Care Home: Egmont Road (31)

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well Each person using the service is clearly regarded as an individual, and the plans of care and intervention are well created, and reflect very closely the needs of each specific person. The service provides a real home to service users who have significantly high levels of autism or other challenging behaviour, and the service responds well, ensuring that a comfortable and satisfying life is created for these people within the boundaries of their capabilities. Respondents to the CSCI relatives / friends survey again unanimously agreed that they were happy with the overall service provided at 31 Egmont Road, reporting a positive welcome when they visit, stating they were provided with privacy with their relative or friend, and reported being kept informed of progress and being involved in decisionmaking, where appropriate. Phrases such as, They cater well for my relatives need and keep me in the picture, and, They support and care very well for my relative and me, reflect the fact that the care is provided in partnership with family and significant others. The home is a pleasant and bright environment, providing as homely an environment as is possible for people who may well be focused elsewhere, rather than appreciating their surroundings. The home was clean and odour free on the day of our visit. Staffing at the service is provided to a good level to address needs and any possible challenges service users may present; staff cohesion is vital and this remains a strong reality at Egmont, thanks to the continuity of staff, with only one staff member moving on and one moving in from another CMG service. Training and direct support to staff is central to the reliability and strength of the team, in every sense, and this is clearly provided, with, commendably, staff supervision being a monthly reality for the team. The service continues to run at a very high level of professionalism - as well as being task focused. The registered manager and staff are once again commended for the service they provide, and, with the remaining requirements resolved since the last inspection visit, the service clearly now merits the rating of an excellent, three star service. Some aspects of the service have changed very little since the last inspection, and therefore the report narrative at times will recant previously used phrases and observations. What has improved since the last inspection? All relatives and people concerned with the service have now been informed about the CMG Complaints process - and, through the CSCI questionnaire, it is evident that people are content that they know how to express a concern. The installation of a new water and room heating boiler system has finally resolved the problems of inadequate or excessively hot water supply. The joint ownership with the neighbouring house of the system had caused a significant problem in the past. Repairs to a window in a top floor bedroom and to an ensuite facility were also resolved. New carpets and floor coverings have been provided in the communal areas, and bedrooms continue to be furnished individually to the level that each can tolerate. The premises generally appeared more homely, interesting and decorative, an indication that behaviour support guidelines are working well, and that behaviour which damages the premises has reduced. The registered manager and the deputy manager now have attained their NVQ at the Level 4 Registered Managers Award. Care staff members are 100% trained in NVQ care, to either Levels 2 or 3. All other statutory training is up to date. Person centred planning of care plans and Health Action Plans have been instrumental in helping staff to focus on each individual person using the service, and this has clearly lead to stability and to people really settling in to the home. The home has a PCP Champion amidst them to encourage and transfer knowledge relating to this approach. Relatives also felt that the determination and professionalism of the management input encouraged staff consistency, and this in turn has resulted in discernably positive outcomes for those using the service. What the care home could do better: There were no significant areas identified for improvement against the National Minimum Standards. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Egmont Road (31) 31 Egmont Road Sutton Surrey SM2 5JR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Pennells     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.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: Egmont Road (31) 31 Egmont Road Sutton Surrey SM2 5JR 02086615534 02086615694 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care Management Group Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (CRH - 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 - Code LD Date of last inspection Brief description of the care home 31 Egmont Road is owned, managed and staffed by the Care Management Group. The project has been open since August 2003 and is registered with the Commission to provide residential care for up to six adults with learning disabilities, currently in the age range of approximately 20 to 45, who also have challenging behaviour, autism or other complex needs. The home itself is a large semi-detached house, attached to No 33, a separate sister CMG home, and is situated in a quiet suburban area of Sutton, within easy walking distance of the town centre with its shops & leisure facilities. There Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home is also, therefore, access to good public transport links. There is hardstanding at the front of the home for the parking of two vehicles off-road, with free, though sometimes scarce, parking available directly on the street itself. A vehicle is provided for the exclusive use by the home. Accommodation within the home comprises of six single occupancy bedrooms all with en-suite facilities comprising toilet, basin and shower. Communal space is composed of a main lounge, a separate dining