Care Home: Favor House

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What the care home does well People are given information about the home, and the chance to visit before they come to live at Favor House.People say they are happy living at the home.People living in the home are able to enjoy an active lifestyle with lots of choices of things they can do.People who live at Favor House are supported to keep in touch with their families and friends.People can choose what they want to eat from the healthy menu that is available.Favor House looks after people well and writes down what help everyone needs.People are supported in their medical appointments.Staff training and development is encouraged by the manager to make sure that people who live at the home receive the best possible service.Favor House makes sure that all staff are trained to give medication safely.The staff make sure that the care provided is flexible, consistent and is able to meet the changing needs of individuals.Favor House makes sure that suitable staff are employed and that all checks are made to keep people safe.The manager has the skills and experience to make sure the home is well run. The management team supports staff. What has improved since the last inspection? The lounge has been redecorated and has new furniture. The hall way has been redecorated.The Deputy Manager has completed her managers training. What the care home could do better: Keep medication records together in one file with photographs of people who take medicines. This will help to keep people safe. Key inspection report Care homes for adults (18-65 years) Name: Address: Favor House 38 Walter Nash Road Kidderminster Worcestershire DY11 7BT 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: Dianne Thompson Date: 1 5 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 38 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 38 Information about the care home Name of care home: Address: Favor House 38 Walter Nash Road Kidderminster Worcestershire DY11 7BT 01562637435 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Faith Elizabeth Burgess,Mr Trevor Burgess care home 7 Number of places (if applicable): Under 65 Over 65 7 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 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) 7 Date of last inspection 2 3 1 0 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Favor House is owned by Mr. Trevor Burgess and Mrs. Faith Burgess. Mrs. Margaret Rowles is the registered manager. Parking is available at the front of the home. 6 people with learning disabilities live at the home. There is a bus stop near the home where people can take buses into the town centre or other places. Care Homes for Adults (18-65 years) Page 5 of 38 People can use trains and taxis to go to other places and the home supports people to make these trips. There is a large lounge and a kitchen with dining area on the ground floor. 4 people have their own bedroom. 2 people share a bedroom. There is a garden at the back of the house with a patio and seating where people who live in the home can meet up and talk to each other. Care Homes for Adults (18-65 years) Page 6 of 38 The fees range from £355 to £700 per week. Care Homes for Adults (18-65 years) Page 7 of 38 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 Care Homes for Adults (18-65 years) Page 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by one inspector who visited the home without telling anyone she was coming. This inspection was to look at what life is like for people who live at Favor House. The inspector was there on Thursday 15th October 2009. Throughout this report the term we will be used as the report is written on behalf of the Care Quality Commission. Care Homes for Adults (18-65 years) Page 9 of 38 We talked to staff on duty and the manager. 6 surveys were returned from people who live in the home. 6 surveys were returned from people who work in the home. We looked around the home. Care Homes for Adults (18-65 years) Page 10 of 38 We looked at the care records of 3 people who live in the home. We looked at other records that told us how the home is run. This included staff records and health and safety records. The registered manager completed an Annual Quality Assurance Assessment (AQAA) and sent this to us when we asked for it. This is a form the manager fills in and sends to the Care Quality Commission telling the inspector how the home is Care Homes for Adults (18-65 years) Page 11 of 38 meeting the needs of the people who live there. What the care home does well People are given information about the home, and the chance to visit before they come to live at Favor House. People say they are happy living at the home. Care Homes for Adults (18-65 years) Page 12 of 38 People living in the home are able to enjoy an active lifestyle with lots of choices of things they can do. People who live at Favor House are supported to keep in touch with their families and friends. People can choose what they want to eat from the healthy menu that is available. Care Homes for Adults (18-65 years) Page 13 of 38 Favor House looks after people well and writes down what help everyone needs. People are supported in their medical appointments. Staff training and development is encouraged by the manager to make sure that people who live at the home receive the best possible service. Care Homes for Adults (18-65 years) Page 14 of 38 Favor House makes sure that all staff are trained to give medication safely. The staff make sure that the care provided is flexible, consistent and is able to meet the changing needs of individuals. Favor House makes sure that suitable staff are employed and that all checks are made to keep people safe. Care Homes for Adults (18-65 years) Page 15 of 38 The manager has the skills