Care Home: Farndale House

Similar services:

• Larch Avenue
• Alderson Road 12
• Cranworth Close Registered Care Home
• The Cornerstone
• John Street Nursing Home
• Pennine Camphill
• Whitwood House
• Whitwood Hall

What the care home does well People have a thorough care needs assessment prior to their admission to the home and have a phased introduction as part of the admission process. People have a care programme in place that has been agreed by them, and these now include personalised `All About Me` information and patient passports. Regular reviews of care planning information take place and this ensures that care programmes always contain up to date information. Care programmes record information about decision making and responsible risk taking and evidence that people are supported to make decisions about their everyday life and that identified risks are managed appropriately. This allows people to be as independent as possible. People live full lives - they attend day centres, undertake employment and attend a variety of leisure activities. They live as a part of the family and enjoy social activies and holidays with the extended family. People are supported to maintain contact with their own family and to keep in touch with friends. Meal provision at the home is good; nutritional screening takes place and this helps to make sure that people`s nutritional needs are met. People are supported to see a variety of health care professionals so that they can retain optimum physical and mental health. Each person has an annual health check and work has commenced on producing Health Action Plans. Quality monitoring systems allow people to express their opinion about the care they receive and to affect the way in which the home is operated. The home provides well maintained, comfortable and high quality accommodation for the people who live there. Infection control is given a high priority and daily checks take place to ensure that excellent hygiene standards are maintained. The registered person attends regular refresher training and ensures that they receive up to date information about best practice guidance. This results in a well managed home where people receive excellent care and where their health and safety is promoted and protected. What has improved since the last inspection? No requirements or recommendations were made at the last key inspection. What the care home could do better: Any handwritten entries made on medication administration records should be signed by two staff to reduce the risk of errors being made. It would be good practice to record the action taken about any concerns or `niggles` expressed by people living at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Farndale House 21 Rowan Avenue Beverley East Yorkshire HU17 9UN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Diane Wilkinson     Date: 2 3 0 3 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: Farndale House 21 Rowan Avenue Beverley East Yorkshire HU17 9UN 01482872015 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): kathleen@fairbrass.karoo.co.uk Mrs Kathleen Susan Fairbrass Name of registered manager (if applicable) Mrs Kathleen Susan Fairbrass Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Farndale House is registered to provide personal care and support for three people with a learning disability, who live as part of the family. The home is based in a residential area of Beverley within close proximity to shops, entertainment and transport links into the town centre. The home has two lounges, a kitchen/dining room and a conservatory/dining room and there is an enclosed garden that includes outdoor seating and a barbeque. People living at the home have a single bedroom and they share a bathroom and toilet. The home has vehicles available to take people to day centres and to enable them to take part in social activities both by themselves and as part of the extended family. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection report is based on information received by the Care Quality Commission (CQC) since the last Key Inspection of the home on the 3rd May 2007, including information gathered during a site visit to the home. The unannounced site visit commenced at 10.30 am and ended at 3.20 pm. On the day of the site visit the inspector spoke with the registered provider/manager and her husband. Inspection of the premises and close examination of a range of documentation, including two care plans, were also undertaken. The registered person submitted information about the service prior to the site visit by completing and returning an Annual Quality Assurance Assessment (AQAA) form. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. As part of the inspection process we sent survey forms to the people living at the home Care Homes for Adults (18-65 years) Page 5 of 29 and they were all returned. Responses in surveys were very positive, such as, Its a palace and nice food. Other anonymised comments are included throughout the report. The registered person told us that the current fee for residential care is £372.54 per week. At the end of this site visit, feedback was given to the registered person on our findings, including recommendations that would be made in the key inspection report. 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. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Any handwritten entries made on medication administration records should be signed by two staff to reduce the risk of errors being made. Care Homes for Adults (18-65 years) Page 7 of 29 It would be good practice to record the action taken about any concerns or niggles expressed by people living at the home. 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for Standards 1 and 2. People are provided with useful information about the home to help them to make a decision about admission, and are only admitted following a full care needs assessment that evidences that their needs can be met and that they are compatible with the people who already live there. Evidence: The registered provider showed us a copy of the new Service User Guide that has been developed. The existing guide already met required standards but has been further improved by the inclusion of symbols - this results in a very clear guide for people who are considering moving into the home or who already live there. We received completed surveys from all of the people living at the home. They all told us that they were asked if they wanted to move into Farndale House and that they received enough information about the home before they moved in so that they could Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: decide if it was the right place for them. One new person has been admitted to the home since the last key inspection. We saw that a full care needs assessment was undertaken by the registered person and that a copy of the community care assessment and care plan was obtained that had been completed by the local authority. Prior to their admission, the new resident had a gradual introduction to the home to ensure that they were compatible with the people who already lived there. The registered person told us that this was very successful and that the three people living at the home have a very good relationship with each other. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for Standards 6, 7 and 9. Care programmes promote individualised care, decision making and responsible risk taking. This enables people to live the life they choose, within agreed boundaries. Evidence: Each person living at the home has a comprehensive care programme in place that has been based on information gathered at the time of admission and then further developed. Each area of the care plan records a summary of the persons strengths and needs, the objectives and the support plan to enable these to be met. Each area of the care plan is signed by the service user to evidence that the information has been discussed with them and agreed by them. Care plans clearly record a persons ability for self care and the areas where they need assistance from staff. In addition to the care programme, the registered person has assisted people to Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: produce a personalised plan that is entitled, All About Me. These give very clear information about their likes and dislikes such as what they like to eat, what they like to wear, what makes them happy/sad, what worries them and the things and possessions that are important to them. A summary of this information has been recorded in a Patient Passport for each person; this is a document that people can take to hospital with them if they have to be admitted or attend for an appointment, and is intended to inform health care professionals of a persons care needs when they may not be able to communicate this clearly themselves. Care programmes describe any restrictions on choice or freedom such as not being able to go out of the home unaccompanied due to their inablility to assess the speed of traffic and the need to monitor food intake to maintain a healthy weight. Daily diary sheets include information about how the person has spent their day, the meals they have taken, details of medication given and the time they got up and went to bed. Each area of the care plan is reviewed on a monthly basis by the registered person and updated accordingly; we noted that any changes and essential information is highlighted in red. An annual review also takes place - this includes family members and the persons key worker from the day centre and gives the person living at the home and anyone else concerned with their care package the opportunity to discuss whether any changes need to be made. Detailed risk assessments have been developed to accompany the care programme. These consist of a risk assessment for each person and their use of all areas of the home including the kitchen, bathroom and their bedroom. In addition to this, there are assessments in place about the individual risks for each of the people living at the home. These include areas such as attempting to leave the home, areas of vulnerability, physical concerns and specific behaviours. Risk assessments include details of the action to be taken to minimise identified risks and hazards, including personal safety. Responsible risk taking is supported by this risk management framework. There is a missing persons form in place ready to assist the emergency services should someone go missing from the home. Care plans record a persons ability to make decisions, both about their day to day lives and about more complex issues; this decision making is recorded in care programmes. All of the people living at the home have their own bank account and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: make decisions about how to spend their money and how much they would like to save. Financial transactions are recorded on a personal allowance sheet and are signed by the person concerned; money handed to service users for them to manage is also recorded. We received completed surveys from the three people living at the home and they all told us that they make decisions about what to do each day and that they can do what they choose during the day, in the evenings and at weekends. The registered person told us in the AQAA form that they promote the use of Mencap Advocacy services when they have their monthly house meetings. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for Standards 12, 13, 14, 15, 16 and 17. People are supported to undertake a variety of leisure activities (both inside and outside of the home), to maintain contact with family and friends and to receive a diet of their choice. Evidence: Each person living at the home has a monthly activity programme included in their care programme. These evidence that people attend day centres on either two, three or five days per week. When they are not at the day centre, people undertake activities with the registered person and her family. One person likes to go to a friends house for tea, two of the people living at the home like to attend the local library and one person helps with shopping, menu planning and meal preparation on one of the days they spend at home; they look at recipies at the library and then choose a meal Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: to cook the following day. One person enjoys a foot and hand massage and manicure. These activities are recorded on their key worker one to one record. When asked what the home does well, one person living at the home told us, Discos, caravan, mini bus, the children and knitting. The people who live at the home live as part of the family and attend social events and holidays with them. The registered persons family visit the home regularly and the people living at the home enjoy this contact and see themselves as part of this extended family. The registered person has two static caravans and, during the warmer months, the whole family spend weekends there. House meeting minutes record that people are asked if they want to continue with the weekends at the caravan and they always say they do. Most years the family also take a holiday abroad. Diary entries include information such as, everyone enjoyed Brandesburton fish and chip restaurant this evening for tea. The registered person recorded in the AQAA form that all of the people living at the home enjoy ten pin bowling and some attend an art and craft group and a church group. There is a barbeque and outdoor seating at the home and they have regular barbeques; people living at the home are encouraged to invite their friends to these events. One person living at the home undertakes light domestic