Care Home: Fairburn Chase

What the care home does well People who live at the home say that they receive good care and support. One person said, `I am very well cared for`, another person said, `staff are very good`. Staff are respectful and sensitive to people`s needs. This helps to maintain the privacy and dignity of people living at the home. People living at the home have the opportunity to take part in activities and spend time out of the home if they choose to do so. This helps in making sure their social needs are met. People said that their views and concerns are listened to and acted on. This helped people to feel safe and valued. The environment is clean, comfortable and pleasant for people who live in the home. The home is managed in the best interests of people who live there. This is supported by good systems that are in place to monitor and improve different aspects of care practice and health and safety. What has improved since the last inspection? Some improvements have been made to the care planning documentation so that care plans are more individualised and include better detail although further improvements are needed in these areas. More one to one activities are provided to enable people to pursue their individual interests and hobbies. The environment has been updated so making the home a more pleasant and comfortable place to live. Staff turnover has improved so that the staff workforce is now more stable and this has created more consistency in the care and support being provided to people at the home. Team leaders have been appointed in the different units in the home to support the registered nurses. This helps in making sure that the different units have leadership and are run smoothly. The manager has completed the Registered Manager`s Award in order to develop her management and leadership skills. What the care home could do better: Decisions about the use of bedrails could be agreed with the person who is intending using them and/or their representative and this could be recorded. This will help in making sure that people are in agreement with the actions being taken. Concerns about people`s weight loss could be passed on to other health care specialists at all times. This will help in making sure any neccessary actions are taken quickly in response to concerns. Further improvements could be made to the care planning documentation so that the information in the care plans is more person centred and encourages people`s independence and personal development. People living in the home and/or their representatives could have more involvement in what is written in the care plans. Arrangements could be put in place to make sure that that meals are always served warm. Measures could be taken to develop staff attitides towards positive risk taking. This will help to maintain and develop the independence and personal skills of people living in the home. Information confirming that a satisfactory Criminal Record Bureau (CRB) has been carried out on prospective employees could include details about the level of disclosure undertaken. This will help in making sure the right type of check has been carried out to safeguard people from unsuitable workers. Findings from questionnaires that are sent out to people at the home, relatives and other stakeholders could be made known to people. This will inform people about what the home is doing well and the actions that are being taken to address areas for improvement. Key inspection report Care homes for adults (18-65 years) Name: Address: Fairburn Chase Wheldon Road Castleford West Yorks WF10 2PY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: David White     Date: 2 2 0 4 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 29 Information about the care home Name of care home: Address: Fairburn Chase Wheldon Road Castleford West Yorks WF10 2PY 01977559703 01977517664 wheldonview@exemplarhc.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Wheldon Health Care Limited care home 76 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodate is: 76 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical disability - Code PD Date of last inspection Brief description of the care home Fairburn Chase is situated on the outskirts of Airedale village and Castleford town centre with limited access to local shops although this is partly compensated for by the home having use of its own minibus. It is a purpose built home for 76 people, caring for both older people and younger adults with a physical disability. The home is registered for personal care and nursing beds. All bedrooms are single and offer ensuite facilities. There is a well-tended central forecourt garden for people to sit out in the good weather. A team of qualified nurses, care assistants and ancillary staff work at the home and the local doctors and their Primary Health Teams support Care Homes for Adults (18-65 years) Page 4 of 29 0 53 Over 65 30 0 Brief description of the care home them. Information about the home is available to people who are thinking about moving to the home via the Statement of Purpose, Service User Guide and the last inspection report, all of which are available in the homes reception.. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We went to the home without telling them we were going to visit. This report follows the visit that took place on 22nd April 2009. The visit lasted from 08:00 until 17:00. The purpose of the visit was to make sure that the home is operating and being managed in the best interests of people living there. Information has been used from various sources for this report. These sources include reviewing information that has been received about the home since the last inspection visit. The manager of the home provided information in their Annual Quality Assurance Assessment (AQAA) questionnaire. On this occasion we did not send out surveys to people living at the home or to others with an involvement in the home. During the visit time was spent talking to people who live at the home, relatives, a visiting GP (General Practitioner), nursing and care staff, the manager and an operational manager from the company who was visiting the home at the time of the Care Homes for Adults (18-65 years) Page 6 of 29 site visit. The manager was available throughout the visit and the findings were discussed with her, a team leader and the operational manager at the end of the inspection. At the time of the site visit on 22nd April 2009 the weekly fees for the home ranged from 466 pounds per week for people needing residential care. Additional fees were charged for people needing nursing and one to one care. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations-but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The previous inspection visit took place on 24th April 2007. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Decisions about the use of bedrails could be agreed with the person who is intending using them and/or their representative and this could be recorded. This will help in making sure that people are in agreement with the actions being taken. Concerns about peoples weight loss could be passed on to other health care specialists Care Homes for Adults (18-65 years) Page 8 of 29 at all times. This will help in making sure any neccessary actions are taken quickly in response to concerns. Further improvements could be made to the care planning documentation so that the information in the care plans is more person centred and encourages peoples independence and personal development. People living in the home and/or their representatives could have more involvement in what is written in the care plans. Arrangements could be put in place to make sure that that meals are always served warm. Measures could be taken to develop staff attitides towards positive risk taking. This will help to maintain and develop the independence and personal skills of people living in the home. Information confirming that a satisfactory Criminal Record Bureau (CRB) has been carried out on prospective employees could include details about the level of disclosure undertaken. This will help in making sure the right type of check has been carried out to safeguard people from unsuitable workers. Findings from questionnaires that are sent out to people at the home, relatives and other stakeholders could be made known to people. This will inform people about what the home is doing well and the actions that are being taken to address areas for improvement. 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 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. Good pre-admission procedures are in place so that people who are thinking about moving into the home can feel confident that their needs will be fully met when moving there.. Evidence: The care records of people who have recently moved into the home showed that proper pre-admission procedures had been followed before a decision was made about their suitability to live at the home. Information is obtained from various sources prior to admission. One person had been recently been admitted to the home from hospital and the care records included a care transfer summary from the hospital detailing the persons needs. The manager also carries out an assessment of the persons needs and this includes any risks that the person may present. Since the previous inspection visit attempts have been made to obtain more information about the persons social needs and goals at the pre-admission stage. However, the manager said this could be difficult if people were unwell at the time and had no family. The assessment of needs did consider peoples individual needs. This included information such as whether the person had any preferences about the gender of the staff supporting them with Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: personal care needs. People are invited to look around the home with their relatives if they choose before they make a decision about moving into the home. Some people attend the home for respite care. People living at the home who were spoken with all said that either they or their relatives were given information about the home and had the opportunity to visit the home before moving there. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to live their daily lives as they choose whilst taking into account any risks from this. This is partly supported by the care planning systems although care plan information needs to be more person centred and focused on encouraging peoples independence and personal skills. Evidence: Care records were looked at in all three units of the home. The care plans were well organised and detailed peoples needs and how these are to be met. They included some information about peoples life history and provided information about individuals likes and dislikes with regard to such things as food and activity interests. Staff spoke to had a good understanding of the needs of the people they are looking after. Care plan reviews are regularly held and involve the person where possible, their relatives and others involved in their care. A care plan review had been held for a person with pressure ulcers and the care records showed that the Tissue Viability Nurse had attended the review. People living in the home were happy with the care received. One person said, I am very well cared for. Another person commented It is Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: a lovely home, the care is very good. Whilst the care plans are detailed they need to be more person centred. The care plans tended to focus predominantly on peoples physical needs and more consideration needs to be given to their social and emotional needs. People enjoyed activities and some did their own cooking and washing. However care planning around these areas was limited. In most cases there was little evidence to show that the person or their relative had been involved in the drawing