Care Home: Falcons Rest

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What the care home does well The home is careful to ensure it could meet the needs of new people properly and that they would fit in with the current residents before they move in. Residents each have a plan showing their care needs, wishes and goals. Plans help staff to know the support they need to meet their care needs and achieve their goals. Residents can make choices about their lives and what they do every day and staff respect their individuality. People are encouraged to express their views and concerns. Staff enable residents to take part in activities they like and go out in the community. They also support them to maintain contact with their families and friends. Residents receive good support with their health and personal care. Staff also manage their medicines safely in the home for them. Falcons Rest gives residents a safe, very comfortable and well kept home. It has good access and is suitably adapted and equipped for people with mobility difficulties. Staff are trained about how to keep the home and people safe and people`s special needs. This helps them protect residents, understand and meet their needs better. What has improved since the last inspection? The home has involved staff and professionals who work with the home more in the assessment process for possible new residents. This means that all staff know about people and the support they will need before they move in. Staff have a clearer role as a keyworker. This means residents have more individual support and their plans better reflect their current needs and goals. The home has made efforts to arrange a wider range of activities for residents. These include therapies and accessing facilities in the community. Residents have a health action plan showing their health needs and issues so staff can monitor their health and support them to stay well. The home has more input from health care professionals and to help staff manage residents` special needs better. Staff received training to help them understand their responsibility and know how to report any concerns about residents` safety and welfare and so protect them. Staff have completed more training relevant to safety and residents` specific needs. This should give them more knowledge and skills necessary to do their job better. Staff receive individual supervision and team meetings are held more regularly. This helps staff to be kept informed and supported and meet the aims of the service better. What the care home could do better: It is good that the manager recognises that the service should continue to improve and develop, as residents wish and their representatives wish. The home`s plans for the next 12 months, such as staff having more training and achieving a social care qualfication, will therefore be beneficial to current and future residents of Falcons Rest. Key inspection report Care homes for adults (18-65 years) Name: Address: Falcons Rest Wormelow Herefordshire HR2 8EQ     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: Christina Lavelle     Date: 0 8 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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: Falcons Rest Wormelow Herefordshire HR2 8EQ 01981541002 01981541002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Voyage Care Ltd care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accomodated is 14. The registered person may provide the following category 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 (LD) 14 Date of last inspection Brief description of the care home Falcons Rest was registered as a care home in August 2008. The provider Voyage is part of a larger organisation running care services across the United Kingdom. It has provided residential, nursing and supported living services for 20 years. People using Voyages services have complex needs and may use challenging behaviours. People living at Falcons Rest must need accommodation with personal care because of learning disabilities. They may also have physical disabilities and/or sensory impairments. The home is in the village of Wormelow, seven miles from Hereford city. It is close to main roads leading to Hereford, Ross on Wye and Monmouth and on a bus route into Hereford. The home was purpose built and has two seperate buildings within a large Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 14 1 9 0 1 2 0 0 9 Brief description of the care home central courtyard. One building Falcons Rest has two floors and can accommodate six people and the other Poachers Cottage is all ground floor for eight people. Both have good sized single bedrooms with ensuite wet room facilities. They have large kitchen and dining areas, separate sitting rooms, activities rooms, assisted bathrooms for everyone to use. Poachers Cottage also has a room with sensory facilities. Information about the service is provided in a statement of purpose and service users guide documents. The guide is available in a user friendly format with pictures. The fee for the service is based on individuals assessed needs, as agreed between Voyage and their funding authority. Additional charged are made for such as personal clothes and toiletries, electrical items, certain activities outside the home and meals out over and above the homes allowance. People who do not have their own vehicle are also expected to contribute to transport using their mobility allowance. Any extra costs should be specified in peoples service agreement and contracts. 