duties, for which they are paid; we saw copies of pay slips and bank accounts that evidenced this. The registered person told us that this person happily took on this role and that they enjoyed the structure and responsibility of having a day when they worked within the home. Care programmes include information about a persons family history and we saw evidence that people are supported and encouraged to keep in touch with family and friends; this includes them being invited to annual care programme reviews where appropriate. We saw that care records included details of birthdays for family and friends so that cards could be sent. People are also taken to see family and friends and sometimes have overnight stays with them. One person living at the home had a close friendship with a former resident who had to move to alternative accommodation due to health needs; the registered person takes them to visit this ex resident so that the friendship can be maintained. People have travel passes (local and national) so that they are able to use public transport when their risk assessment evidences that this is safe for them to do so. We saw that peoples independence is promoted. All bedrooms have been fitted with Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: locks and keys so that people can maintain their privacy. People have unrestricted access around the home and garden apart from the providers bedroom accommodation. People take their meals with the family and meal provision is based on peoples known likes and dislikes, although healthy eating is also taken into consideration. People have a nutritional assessment in place and their weight and BMI is taken and recorded each week. One person living at the home recorded in a survey, nice food. On the day of the site visit we saw a resident meal request folder; this includes information such as, x asked for spaghetti today and x requested chicken and yorkshire puddings. One person living at the home recorded in a survey, nice food. A persons specific needs around eating and drinking are clearly recorded in the All About Me document, the care programme and the patient passport. As a result of nutritional screening, it was identified that one person would benefit from having their meal liquidised and this has resulted in them now eating well. Care Homes for Adults (18-65 years) Page 17 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. We looked at outcomes for Standards 18, 19 and 20. People have their health needs met, including appointments with appropriate health care professionals and the administration of medication. Evidence: We looked at the care records for people living at the home. These include detailed information about a persons ability to manage personal care tasks and any support that may be needed. Each area of personal care is listed and is accompanied by details such as assistance needed to wash back and advise to use deodourant. People have single bedrooms so assistance with personal care is undertaken in private to promote their dignity. A bath seat has been provided in the residents bathroom so that people who need assistance can be helped in and out of the bath, and an additional stair rail has been fitted to assist people to get up and down the stairs safely. Care programmes record a persons preferred time for getting up and going to bed Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: and care records (including photographs) evidence that people choose their own clothes and hairstyle so that their appearance reflects their personality. There is a record of all contacts with health care professionals, including visits to the GP, hospital appointments and appointments with other health care professionals. The registered person told us in the AQAA form that people living at the home have an annual health check, a 6 monthly dental check and a 6 weekly chiropody appointment. The registered person told us that she is in the process of liaising with the GP of two of the people living at the home around the development of a Health Action Plan. This will be discussed for the other person living at the home when they have their annual health check with their GP. The registered person has undertaken training on the production of Health Action Plans to help her with this process. Care records evidence that people are referred to opticians, psychologists and consultants when any health concerns are identified, and that people also attend health screening appointments. Care records clearly record a persons medical history and current medical condition, as well as medication that is prescribed by their GP. A monotored dosage medication system is used at the home. We checked the medication administration record (MAR) sheets and noted that there were no gaps in recording and that a record is made of the amount of medication received. Each MAR sheet was accompanied by a photograph of the person concerned and information about any allergies the person may have. We advised the registered person that any handwritten entries on MAR sheets should be checked and signed by two people to ensure accuracy and reduce the risk of any errors being made. None of the current service users are prescribed controlled drugs but there are suitable storage arrangements in place should this occur. Medication is stored securely and there is a returns book in use for any medication that needs to be returned to the Pharmacy. The registered person did medication training in 2006 and they are planning to undertake refresher training this year. We noted that the registered person had downloaded professional advice on medication from the Care Quality Commission (CQC) website. Care Homes for Adults (18-65 years) Page 19 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. We looked at outcomes for Standards 22 and 23. The policies and procedures in place at the home support people to raise concerns and protect them against the risk of abuse. Evidence: We received completed surveys from the three people living at the home and they all told us that they know who to speak to if they are not happy; one person added, Tell Kath. They also told us that they know how to make a complaint. No formal complaints have been made to the home or to the Care Quality Commission since the last key inspection. The service user guide includes a form for people to use should they wish to make a complaint; this is in symbol format and each service user has a copy. We saw the minutes of the house meetings that are held and noted that these record Kath asked if anyone had any issues, problems or thoughts but everyone said no and that everything was OK and they were happy. This is asked at every house meeting. We advised the registered person that it would be good practice to have a concerns or niggles book to record action taken to deal with any minor issues raised. We are confident