up of the care plan. Each care plan included a comprehensive risk assessment covering areas such as risk to the person from falling, malnutrition and pressure ulcers. Risk assessments were detailed and specific in saying what actions were needed to minimise risks to people and a care plan was put in place to address this. Some people at the home had been assessed as needing bedrails. However, these assessments had been carried out by the nursing team in the home and did not involve the person and/or their representative and relevant others in the decision-making process. This could potentially mean that limitations were being put on people without their agreement. The manager acknowledged this and said she would address this issue so that this aspect of care planning is included within the care plans. People said that they are able to make their own decisions about how they plan their daily routines. People said that they can always have a bath when they want and said that staff are always available to support them with this. One part of the home is now a residential unit. Staff said that some people in this part of the home have the ability to do their own cooking and washing. On being asked how many people were able to do this on their own a member of staff said, No one does this on their own, there is always a staff member with the person. This is done more to reassure staff. The manager acknowledged that some work is needed on developing staff skills in positive risk taking to maintain and develop the independence and abilities and skills of people who are able to do things for themselves. Daily records are kept up to date and reflect the care and support being given. Handover periods take place between shifts so that staff are kept up to date with information about peoples needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a lifestyle that is suitable to their needs. Evidence: The home employs two life skills co-ordinators who seek suggestions from people living at the home and staff about the activities that are provided. People said that they enjoy playing dominoes, knitting and sewing in the home. There are other inhouse activities and opportunities for people to spend time out of the home. One person said, I like going to the pub and to the theatre. Another person talked about how much they had enjoyed a trip to Blackpool and holidays had been planned for later in the year. One person has certificates in their bedroom to acknowledge their achievements in completing an art course at a local education centre. The home has a minibus to help people to access places. The minibus is equipped to accommodate people with mobility problems and is also used to assist people to Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: attend local church services. The home has a library where people can obtain books. One person with visual difficulties spent most of their time in their room and had talking books to listen to. The manager said that the life skills co-ordinators spend one to one time with people including those people who are bed bound. Relatives and friends are encouraged to visit the home as was seen at the time of the site visit. Relatives said they are made to feel welcome. One relative said, staff have humour with me. I find this useful in helping me to cope. At the request of people living at the home, mealtimes vary in each part of the home. In two of the three units at lunchtime there is a cafe style menu with choices of meals such as burgers, sandwiches, jacket potatoes and salads. The menus are on display on the dining tables in picture and written format. People said they enjoyed the food. One person said, the food is beautiful. The menus showed that there are always choices of food and healthy eating options available. Staff could be seen supporting people with their eating in a sensitive and patient manner. Specialist meals are catered for and a person living at the home said that birthdays are celebrated. One person who is bed bound did say that on occasions the food had become cold by the time it had been served to them. This was mainly on a lunchtime when the cafe style meal was being served. Staff did say it could be difficult keeping these meals warm as the meals were transferred from the kitchen into the dining room and by the time all the meals had been served food could have cooled as there was no system in place for maintaining the warmth of the food. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good support with their personal care needs. Overall peoples health needs are well met although action must be taken at all times to make sure concerns are passed onto specialist health care services at all times. Evidence: Staff gave good support with any personal and health care needs and made sure these were carried out in private to respect peoples dignity. The support that people need is documented in the care plans and makes sure the needs of people who use services are properly met. One person who lives at the home said, I am well looked after and other people who were spoken to all said that medical attention is sought immediately if there are any concerns about their health. The care plans contain information about peoples health needs and contact details of professionals that people see. One of the local GPs undertakes a weekly visit to the home to hold a clinic. People at the home can choose to visit the local GP surgery if they wish to do so. People attend appointments for health screening and records of all health care input is well recorded. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Staff said that the relationships and communication between the home and health care professionals continues to improve. A GP who was visiting the home said that the home is good at communicating problems and that they are made aware of any issues. They also commented that any matters raised with management had been responded to appropriately. Overall referrals are made to specialist services as needed. One person who has swallowing and choking problems had involvement from a speech and language therapist. Another person had a care plan for weight loss. The persons weight was regularly monitored and the care records showed that in the past referrals had been made to the GP (General Practitioner) about concerns about weight loss. However, the care records showed that the person had recently experienced further weight loss and this had not been picked up on so these concerns had not been passed on to other relevant health care specialists. A person who is cared for in bed had some instructions on their bedroom wall about a personal exercise programme that had been suggested by a physiotherapist. The persons relative said that their relative was not having these exercises. This was discussed with the manager and staff team who understood that the relative had said they would provide the support needed. The manager acknowledged that this needed to be clarified with the person and their relative in order to make sure that the person received assistance with this aspect of their care. Medication is securely stored and the Medication Administration Records and the Controlled Drugs register were found to be up to date and accurate. There are good systems in place for recording incoming and outgoing medications. A sample check of the supplies tallied with the records. The registered nurses have received training updates in relation to medicine management and practices and procedures are monitored. In the newly opened residential unit the senior support staff are responsible for administering medication. They have received basic training and more advanced external training has been arranged for them. The homes nursing team provide additional support with this. 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. Peoples concerns are properly listened to and acted on and systems are in place and followed to safeguard people from harm. Evidence: The home has a complaints procedure that is on display at the entrance of the home. Some of the details in the procedure needed updating and the manager said she would be doing this. The complaints records showed that all complaints are logged and investigated. The complainant is notified in writing about outcomes from the investigation. All the people spoken to with the exception of one person knew who they would need to speak if they had any concerns and had confidence that any concerns would be properly dealt with. The number and nature of complaints is monitored through the company audit systems. The manager said that the number of complaints has greatly reduced within the last year. Staff are aware of and have access to the local authoritys safeguarding policies and procedures. Incidents that put people at risk had been referred on to the appropriate agencies so that proper procedures could be followed to keep people safe. Staff spoke to had a good understanding of their roles and responsibilities in reporting abuse. Staff receive training about safeguarding people at the point of induction and this is updated annually. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and safe environment that is suitable for their needs. Evidence: The home is modern and purpose built. The home is separated into three different units. One unit on the ground floor (Cygnet Square) accommodates younger adults who need personal and/or nursing care. There are two units on the first floor. The Heron Unit accommodates older people who may need personal and/or nursing care and the newly designed Kingfisher Unit accommodates younger adults who need personal care only. There is level access to the home and a passenger lift to help people to access the building and to encourage their independence and mobility. The bedrooms all have en-suite facilities and are personalised to suit individual tastes. There are communal lounge areas where people can sit and watch television or just sit quietly. The home also has a library area where people can sit and read. There are allocated areas where people at the home and their relatives can make drinks. There is also a designated area where people can smoke. A range of aids and equipment are available to support people with their needs. There are bathing and shower facilities in each unit with walk-in showers and shower trolleys to help people who have mobility problems with their bathing needs. A member of staff said, we can have any Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: equipment we need if it is seen as a benefit to people. A number of areas in the home have been redecorated and people commented that this had made the environment brighter and more comfortable. People at the home commented on how they liked living there. One person said, the home is lovely and I like my bedroom. People could have their own bedroom key if they chose to and the risk assessment supported this. The home was very clean throughout and at the time of the visit there were no odours. Bathroom and shower areas were spacious and equipment was being stored in an appropriate way so it did not limit the amount of space in bathing areas. Oxygen was being used in some parts of the home. Where this was the case this was clearly indicated on doors and other appropriate measures had been put in place to minimise any potential risks to people from this. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Evidence: Staffing rotas are now planned around three different units in the home. People who live in the home with the exception of one person and all staff spoken to said that there are sufficient staff on duty at at all times to meet peoples needs. One person said, staff are always available if you need them, and people commented that call bells are usually responded to promptly. Staffing turnover has reduced and no agency staff are used by the home. This enables people to receive consistent care from staff who have a good understanding of their needs. Recruitment is properly managed by the home, interviews are held and references and CRB (Criminal Record Bureau) checks are obtained before someone starts working at the home. Following interview candidates are introduced to people living at the home so that their ability to interact with people can be demonstrated. In one case a verbal reference had been obtained for a prospective employee and the manager confirmed that a letter has been sent to the referee to confirm the reference in writing. The home receives written verification confirmation from head office about CRB disclosures that have been undertaken on prospective employees. This information should include Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: the level of disclosure that has been carried out. Staff said they receive good training and have annual updates. All new staff undertake a full induction and have a thirteen week probationary period. Induction training is based on the Skills for Care programme. At the end of their probationary period staff have an interview to determine their level of learning. The home has had problems with their previous NVQ (National Vocational Qualification) provider so the majority of staff do not hold NVQ. Because of problems with the previous NVQ provider, the company has now become accredited as an NVQ provider and it is envisaged that more staff will undertake and complete the NVQ programme as a result of this. Staff said that the home is continuing to improve. One staff commented the home has improved and this has been helped by staff changes which have helped to boost staff morale. Another staff member said, colleagues now work as a team. Staff have regular supervision and staff meetings take place although the manager did say that these need to be more regular. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the best interests of people living at the home and proper attention is given to maintaining their health and safety. Evidence: The registered manager is a qualified nurse who has now completed the Registered Managers Award to develop her management knowledge and skills in running the home. People living at the home and staff were complimentary about the way the home has progressed under the managers leadership. One staff member said, The manager is very approachable. We can contact her at any time for support. Team leaders have now been appointed in each unit of the home. This provides support to the manager with the running of the home. There are systems in place to assess and monitor the quality of the services being provided. The home has an ongoing programme of internal and external audit to look at different aspects of care and to make any necessary improvements. Annual satisfaction questionnaires are sent out to people using the service, relatives and other stakeholders to seek their views and opinions about the care and services on Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: offer. Findings from the information received back are currently not made known to people and this was discussed with the manager. Meetings are held with people at the home, relatives and staff to involve them in decision making about how the home is run. Information received from the manager in the AQAA (Annual Quality Assurance Assessment) before the site visit confirmed that all the necessary health and safety checks are up to date. Staff attend a range of health and safety training and this is regularly updated. The audit systems include checks in different areas of health and safety. The manager has carried out a fire risk assessment of the premises. This provided good information about the control measures that are in place to minimise risk from fire. Following discussion the manager will be including the use of oxygen in the home as part of this risk assessment. Care Homes for Adults (18-65 years) Page 25 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 15 Bedrail risk assessments 31/05/2009 must be carried out with the involvement of the person who is being assessed to use them, relatives and relevant others. This will show that people are in agreement with the actions being taken. 2 19 13 Concerns about peoples 28/05/2009 weight loss must be referred to the relevant health care specialists so that they can consider whether any further advice and guidance is needed. This will help in making sure that peoples health and nutritional needs are fully met. Care Homes for Adults (18-65 years) Page 27 of 29 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 6 Care planning information should include more information about interventions that are to be used to develop peoples independence and personal skills. Care plans should be further developed to include more person centred information about people and their wishes and should evidence that people living in their home, relatives and relevant others have been involved in this process. Arrangements should be put in place to develop staff attitudes towards positive risk taking in order to encourage peoples independence. Arrangements should be put in place to make sure that cooked meals are always served warm. More staff should undertake and complete NVQ level 2 award in care. This will help in making sure that people at the home receive care and support from staff who have the up to date skills and knowledge to meet their needs. The information within the CRB (Criminal Record Bureau) disclosure verification confirmation should include the level of disclosure that has been carried out. This will help to confirm that the correct type of check has been undertaken on each prospective employee. The findings from questionnaires that have been sent out to and received from people at the home, relatives and other stakeholders should be made available to those people and any other interested parties. 2 6 3 9 4 5 17 32 6 34 7 39 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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!