area, kitchen, laundry, office, sensory room and a conservatory. There are sufficient additional communal bathroom / shower and toilet facilities located throughout the home, in addition to the individual en-suite facilities. A garden is provided at the rear with its own patio area directly off the conservatory at the higher house level, the garden being down a flight of steps. Care Homes for Adults (18-65 years) Page 5 of 29 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: We visited the home on a weekday from mid morning and stayed for the afternoon, ensuring we met with most people at the home, as a number were out, returning from activities subsequently. Adequate staff members were in evidence on duty, and the manager was present, and able to assist us in reviewing the requirements and recommendations from the last report, to access current documentation and to tour the premises themselves. We were able to observe and engage with the majority of people living at the service during the visit - and we are grateful to them, the staff, and the manager, for their cooperation, welcome and warm hospitality during the visit. Questionnaires were left for those using the service, for their relatives / friends and Care Homes for Adults (18-65 years) Page 6 of 29 also for staff. Responses were received from six, three and five people respectively and the overwhelming outcome from all three surveys was a positive opinion of the home and its achievements. What the care home does well: What has improved since the last inspection? All relatives and people concerned with the service have now been informed about the CMG Complaints process - and, through the CSCI questionnaire, it is evident that people are content that they know how to express a concern. The installation of a new water and room heating boiler system has finally resolved the problems of inadequate or excessively hot water supply. The joint ownership with the neighbouring house of the system had caused a significant problem in the past. Repairs to a window in a top floor bedroom and to an ensuite facility were also resolved. New carpets and floor coverings have been provided in the communal areas, and Care Homes for Adults (18-65 years) Page 8 of 29 bedrooms continue to be furnished individually to the level that each can tolerate. The premises generally appeared more homely, interesting and decorative, an indication that behaviour support guidelines are working well, and that behaviour which damages the premises has reduced. The registered manager and the deputy manager now have attained their NVQ at the Level 4 Registered Managers Award. Care staff members are 100 trained in NVQ care, to either Levels 2 or 3. All other statutory training is up to date. Person centred planning of care plans and Health Action Plans have been instrumental in helping staff to focus on each individual person using the service, and this has clearly lead to stability and to people really settling in to the home. The home has a PCP Champion amidst them to encourage and transfer knowledge relating to this approach. Relatives also felt that the determination and professionalism of the management input encouraged staff consistency, and this in turn has resulted in discernably positive outcomes for those using the service. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 10 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. The home provides a comprehensive Statement of Purpose which ensures that all necessary information about the service is available both for people who may have a direct interest and others enquiring about the home. People who may use the service and their relatives can be confident that they will have the opportunity to find out about the home, to visit, including staying for short periods, and, through adequate assessment and consultation, be assured that the home can meet their needs prior to making a firm decision to stay. People using the service will receive a contract in a communication strategy suited to their needs, and this seeks to ensure that all terms and conditions are known and recognised from the point of confirmation of the contract. Evidence: The Statement of Purpose for the home is a very comprehensive document holding all necessary information as required by the revised Standards, Schedules and Regulations. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Important elements, such as the contract (standard 5) is presented in a Symbols style, to enable service users to engage with this part of the document as much as possible. The Complaints procedure is also clearly stated in this symbols style. No new placements have been made at the home since May 2006, half a year before the last inspection visit. The user group ages span from early 20 to mid 40. It continues to be more than possible that this community will be settled at home for a number of years. Referrals to the home require full and concise information to be provided; admissions are based on a full needs assessments undertaken by the registered provider at a regional level, involving the homes manager, and a care manager from the relevant placing Local Authority. The introductory phase - including site visits - gives the staff the chance to ensure that they are able to offer an appropriate service, along with assessing compatibility with other service users in this small community for six distinct, generally strong, personalities. The homes admission policy is conditional to a three-months trial basis. In keeping with good practice, all the other service users would be consulted / observed about the possibility of the prospective new service user eventually moving in on a permanent basis, and the permanence is then confirmed after a thorough review. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service maintains care plans and assessment documents designed to ensure that the needs of people are met in a focused and individual way, with their rights to individuality and self-expression being protected, and the wishes and aspirations of that person being taken into account. Consultation with people using the service relies on both direct contact and also a broader approach of checking with relatives and carers as well as associated professionals. People using the service can be assured that risk-taking will be an integral part of the support and protection plans put in place by the home. Evidence: Ensuring that the service provided is as close to the individual person and their wishes as possible relies both on contact directly with the service user, and on the accrued knowledge about that person using the service. Observations by staff members of Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: behaviours and reactions, consultation with relatives and their previous carers, and input from professionals who may well be able to help develop strategies to access a persons deeper self, all help to develop a fuller picture. There have been no changes in the service user composition since the last inspection visit. At that time, the admissions process was appropriately handled, with information created and dated on the day of admission and full risk assessments being in place within seven days of the admission. An induction checklist and questionnaire had also been completed on the day of admission; ensuring adequate information was gathered to meet specific needs immediately the home engaged with the person joining the service. All care plans inspected were person centred in approach and sought to express themselves from the perspective of the people using the service. Documents are pictorial as far as possible, and daily social activities are shown on clear wall charts for each individual. Written documents contained individualised procedures for staff to follow for people assessed as likely to have challenging behaviour, focusing on positive intervention, such as communication support and de-escalation techniques, in preference to physical intervention. Risk assessments are provided for each individual, specifically created to reflect their assessed situation. Risk assessment is clearly a fundamental part of the ethos / thinking of the home, and is well covered in the associated documentation. Assessments are in place for all aspects, and cover various needs, including personal hygiene, community presence, and behaviours likely to challenge the service. Each risk assessment identifies the risk, possible consequences, and the minimising action necessary to handle the challenge. Decision-making for the community at 31, Egmont Road is a complex strategy, seeking the best for all through intuitive experiment, whilst respecting every individual rights to opt out. The manager and staff team achieve an excellent fine balance here. Care Homes for Adults (18-65 years) Page 14 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 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 can be assured that the service provides opportunities for them to engage in activities, both within and outside the home within the local community, and to adopt a lifestyle best suited to the individual. People are encouraged to engage with the local community and also to exercise their rights in this regard, through proactive use by the home of local community leisure facilities and resources. Relatives / friends can expect a positive welcome from the home, within the context of respect for a service users own choices, rights and decision-making with regard to relationships and their lifestyles. People using the Service can expect to be provided with a good standard of nutritious and wholesome food, meeting dietary needs and ensuring that mealtimes are a pleasant and enjoyable time. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Opportunities for exercise, be this walking in the various local parks, or engaging in some shopping, or having lunch in Sutton town centre, or to other shopping venues, all contribute towards enjoyable focused activity. People using the service are positively encouraged to enjoy and engage with appropriate opportunities presenting themselves in the local community, both main stream, and within the local learning disability community. Service users regularly engage with leisure pursuits such as swimming, bowling, attending the cinema. Daily diary notes again showed that service users are being provided with numerous opportunities to participate in a wide variety of stimulating social and recreational activities. Service users are positively supported to participate in a hugely wide variety of individually appropriate and assessed activities, which may include regular attendance at day centres, educational centres and other specific locations. Contact with local Churches is encouraged, though elements of challenging behaviour can sometimes create a difficult dynamic in formal community settings. The house also has a good relationship with their next-door neighbour home at No 33, and they sometimes share activities, such as Christmas or Birthday or other celebratory parties. The home is clear in its Statement of Purpose that visitors and especially family contacts are welcome to the home on an unrestricted basis. The majority of people at the home have active engagement with their loved ones, and varied approaches agreed with the individual cover visits to or from the home. At least half of the current community have contact regularly with relatives, though not all go home. Strategies could be an encounter on neutral ground in a cafe, with the keyworker present, when individual relatives have difficulty coping with challenging behaviour. The service tries to be creative in ensuring that family contacts are maintained and should be commended for this. We again observed people and staff preparing for their mealtimes, which service users evidently enjoy, though some sittings are relatively quick. Safe catering records were well recorded. Meal times can be somewhat haphazard, but the food is enjoyed and does bring the community together with a common routine, focus and purpose. The kitchen is functional and appears to meet the homes