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: This is a key inspection of the service provided by Falcons Rest. This means all the standards that can be most important to people using care services are assessed. People using this service are called residents and are referred to as such in this report. We, the commission, used a range of evidence to make judgments about the quality of the service. This included visited the home for seven hours during one day without telling the manager, staff or the residents beforehand. We discussed how the service is being run, changes made since the last inspection and plans to improve the service with the manager Ms Kimberley Hewins. We also spoke with three care staff individually to ask them about their role, training and support. We spoke with one resident but were not able to talk to any other residents directly because of their communication difficulties and so we observed their activities and Care Homes for Adults (18-65 years) Page 6 of 29 interactions with staff. Surveys were sent out asking peoples views of the home, which were returned by one residents family, two social or health care professionals and one support worker. We looked at some records that homes are required to keep about people using their services, staffing and other aspects of their service. We also had a tour of all the communal areas and some residents bedrooms in the two buildings. An annual quality assessment form (AQAA) had been completed by the home, as required. The AQAA asks managers to say what their service does well and could do better, what has improved in the last 12 months and about their plans for further improvements. All other information we received about the home since the last key inspection is also considered. This includes events that had affected the health, welfare and safety of people in the home (we call these notifications). 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: It is good that the manager recognises that the service should continue to improve and develop, as residents wish and their representatives wish. The homes plans for the Care Homes for Adults (18-65 years) Page 8 of 29 next 12 months, such as staff having more training and achieving a social care qualfication, will therefore be beneficial to current and future residents of Falcons Rest. 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. People can be confident that the home could support them. This is because a full assessment will be made of their needs so the home knows about their needs and wishes by involving them and people close to them in their assessment and admission. Evidence: Voyage has comprehensive assessment and admission procedures for staff to follow before people use any of their care services. This involves referrals being made by local authority care managers to Voyages Referral and Assessment manager. If a suitable placement is identified they will contact the service manager The AQAA states potential residents, their family, representatives, professionals such as speech and physiotherapists and staff are involved and a transition plan devised to ensure peoples needs can be fully met and the environment is suitable. Their families are also given information about the home such as the service users guide. We looked at the care records of one resident who had moved into the home recently and discussed their admission with the manager and staff. It is evident that a full Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: assessment of their needs was carried out. This included the manager and staff spending time with them and their former staff team getting to know them and their support needs. Information was also obtained from the persons family and involved professionals, which included about their likes, dislikes and preferred routines. It is good that speech therapists and physiotherapists also worked with home staff so they would know about the individuals ways of communicating and their mobility needs. We confirmed the prospective resident visited Falcons Rest over a few weeks before their trial stay of three months was arranged. One of their parents stayed overnight at the home with them when they first moved in. Staff feel residents transitions are carried out well and say they know all about people before they move in. The manager told us that potential residents compatibilty with people already living at the home is also always considered, as it should be. Some people referred having not been offered a placement because they did not fit in with the current resident group. A review takes place after a three month trial stay to ensure the home is meeting the new persons needs with them, their family, representatives and staff involved. If the placement is deemed suitable a residency contract and service agreement are produced by Voyage and these documents and a contract with their funding local authority are agreed by relevant parties. 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 needs are met and they all have a plan of their care, which they and their representatives are involved in making and reviewing. Staff enable residents to make choices in their daily lives and safety risks are assessed so they can be minimised. Evidence: Each resident has a detailed care plan showing all their current needs, strengths, preferred daily routines, likes/dislikes, interests and goals. Plans are based on their needs assessments and are appropriately person centred. This means that they focus on the individual and how they can be supported to make choices and achieve their goals. Needs associated with such as particular disabilities and gender are included. The home and residents plans include detailed information about residents communication. Voyage employs a speech and language therapist to as the AQAA states develop communication and encourage participation. Techniques used by staff include pictures, objects of reference and smells and they have received training on communication and sensory impairments. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Staff aim to enable residents to choose what they do each day and make other lifestyle choices, although this can be limited because of their disabilities. One health care professional comments that staff provide sensitive care to individuals. Keyworkers from the staff team are allocated or chosen by residents. They spend more time with them, arrange activities and liaise with their family and health care professionals on their behalf. Staff we spoke with are clear about the role of key workers and take this responsibility seriously and advocate for residents when needed. They write monthly reports summarising issues, their health and progress to achieve identified goals. One residents family comments in their survey excellent keyworker. Relevant risk areas for each resident are assessed with input from health care professionals such as physiotherapists. These cover generic areas such as fire safety but are also individualsied to include such as bathing protocols, detailed moving and handling assessments and pressure sore prevention. Management plans are in place as a result, which should ensure that staff manage residents physical needs and difficulties more effectively and consistently. 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 treated as individuals. They take part in activities that reflect their personal interests, go out in the community and are supported to live their chosen lifestyle. Staff also enable them to maintain links with their family, friends and representatives and provide healthy meals they like and that meet their special needs. Evidence: The home clearly recognises that residents should be encouraged to develop their social and daily living skills. Although for most people the nature and level of their disabilities makes it difficult for them to be involved in work related activities staff seek educational, social and leisure opportunities. They support them to participate as much as possible in household tasks, activities and go out in the community. Plans show residents interests and they all have a weekly activities planner. These include using sensory facililties, hydrotherapy and special swimmimg facilities and Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: other therapies such as physio and massage. They also go shopping weekly for their personal stuff and on individual outings and holidays with their keyworkers. A daily checklist shows what people have done and where they have been. Falcons Rest has a sensory room and two activities rooms. Sessions are arranged such as music, painting and crafts and things produced are displayed around the home. Involvement in domestic tasks and cooking are part of peoples regular routines and can be helping or just observing staff prepare and cook meals, clean their bedrooms and do their laundry. The home has two assisted vehicles and two residents have their own cars to provide transport out in the community. Staff comment that sometimes lack of staffing can effect their capacity to take residents out as often as they would like. Residents do also go to the local shop and pub and one of the staff designated as activities organiser looks out for local events such as fetes and cricket matches they can attend. Staff support residents to maintain their family links. Relatives are also fully involved in their admission and care reviews. One relative indicating in their survey that they are always kept up to date about important matters. Staff make people welcome in the home and arrange social events and parties when people from other local care homes, family and friends are invited. Regarding food provided staff keep individual food diaries for residents. They know what people like and have compiled a list of ltheir ikes/dislikes with family etc. Weekly menus are drawn up, which show a range of wholesome homemade meals. There are recipe cards to help staff with the cooking and shopping is done twice a week so food is fresh. We saw food stocks included a lot of fresh fruit and vegerables, cereals and other healthy products. Staff say they aim to promote healthy eating. One resident needs a specific diet and had a nutritional assessment with very detailed guidance in place. The home takes advice when needed from a dietician and provides assistance residents need. This support and aids for eating and drinking are provided. We saw staff assisting people in a sensitive way whilst eating a meal with them, which was a relaxed social occasion. 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. Residents receive personal care from staff in ways they need and prefer. Their health needs are met and whenever necessary the home has procedures for staff to follow. Residents medicines are managed safely in the home by staff on their behalf. Evidence: Residents plans show the personal care they need and their preferred daily routines. Individual protocols are in place for any special support they may require, especially as most people need a lot of input because of their complex and profound disabilities. This includes in relation to their mobility, diet and condition with such as exercises (shown in pictures), communication, prevention of pressure sores and epilepsy. The home is adapted for people who may be wheelchair users and aids and equipment are provided. Staff are all trained in moving and handling and how to use hoists and the use of bedside rails is risk assessed with health professionals, as required. Staff are supported in their practice by working closely with physio and speech/language therapists and most staff have received relevant training. One health care professional confirms in their survey that residents health care needs are always properly monitored, reviewed and met and that their advice is usually sought and acted on. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: We saw in residents care records that there is detailed information about their medical condition and health care needs. They each have a separate health action plan and the home is also working to set up end of life plans. Their plans cover all relevant aspects of their physical and emotional health and include procedures to help staff effectively manage behaviours that could be challenging or self harming. Residents access health care from the local GP surgery and their keyworkers arrange and support them to attend routine and specialist health care appointments such as the dentist. The home is also arranging well person checks. Records are kept of all medical input sought and treatment etc that individuals receive. Residents daily reports are also used to identify and monitor their health care problems as they arise. Where necessary records are also made about physical checks staff carry out such as their weight and diet/fluid intake. Voyage provides a clear policy and procedures for staff in their care services for managing peoples medicines. We saw the homes policy for residents medicines, which appropriately includes for homely remedies and when medication and creams can be administered as and when required. Residents plans also show all their prescribed medicines with information about their purpose for staff. We checked and noted that records of medicines kept, administered and disposed of are being maintained properly and medication audits carried out. There are suitable and secure storage arrangements for medicines in the home. Staff designated to administer have undertake formal training for safe handling medicines and they are not allowed to do so until their competence has been assessed by management. 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 can express their views and if they have any concerns about the service they also know how to complain and are confident that they will be listened to and dealt with. The home safeguards residents from abuse, neglect and self harm and takes action to follow up any allegations. Evidence: Voyage provides a formal written complaints procedure. This is also available in a user friendly format with details of advocates and other people that will support residents. Each resident has a copy of the procedure in their care records; their family have been given a copy and they are also available in the entrance hall of the home. The home appropriately keeps a record of complaints showing details of concerns raised and actions taken. One resident told us he is aware of and has used the complaints procedure and now meets with the manager monthly to discuss any issues. One residents relatives confirms that they know about the complaints procedure and any concerns they have raised have been dealt with appropriately. Staff also say they would know what to do if any concerns are raised with them and feel confident that any issues or concerns about the welfare of residents would be dealt with properly. Policies and procedures on recognising abuse, protecting vulnerable adults, whistle blowing and managing residents finances are provided. Staff receive instruction on Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: adult protection as part of their induction and through a Voyage interactive computer training programme. Most staff have recently training on safeguarding vulnerable people through Herefordshire Council and know how to report any incidence or suspicion of abuse or neglect under multi-agency safeguarding procedures. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a safe, well maintained and equipped environment that suitably needs their needs. The home is pleasant, comfortable and kept clean and hygienic. Evidence: Falcons Rest is located in the village of Wormelow, which is about seven miles south of Hereford city. There are main roads nearby into Hereford and the towns of Monmouth and Ross-on-Wye and it is on a bus route into Hereford. The village has a shop, post office and a pub that are within walking distance of the home. Falcons Rest was purpose built to a high standard. The buildings are constructed in an eco friendly way using sustainable materials; having such as sensor operated lights and a water recycling system. The home is situated in a courtyard in the same large grounds as another Voyage care home and a supported living complex. It has its own garden and parking areas with ramps and patio areas offering easy access. The home comprises of two buildings, one called Falcons Rest and the other Poachers Cottage. Poachers Cottage is all on the ground floor and has eight bedrooms. Falcons Rest has two floors with a lift and six bedrooms. Both houses have a large sitting rooms, open kitchen/dining araes, seperate activities Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: rooms and assisted bathrooms for everyone to use. The corridors are wide and there are grab rails, tracking hoists, other aids and equipment provided. Accommodation is open and spacious so providing plenty or room for wheelchair users. Poachers Cottage also has a room with sensory facilities. Bedrooms are all a good size with en-suite toilet and wetroom showers. We saw that bedrooms are being well personalised and equipped as each of the residents needs and likes. Our impression of the homes environment is bright, comfortable and very pleasant and that the furniture, decor, fittings and equipment are of a high quality. We also noted that all areas visited were clean, tidy, fresh and airy. The home has suitable laundry and sluicing facilities and staff have cleaning schedules to follow. Voyage provides policies and procedures on infection control and protective clothing and gloves are available for staff. Arrangements are made for the proper disposal of waste and there are appropriate hand washing facilities with liquid soap and paper towels. This should all help to ensure that staff maintain good hygiene, which also promotes control of infection . 