that any minor issues are dealt with appropriately and in the best interests Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: of the people living at the home, but recording these would evidence that any minor issues are dealt with efffectively. There are appropriate policies and procedures in place on safeguarding adults from abuse and we noted that there are notices around the home about this topic. The registered person did refresher training on safeguarding adults for managers on the 11th November 2009. There has been one safeguarding issue at the home since the last key inspection; this was dealt with effectively and professionally by the registered persons. Care Homes for Adults (18-65 years) Page 21 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. We looked at outcomes for Standards 24 and 30. People live in a home that is comfortable, homely, well maintained and hygienic. Evidence: People live as part of the family and have access to all areas of the home. Communal areas consist of two lounges, a dining kitchen and a dining room/conservatory. All of the people living at the home have their own bedroom and they share a bathroom; this has had a shower fitted so that people have the choice of having a bath or a shower. A bath seat has been provided to promote safety, and a new shower mixer valve has been fitted and the bath panel resealed to ensure the bath and shower are in good working order. Communal and private accommodation is well maintained and comfortable, and furniture and fittings are of a high standard. One person living at the home recorded in a survey, Its a palace. The garden area is equipped with outdoor furniture and a barbeque and is enclosed to enable people to use the garden independently but safely. The registered persons told us that they have fitted new windows to all first floor accommodation to meet new legislation. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Food hygiene guidance is followed - temperatures are taken and recorded on a daily basis for the two freezers and two fridges at the home. The registered person is due to attend food hygiene training in April 2010. All of the people living at the home told us in returned surveys that the home is always fresh and clean and we observed that excellent hygiene practices are promoted and followed. The registered person has obtained a copy of the code of practice for the NHS on the prevention and control of healthcare associated infections and related guidance, and there is also a comprehensive infection control policy in place. This is written in symbol format and has been shared with all of the people living at the home. Information on good hand hygiene has also been obtained and shared with service users. Daily infection control checks take place and these are recorded - they include checking and cleaning toilets, the service users bathroom, door handles, light switches and the kitchen. Care Homes for Adults (18-65 years) Page 23 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. These standards were not assessed as there are no staff employed at the home. Evidence: There are no staff employed at the home so these standards were not assessed. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for Standards 37, 39 and 42. People live in a well managed home where they are encouraged to be involved in its development and that has procedures in place to protect their health, welfare and safety. Evidence: The registered person continues to manage the home well. She keeps her practice up to date by attending refresher training - over the last year she has attended training on the care of dying people, health and safety in the workplace, conflict resolution and personal safety, loss and bereavement, mental health first aid, deprivation of liberty (levels 1 and 2), health action plan training, person centred awareness, dementia, risk assessment, infection control and diabetes awareness. The registered person also attended a course on fire safety and she received updated information that was relevant to the home. As a result, she has re-written the fire safety and guidance policy; this is very detailed and includes information about Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: fireworks, portable equipment, bottled gas, caravanning, christmas lights and the barbeque. The registered person uses the CQC website to obtain up to date information on good practice guidance and changes in legislation, and has recently joined a Better Health group held by the Hull Learning Disability Partnership Board. There are quality assurance systems in place that allow people to affect the way in which the home is operated. There is an annual development plan in place that summarises the level of achievement regarding last years development plan, and records plans for this year. These include the development of patient passports and All About Me guides, the training that the registered person plans to undertake and maintenance plans for the premises. These are: the replacement of soft furnishings in service user bedrooms, the upgrading of flooring in the service users bathroom with non-slip tiles, all rooms to be redecorated and all upstairs windows to be replaced. Quality monitoring includes three monthly service user meetings, annual reviews and the use of service user surveys; different standards are assessed on each occasion. There are health and safety policies in place and health and safety checks of the premises take place on a regular basis. Water temperature checks take place each week on outlets accessible to service users and these are recorded. Weekly tests of the fire alarm system also take place, as well as monthly fire drills. There are fire alarms in each room of the house and they have also had a carbon monoxide alarm fitted. Gas appliances were serviced on 1/6/09 and it has been arranged for the company to undertake a check of the electrical installation as well as the gas appliances when they return in June of this year. Checks on portable appliances take place in-house. Substances that may be hazardous to health (to comply with the Control of Substances Hazardous to Health guidelines) are stored in the utility room out of the reach of people living at the home. Tests have taken place to ensure that the water supply meets with the Water Supply (Water Fittings) Regulations 1999. There is an accident book in use and we noted that recording was appropriate. Information seen in the accident book is cross referenced to care records to ensure that they are kept up to date. 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 1 2 19 22 Two people should check and sign any handwritten entries on MAR sheets to reduce the risk of errors being made. It would be good practice to record how minor concerns or niggles have been dealt with. 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!