needs adequately. Care Homes for Adults (18-65 years) Page 16 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 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 can be assured that their personal, health care and emotional needs will be recognised and met by the homes assessments and individual careplanning programme. The systems adopted by the home regarding medication ensure the safety and consistent treatment and support for each person using the service. Evidence: Each individual is respected and supported in a positive way to be themselves as much as possible, without offence or upset to others, whilst their clothes, hairstyles and appearance reflects their gender and ethnic or cultural background. There is little in the routine of the house that is not to a large extent flexible, though some people rely on a domestic routine to enable them to build in their own activities. Familiarity with staff, routines and everyday processes are all-important to the people using the service. The idiosyncrasies of each individual are certainly acknowledged, being appropriately responded to, and respected. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: GP and other medical / health professional contacts are made as needed; records of these appointments / visits are appropriately maintained. Specialist practitioners monitor service users mental health on both as-required and a regular basis. Specialist dental input is gained via Orchard Hill and optical services are also either local community or specialist-worker based. Service users now have fully completed Health Action Plans in place - this assisting the person centred planning of health care needs alongside the daily care plan. HAPs showed that at a recent visit by the Consultant Psychiatrist, all medications to treat challenging behaviour, bar one, were reduced in dosage, thanks in part to the consistent observational sensitivity of the home. Records relating to medication were well maintained; all medicines received, administered, and disposed of, being easily auditable. Medication profiles were also available, and clearly identified current and discontinued medication regimes. The homes procedures for administering as required, PRN, medication were well documented to minimise any risks associated with its misuse. Management, team leaders and seniors administer the medication at the home. Management also audit the medication process on a daily basis. Care Homes for Adults (18-65 years) Page 18 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. People using the service can be confident that their comments and complaints would be responded to, with appropriate action taken, within reasonable timescales. The home provides support to people to ensure that they are protected from harm and any form of abuse within, or outside, the home. Evidence: The homes complaints procedure is included in the Service User Guide, which is available to the homes residents in a suitable language and also stand alone symbols format, and it is also within the Statement of Purpose. The procedure includes information about how to contact the Commission for Social Care Inspection should the complainant wish to do so. There have been no complaints recorded in the past twelve months. Safeguarding or Adult Protection policies and procedures are fully in place to support people living at the service, and are known by all staff, who have had training in such issues. The issue is also raised in Team meetings and supervision sessions to ensure that all are fully conversant with it. The registered providers finance officer is Appointee with regard to benefit issues for all six current service users. People using the service have monies held at the home, which are checked at each daily staff handover. A second member of staff - who Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: witnesses any transaction - countersigns all incoming and outgoing payments undertaken by the home. Care Homes for Adults (18-65 years) Page 20 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 residing at the home may expect the premises to be clean and a pleasant and a comfortable environment to live in, with safety and comfort being a primary concern. Evidence: Accommodation within the home comprises of six single occupancy bedrooms all with en-suite facilities comprising toilet, basin and shower. There are sufficient additional communal bathroom / shower and toilet facilities located throughout the home, in addition to the individual en-suite facilities. It was noted that some of the shower units in certain bedrooms would benefit from refurbishment or replacement at some time in the next year or so. Communal space is composed of a bright and functional main lounge with new sofas, a separate dining area, kitchen, laundry, office, sensory room and a large conservatory space. A new, larger television is on order and expected soon. A garden is provided at the rear with its own patio area directly off the conservatory at the higher house level, the garden being down a flight of steps. Premises issues which had been outstanding for some while have now been resolved: the entire population of the house moved out for a short while and went on holiday, Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: whilst the major water heating issue for the house, previously posing a risk of scalding and inadequate water temperatures compromising heating to both 31 and 33 Egmont Road, was finally resolved. Furnishings generally throughout the home are modern, bright and attractive. The general environment - including all bedrooms - has been redecorated in the past twelve months. Inevitably, challenging behaviour can take its toll on some furnishings or decorations, however the general state of the house was a positive credit to all. Care Homes for Adults (18-65 years) Page 22 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 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 can rely on the home providing staff in sufficient numbers, being duly competent and well trained to provide a