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have safe personal support as there are enough staff on duty. Their needs are being met because staff receive the right training and support. People can have confidence in staff because checks are made to help to ensure they are suitable. Evidence: Staffing for the seven residents in both houses include six or seven staff on duty betwen 7.30am and 9.30pm with two waking and one staff sleeping in during the night. There are three care staff vacancies and there has been issues with staff sickness, although recruitment is ongoing and permanent staff are able to cover the home. Staff expressed the view however that staffing levels can at times effect their availability to take residents out and follow their activity schedules. Voyage operate thorough recruitment procedures and staff are not appointed until their Human Resource team have checked that these have been adhered to. The AQAA and staff confirm they had necessary checks, including a criminal records bureau (CRB) and two written references, taken up before they started working at the home. Whilst copies of the actual checks and references are not at the home a checklist is kept and the manager sees them to verify they are satisfactory. New staff are only confirmed in post following a satsifactory six month probationary period. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: New staff have to complete Voyages accredited induction programme. Staff confirm this covers everything they needed to know about their role. They also say they had good support and benefitted from being able to shadow experienced staff. It is good that some staff have also completed a learning disability qualification (LDQ). Although less than half the staff team have achieved a social care qualification (National Vocational Qualification) this is one of the homes plans for the next 12 months. Efforts have also been made to provide more training for the team in respect of residents special needs such as communication, epilepsy and sensory impairment. One of the staff team is a trainer for moving and handling. Voyage has a training team and each care home has a training plan, which should make sure that all staff receive necessary training and updates. Each staff member also has an individual record of their training and their supervision identifies any training or developmental needs. Staff say they receive enough training and support and have the knowledge to meet residents needs. They have regular team meetings, individual supervision and an annual appraisal. The staff team seem well motivated and those we spoke with say there is a good team ethic and that their views are listened to by management. We observed and staff told us that team working has improved within the staff team and usually works well. This also applies to ways of communicating and through records and shift handovers. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident in the service because the home is being run and managed more effectively. There are ways of monitoring practice and reviewing the service so it continues to improve and develop as residents wish and/or for their benefit. The environment is safe for people because health and safety practices are carried out. Evidence: The manager (Kimberley Hewins) has had a management post for Voyage since July 2007 and had previous management experience. Ms Hewins has achieved a care management qualification and completed other relevant training relating to health and safety, the special needs of people using the service, supervision and appraisals. Although Ms Hewins has not yet completed the companys management development programme it is planned that she and the deputy will do so this coming year. The homes management team also comprises a deputy manager, two senior support workers and two team leaders. Staff report that they feel better supported and team working (and so their morale) has improved. One comments in their survey that management have an open door policy and makes me feel that I can approach them Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: on any subject with confidence. Voyage operates a formal system to review and assure service quality. This includes their required monthly visits when relevant aspects are checked and/or audited and people at the home interviewed. There is an annual service review carried out by Voyage following which a development plan is set up with actions outlined to improve the service. The views of residents, their families and involved professionals are also sought and should be incorporated in the development plan. The AQAA gives a clear picture of what the service does well and areas that could be better. These include more staff achieving a qualification, resident related training and to make documents user friendly. Regarding health and safety in the home staff are now receiving training in all the mandatory health and safety areas such as fire safety, first aid, infection control, food hygiene and moving and handling. Voyage provide comprehensive health and safety policies and procedures for staff to inform them and that they follow in their working prcetices. The AQAA confirms that necessary risk assessments are carried out or in place; checks are made on the fire safety and water systems and the heating and equipment, call bells etc are serviced regularly. We did not observe any safety hazards. 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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