Care Home: Fairways

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What the care home does well All people at the home had received an assessment with regard to the Mental Capacity Act with reference to deprivation of liberty. This information was clearly documented in their files. Fairways is an appropriate environment to the specific needs of this resident group. The space and style of the all ground floor accommodation suits the needs of these residents. The garden is well maintained, safe and full of interest for the residents. Staffing levels have been consistently good to meet the needs of the residents. What has improved since the last inspection? The service has worked hard to improve this care facility and much progress has been made. The outcome of which will be an improved experience of care and support for the resident group at Fairways. Developments include: The majority of placing authorities have recently been reviewing their residents at this home to ensure that the service is appropriate and able to meet their residents needs. We are pleased to see that care plans have developed consistently based around individual needs and choices. The new care plans set out key areas for staff to be aware of such as self neglect and personal hygiene, social integration and inclusion or aggression and self harm. These plans for staff to follow had appropriate instruction that took account of individualism, choice and abilities to make decisions. Since our key inspection of Fairways the knowledge and understanding of the local policy and procedure for dealing with safeguarding of adults from abuse has developed. We have seen the management of this service take matters very seriously and they have attended and participated in joint working processes to protect vulnerable people. Measures have been put in place within the home to ensure the ongoing safety and welfare of all the residents. We met the cook and found that they knew the individual residents well and were aware of their preferences in terms of any special diets, cultural needs and dislikes. Based upon on this information new menus had been developed that included culturally diverse foods. Fairways was light, airy and clean. This is because the home has undergone a deep cleaning process and the tints on windows have been removed. Natural day light is now able to come directly into the home. We were pleased to see that all staff had received training in infection control, fire safety awareness, Emergency First Aid, Moving and Handling, Food Hygiene, Health and safety at Work, Using Chemicals ( CoSHH) and Equality and Diversity, Safeguarding Vulnerable Adults, and and introduction to Mental Health Acts. What the care home could do better: People living at the home will find that medication procedures have improved and now offer better protection, but further development is needed to ensure as much protection as is possible. This included ensuring the medication fridge was locked. That creams are dated when opened so staff know when these need to be replaced. And finally the home needs to receipt medication in order that an audit is possible. The manager should audit medication and formally record their findings to enable medicines to be accounted for and promptly identify and resolve any discrepancies that may arise. A lack of consistency and follow up in health matters could potentially place people at risk. We found 2 incidences of health appointment being arranged and no record of the outcome was made in residents notes to ensure any follow up of other medical treatment or instruction to staff. There is information available about this home, and we believe it could be more informative. We have detailed in the previous 2 reports the improvements that should be made and at this inspection we found no further improvements. At this key inspection we found that a clinical psychology assessment had not progressed since November 2009 and Fairways were no clearer about a firm diagnosis to plan care needs for the future of this person. We looked at the community access for people and found that the home do have a lack of staff able to drive the mini bus. Currently one care staff, the manager and the cook drive therefore this needs to be addressed to enable easier planning to take people out. Key inspection report Care homes for adults (18-65 years) Name: Address: Fairways The Fairways Fuller`s Field, Swan Lane Westerfield Ipswich Suffolk IP6 9AX     The quality rating for this care home is:   one star adequate 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: Claire Hutton     Date: 1 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Fairways The Fairways Fuller`s Field, Swan Lane Westerfield Ipswich Suffolk IP6 9AX 01473214966 01473214997 manager-fairways@careaspirations.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cambian Learning Disabilities Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 8 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 8 The registered person may provide the following categories of service only: Care Home only - Code 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 Fairways Residential Home is situated in a residential area of the village of Westerfield on the outskirts of the town of Ipswich. The home was first registered in April 2004 and offers care and accommodation for up to eight service users who have a learning disability coupled with challenging behaviour. Fairways is owned and administered by Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 2 4 0 7 2 0 0 9 Brief description of the care home Care Aspirations, a specialist independent healthcare provider, established in 1986, who provide residential care and private hospital services for adults within this service user group. During the visit the inspector was informed that the fees for the home range from £1283 to £2607 per week dependent on the care that each resident required. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection, which focused on the core standards relating to care homes for Adults (18-65). The inspection was unannounced on a weekday, which lasted 6.5 hours. This report has been written using accumulated evidence gathered before and during the inspection, including information obtained from notifications, improvement plans and a random inspection completed on 5th November 2009. We (CQC) also assessed the outcomes for the people living at the home against the Key Lines of Regulatory Assessment (KLORA). A tour of the premises was made and a number of records were inspected, relating to people using the service, staff, training, the duty roster and medication. Time was spent talking with and observing people who live in the home and members of staff. Their comments are included in this report. The manager of this home was present Care Homes for Adults (18-65 years) Page 6 of 29 during this inspection and participated fully, he also received comprehensive feedback at the end of the inspection along with his colleagues, a Senior Manager within Care Aspirations and the newly appointed manager. Since our Key inspection to the home a new manager had been appointed. He had the relevant qualifications and experience to manage this home. However at this inspection we were told that this person was not to become registered with us as they were moving on to a different job elsewhere. A full time manager from another of Care Aspirations Homes was to take his place. 