extract from the providers Annual Quality Assurance Assessment (AQAA). The homes manager has been registered by the Commission and previous regulators since 1999. She has completed her National Vocational Qualification (NVQ) Level 4 award for care home managers and has the experience and skills to manage a registered care home. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The provider returned the homes AQAA when we asked for it in November 2009. We found this to be one of the best completed AQAAs we have seen. It gave us detailed information about how the home provides the best possible outcomes for residents that we have used to inform this report. The AQAA also showed us that the provider is aware of the homes strengths and areas where further improvement is needed. The AQAA showed us that the provider had developed all of the policies and procedures needed to meet the National Minimum Standards for care homes for adults. The policies were regularly reviewed and showed us that staff had access to clear guidance on how to support residents effectively. The provider and staff also told us that people living in the home were regularly involved in monthly audits that were part of the homes quality assurance systems. During this visit we checked a selection of care records kept in the home, including residents care plans and risk assessments and daily care notes kept by staff. We found that standards of record keeping in the home were excellent. All of the records we checked were up to date and regularly reviewed. This showed us that staff were ware of the importance of good recording to evidence the delivery of positive outcomes for people living in the home. During this visit we saw no health and safety issues, apart from the need to make sure fire doors were not wedged open. When we last inspected the home in 2007 we asked the provider to make sure a record was kept of weekly tests of the homes fire alarm system. This requirement was met following the last inspection and staff told us that the record is still kept. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 24 23 Fire doors in the home must not be wedged open at any time. This will help to make sure that residents and other people are safe in the event of a fire. 26/02/2010 2 33 18 The owner must review working patterns to make sure that staff have sufficient breaks and days off. This will help to make sure that staff are working effectively at all times. 26/02/2010 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 1 22 The provider should update the homes complaints procedure to include a reference to the Care Quality Commission. Care Homes for Adults (18-65 years) Page 25 of 26 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). 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. 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