service that seeks to meet identified needs. The company recruitment and staff support mechanisms are organised so as to ensure the safety, protection and wellbeing of people using the service. People can rely on the staff members having sufficient clarity of role, and support from senior staff through one to one supervision, that the service will be delivered with competence and well-informed proficiency. Evidence: Staffing levels at the home have been maintained to the appropriate minimum level, even though there are currently two support worker vacancies at the house, one due to maternity cover and one a true vacancy. Agency staff are not used, staff members working extra shifts, and two familiar bank workers provide this cover currently. Staffing during the day never falls below three staff with a float worker, the majority of the time there being five staff available. A single staff member remains awake throughout the night, and a second staff member is asleep on call within the building. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: At previous visits, we have previously inspected a variety of job descriptions attached to the personal files, which evidenced that the staffing structure is well thought through, and supports the aims of the house. The staffing structure runs from manager, through a deputy manager role, to team leaders and then senior support, and support worker. Staff members at the home have regular opportunities to renew their training in dealing with challenging behaviour. Other training, especially for statutory courses such as food hygiene and first aid are mapped and monitored by the deputy manager and renewals or updates are booked as needed. NVQ training is now a reality for 100 of the staff team, the manager and deputy having the Award at level 4, the team leader having gained a level 3 qualification, with three lead support workers also approaching their level 3 certificate and all other staff having completed to level 2. It continues to be standard practice for CMG not to permit new members of staff to start work until the company has obtained two satisfactory references from their previous employer and a Criminal Records Bureau and PoVA check has been undertaken. Staff files hold signed acknowledgment letters from CMGs Regional Director as proof that staffs CRB checks have been carried out and are held at CMGs Head Office. Examination of a staff file at random again evidenced regular one to one supervision input to staff, on a frequency above that required by the National Minimum Standard. This provides an opportunity for any subjects to be raised by the staff member and for performance and training issues to be examined and followed through. An annual appraisal also takes place. Staff members have confirmed this supportive reality for them in their questionnaire responses, so this standard (36) is again awarded an excellent score to reflect the excellence in providing support and supervision to staff on a one-to-one basis. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service and their relatives and friends can rely on the home being run well, providing a professional service with the best interests of the service user being central to the care provision. The culture of the service ensures that each person resident at the home is treated with respect, and that family, friends and staff feel valued and that their opinion matters. The registered providers can be relied upon to take seriously service audits and health & safety issues, to the benefit and for the safety of those residing at the home. Evidence: The manager and deputy manager remain the same personnel, and staffing at the home continues to be remarkably stable; in the past year, one staff member has left and one has joined from another CMG service. This has great benefits to the service users, as new relationship building will be kept to a minimum, with continuity being a prime consideration. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Lesley Somerville is the registered manager of the home. Mrs Somerville has been in day-to-day control of the home since it opened in August 2003, and has at least two years previous managerial experience working in another CMG home with service users with similar needs - and an additional fourteen years of experience in care work. She has now achieved her NVQ at Level 4 in Management and Care, the Registered Manager Award, and, commendably, the deputy manager has also achieved this qualification. We have no concerns about the general management of the home; the structure and support for staff and service users is evident from the general organisation of the house, and the good order of paperwork and the house-based service in general. The registered provider regularly asks relatives for their opinions of the service on paper to elicit feedback about the quality of the service provision. Reports compiled by the homes Regional Director follow monthly unannounced visits to the home, are thorough and completed regularly in accordance with Regulation 26 of the Care Homes Regulations 2001. Records seen at the home were well kept, accurate and up-to-date. Service users are welcome to view their own files and any personal information held about them by the home, should they so wish, in line with Data Access and Protection principles. The registered provider is duly notified with the Information Commissioner under the Data Protection Act 1998, thus ensuring adherence to good practice in general. Health & Safety issues were satisfactorily dealt with at the home. All regular, annual and more frequent health and safety checks were up-to-date, with certification available as evidence. Just one item was outstanding, that of the mains electrical testing, coming due within the fifth year from the start of the service. The registered manager ensured that a date for the completion of this testing procedure was arranged promptly soon after the inspection. 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 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!