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: People living at the home will find that medication procedures have improved and now offer better protection, but further development is needed to ensure as much Care Homes for Adults (18-65 years) Page 8 of 29 protection as is possible. This included ensuring the medication fridge was locked. That creams are dated when opened so staff know when these need to be replaced. And finally the home needs to receipt medication in order that an audit is possible. The manager should audit medication and formally record their findings to enable medicines to be accounted for and promptly identify and resolve any discrepancies that may arise. A lack of consistency and follow up in health matters could potentially place people at risk. We found 2 incidences of health appointment being arranged and no record of the outcome was made in residents notes to ensure any follow up of other medical treatment or instruction to staff. There is information available about this home, and we believe it could be more informative. We have detailed in the previous 2 reports the improvements that should be made and at this inspection we found no further improvements. At this key inspection we found that a clinical psychology assessment had not progressed since November 2009 and Fairways were no clearer about a firm diagnosis to plan care needs for the future of this person. We looked at the community access for people and found that the home do have a lack of staff able to drive the mini bus. Currently one care staff, the manager and the cook drive therefore this needs to be addressed to enable easier planning to take people out. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about Fairways does not allow people to make an informed choice about what is on offer. Majority of assessments are completed enabling the service to confidently decide they can meet residents needs, however lack of access to specialist assessment is potentially placing people at risk. Evidence: There is information available about this home, and we believe it could be more informative. We have detailed in the previous 2 reports the improvements that should be made and at this inspection we found no further improvements. The majority of placing authorities have recently been reviewing their residents at this home to ensure that the service is appropriate and able to meet their residents needs. We saw evidence of this and the resulting developments from these reviews. We were concerned about one individual whose needs had changed considerably. On our previous visit at the random inspection we found that an assessment had been Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: completed and that there were plans to refer the individual for a further assessment with a clinical psychologist and involve the intensive support team at Walker Close. This is a specialist health team for adults with a learning disability. However, at this key inspection we found that this additional assessment had not progressed and Fairways were no clearer about a firm diagnosis to plan care needs for the future of this person. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to have care plans that reflect their lives and personal goals. They can also be supported to take risks, which will enable them to lead positive lives. Evidence: At the last key inspection of this service we found care plans were not clear how to meet individual needs. However at the random inspection in November 2009 we found the one care plan we had main concerns with did reflect good, clear instructions to staff. The plan was respectful to the individual and it ensured that others as well as the individual were protected. The plan explained the use of basic Makaton to aid communication and contained appropriate risk assessments around inappropriate sexual behaviour and gave a consistent message to staff on how best to deal with matters when they arise, but also how to prevent such occurrences. We re-examined this care plan at this inspection along with looking at other care plans and associated documentation. We are pleased to see that care plans have developed consistently based around Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: individual needs and choices. The new care plans set out key areas for staff to be aware of such as self neglect and personal hygiene, social integration and inclusion or aggression and self harm. These plans for staff to follow had appropriate instruction that took account of individualism, choice and abilities to make decisions. Each plan had individualised risk assessments. Staff spoken with said plans were updated quickly and provided enough information for them to support people appropriately. All people at the home had received an assessment with reference to the Mental Capacity Assessment with reference to deprivation of liberty. All reached a similar conclusion that it was in the best interests of the individual to have their liberty restricted, to enable the individuals to be safely cared for and supported. 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. Residents are supported to have fulfilling opportunities both within the home and wider community. Residents receive meals that are nutritious and suitable to meet dietary and cultural needs. Evidence: The plan of care and support for one individual in relation to social integration and inclusion set out the objective to have a minimum of 2 meaningful trips out into the community per week. This is an appropriate objective to set. We looked at the community access for people and found that the home do have a lack of staff able to drive the mini bus. Currently one care staff, the manager and the cook drive therefore this needs to be addressed to enable easier planning to take people out. However people were still able to go out and we found that over the previous weekend all residents had a trip out either to Felixstowe or to Rendlesham forest, which ever their preference was. Regular swimming sessions had been arranged at a private pool for 2 Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: people as well as access to Genesis a local day centre. Staff spoken with said that residents do get out and about, but it takes planning to have drivers on shift, and residents are supported to go out for a walk in the local community whenever they liked. Whilst we were there residents were seen to go out for a walk and there was a music session. The self contained snoozelem area was not in use during our visit, but is a resource staff and residents have use of when needed. Each individual has a routine to their day, but there are no rigid schedules of time to get up and go to bed. The atmosphere is relaxed with residents getting up when they are ready and they were seen to be supported accordingly. Some residents did participate in simple chores such as putting their laundry away. The main meal of the day is at lunch time. This is prepared by a cook. We met the cook and found that they knew the individual residents well and were aware of their preferences in terms of any special diets, cultural needs and dislikes. Based upon on this information new menus had been developed that included culturally diverse foods. Also once a month the residents were able to choose from Indian and Chinese take away. The menu is well balanced and provides appropriate nutrition as well as choice. Food is bought from local supermarkets on a weekly basis and therefore is fresh and domestic in scale. 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 adequate 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 home will find that medication procedures have improved and now offer better protection, but further development is needed to ensure as much protection as is possible. A lack of consistency and follow up in health matters could potentially place people at risk. Evidence: We would expect support plans to identify the health and personal care needs of the residents and their preferences of how and when they require staff support. We found good evidence to show that residents had their personal care needs met and the residents looked well groomed with appropriate clothing that reflected them as individuals. Staff have also received training in First Aid. At the last inspection we were told of the development of health action plans and how these would enable the service to ensure all health matters from routine screening to ongoing support with known health issues were actively being managed. However we did not see any development in completing these for each resident. We tracked one Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: individual and found that they had attended an appointment with the psychiatrist, however the details of the consultation were not recorded, therefore staff are unaware of any action they should be taking as a result of the consult. The same person had also been contacted about a swine flu vaccination as they were eligible to receive this injection. The date that this was due and when the medical professionals called was examined in the daily notes, but once again no record of the event was made by staff. In addition, relevant to this section is the concerns raised with the lack of follow up on the referral to a clinical psychologist. This lack of consistency and follow up in health matters could potentially place people at risk. At the last inspection of this service we made 8 requirements relating to medication. We are very pleased to see that there is considerable improvement in the management of medication. A new medication system called biodose has been introduced. The drug sheets included full written directions for staff, a photo of the medicine to be administered and medicines are already in the pots to administer. We observed staff administer medication and found this process to be satisfactory. We found that medication times had been altered and now reflected more accurately when people received their medication. We found that for people prescribed PRN (as required) medication was clear guidance as to its use. For one person who we saw had covert medication a mental capacity act assessment had been completed and a letter obtained from the GP to demonstrate that staff who acted in giving medication covertly were acting in the best interest of the individual. We did not find any expired or no longer used medication - this had been returned to the pharmacy. The drugs cabinet was being replaced and 9 staff had received training. We were able to view their certificates. Mangers were participating in drug rounds and had developed micro teaching sessions on medication to ensure ongoing competence and compliance with the homes policy and procedure. There has been considerable development, but there still were issues that we found that need to be addresses. This included ensuring the medication fridge was locked. That creams are dated when opened so staff know when these need to be replaced. And finally the home needs to receipt medication in order that an audit is possible. The manager should audit medication and formally record their findings to enable medicines to be accounted for and promptly identify and resolve any discrepancies that may arise. 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. Residents are protected and listened too and their concerns are taken seriously. Evidence: Since our key inspection of Fairways the knowledge and understanding of the local policy and procedure for dealing with safeguarding of adults from abuse has developed. We have seen the management of this service take matters very seriously and they have attended and participated in joint working processes to protect vulnerable people. Measures have been put in place within the home to ensure the ongoing safety and welfare of all the residents. This has included reviewing of care plans and risk assessments and changes in staffing levels to provide one to one support for one resident currently who needs the support. Staff have attended training on recognising and responding to abuse. On the staff room wall we saw current high profile policies and procedures that staff had signed to say they had read. This included the Suffolk Policy on responding to Adult Safeguarding in Residential Care Homes Whistle Blowing Accident and Emergency Emergency On Call and The Mental Capacity Act 5 Key principles. The manager told us that 2 senior staff had also attended the local authority safeguarding training. We spoke to them about any differences between their organisations training and that provided by the local authority. We were pleased to hear it was very similar and gave the same messages to staff. The manager told us he Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: was confident that staff know the local policy and procedures and would follow them should the need arise for a safeguarding referral to be made. Since the random inspection we have been kept informed of developments regarding safeguarding referrals and have found that incidents that previously would not have been referred and investigated have been taken seriously and reported. This keen action has ensured that the vulnerable people living at the service are being protected. There is information about how to make a formal complaint and staff spoken to were aware of this. Staff believed it was their duty report any changes in behaviour or concerns they had on behalf of the resident group, thus enabling the residents concerns to be taken seriously. 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. Fairways provides and environment that is clean, well maintained and pleasantly decorated. It is appropriate to the specific needs of this resident group. Evidence: Fairways was light, airy and clean. This is because the home has undergone a deep cleaning process and the tints on windows have been removed. Natural day light is now able to come directly into the home. There has been redecoration and replacement of furniture. There were some lovely large bold pictures of nature that made the home feel modern and relaxed. The home is well maintained, which can be a challenge given the potential for fittings and furniture to break as the environment is well used. The entrance hall was much improved and inviting to visitors. The space and style of the all ground floor accommodation suits the needs of these residents. The garden is well maintained, safe and full of interest for the residents. 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. Residents can expect to be supported by a staff team that are trained and have the skills and knowledge to care for them. Staff are well recruited and in sufficient numbers to meet residents needs. Evidence: We looked at the previous 2 weeks rosters and found that there were sufficient staff on duty. We found 5 staff on days and 2 staff on nights. There was also a clear record of time spent on a one to one for an individual to ensure they and the other residents were safe from harm. We examined the recruitment records for recently recruited staff and found that all the required checks set out in regulation had been met before the person started work. The person also received induction training including control and restraint before they started work. The first week they started work was as an extra staff member and they told us they shadowed other staff to get to know residents routines and preferences. The staff member said the week was valuable as they were able to develop relationships with residents to gain their trust and understanding. Since our key inspection all staff have received a 2 day intensive refresher training. This included first aid training and how to complete incident and accident report forms. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: We looked at the recording in place and found that records kept were in order and a system of logging and tracing a form was able to be used with ease. The records we saw were good and no serious incidents or accidents have occurred since our last visit to the home. We were pleased to see that all staff had received training in infection control, fire safety awareness, Emergency First Aid, Moving and Handling, Food Hygiene, Health and safety at Work, Using Chemicals ( CoSHH) and Equality and Diversity, Safeguarding Vulnerable Adults, and and introduction to Mental Health Acts. Some staff had training on The Mental Capacity Act. In addition to this formal training the manager had introduced micro teaching sessions. these were short session with staff based around either a procedure or a practice session e.g. Makaton. The manager kept note of each session with who had attended. The manager agreed to finding training on epilepsy and autism, both of which are relevant with this resident group. All staff vacancies within the home have now been filled. Supervision of staff was discussed and currently staff receive group supervision. Staff feel well supported by the manager, but the home do need to develop regular, formal recorded supervision that occurs at least 6 times a year. 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. Residents can expect to live in a home that is effectively managed and protects their health, safety and welfare. Evidence: Since our Key inspection to the home a new manager had been appointed. He had the relevant qualifications and experience to manage this home. Staff told us that they felt very supported by the manager and welcomed his knowledge and sharing approach to managing and developing the care home. However at this inspection we were told that this person was not to become registered with us as they were moving on to a different job elsewhere. A full time manager from another of Care Aspirations Homes was to take his place. We therefore await an application for a manger to become registered for Fairways. We found that the manager had ensured that significant progress has been made on the requirements we had made. The outcome of which will be an improved experience of care and support for the resident group at Fairways. We had regular contact with management of this home and were provided with improvement plans that showed Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: how the service planned to improve. These actions have enabled this service to move from a poor rating to adequate. When we asked how the service ensures quality and involves residents views we were told about an advocacy service that is involved with the residents. A representative was recently at the home and attended reviews. In addition there is an annual survey completed by peloton consultancy who survey and obtain the views of relatives and professionals involved in the home. In relation to to day to day quality the home had a process of regular health and safety checks that are completed by staff and recorded. We sampled these records and found that all checks for November and December had been completed. We also saw a regular record that showed all hot water outlets were recorded to ensure the hot water did not pose a scald risk to residents. 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 1 14 The service must ensure residents assessments are kept under review and access specialist assessments. This will determine if they are able to continue to meet the needs of one individual. 01/04/2010 2 19 17 The health care needs of residents must be recognised, monitored and appropriate recordings made. This will ensure potential complications are identified and dealt with at an early stage. 03/05/2010 3 20 13 The manager should audit medication and formally record their findings. This will enable medicines to be accounted for and promptly identify and 03/05/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 resolve any discrepancies that may arise. 4 20 13 The home needs to receipt medication and keep a record of all medication coming into and leaving the home. This will ensure that an audit is possible. 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 03/05/2010 1 13 The choice of transportation for the residents is a homes mini bus, however there is a lack of people able to drive this vehicle, therefore serious consideration should be given to solving how residents access the wider community. Creams must be dated when opened so staff know when these need to be replaced. The medication fridge must be locked to ensure the security of medicines. The home needs to develop regular, formal recorded supervision that occurs at least 6 times a year. 2 3 4 20 20 36 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. 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