and experience to make sure the home is well run. The management team supports staff. What has got better from the last inspection The lounge has been redecorated and has new furniture. The hall way has been redecorated. Care Homes for Adults (18-65 years) Page 16 of 38 The Deputy Manager has completed her managers training. What the care home could do better Keep medication records together in one file with photographs of people who take medicines. This will help to keep people safe. Care Homes for Adults (18-65 years) Page 17 of 38 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Dianne Thompson CQC (West Midlands) Citygate Gallowgate Newcastle Upon Tyne NE1 4PA If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 18 of 38 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 19 of 38 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. People can be confident that they will be looked after by the staff at Favor House. This is because detailed assessments are completed to make sure peoples support needs can be met before they move into the home. Evidence: Favor House makes sure information is accessible to everyone who uses their service. We saw the statement of purpose, service user guide and copies of the contract agreement. The statement of purpose and service users guide has been produced in easy read format with words, pictures and photographs. The service makes access to information a priority as seen in the contract agreement which is also written in words and picture format. We looked at the files belonging to 3 people. These files show that a detailed assessment is carried out by the manager. This includes peoples likes and dislikes, theri care needs as well as details of emotional health, mental health, behavioural and medical information, communication skills and cognitive skills. Other people such as parents are involved if possible. Local Authority assessments are also completed. People are able to visit Favor House before considering a move there. This also gives people already living Care Homes for Adults (18-65 years) Page 20 of 38 Evidence: at Favor House the opportunity to assess how new people would fit in with them. The Annual Quality Assurance Assessment (AQAA) tells us that statement of purpose, service user guide (written and symbolised ), agreements of care in place for current service users are all in place. Photos, objects of reference and symbols are used regularly within the home. Service users have opportunity to have advocates where this is appropriate. Home visits and current service user input into selection of new service users ensure they match the homes current provision. Care Homes for Adults (18-65 years) Page 21 of 38 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. Favor House keeps care plans up to date to make sure that people can be confident they will receive the support for their specific care needs. Risk assessments are in place to manage risks in a way that promotes independence. Evidence: Information obtained from care needs assessments are used to develop a care plan. A care plan tells staff about the persons care and social needs and the level of support required for maintaining their health and independence. Each person has a pen portrait to give staff information about who people are. We case tracked 3 peoples care. This is where we look at what life is like at Favor House for the people who live there. This includes looking at care plans to see how health and social care needs are being met. From the care plans we see that regular reviews are carried out. Information provided in care plans covers areas such as likes and dislikes, diet, and personal care. We saw details about the methods of communication people use or understand, such as signs and symbols, makaton, audiotapes, and objects of reference. Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: We saw that consent agreements have been completed where people want to be involved in the recruitment and selection of staff, or take responsibility for specific household tasks. The manager said in the services Annual Quality Assurance Assessment (AQAA) that service users are aware of what is contained in their care plans and have copies of this in the correct communication format in their own rooms. Service users discuss their support needs with their key workers and ensure this is included in their care plans. Key workers ensure that any decisions re their key person are discussed with them, to ensure they are able to make an informed choice. Surveys from people who use the service confirm that staff take good care of us and help us, and that staff treat them well. Risk assessments are completed to give people the support they need so they can be as independent as possible. Assessments for crossing the road, and going out alone have been completed. These risk assessments are reviewed regularly or as needs change. Care Homes for Adults (18-65 years) Page 23 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead active and interesting lives. Staff encourage people to maintain links with their families and to develop friendships. Dietary needs are generally well catered for with a varied and healthy menu provided. Evidence: The manager said in the services Annual Quality Assurance Assessment (AQAA) that they identify in service user care plans areas for personal development and use programmes developed in conjunction with other professionals to develop those skills. Appropriate day placements have been identified and maintained for all service users. People have their weekly programme of activities, and records show that a range of activities takes place in the home and in the community. These include visits to the local pubs, clubs, cinemas, shopping, swimming, attending college and Offmore Day Centre, trips into town, attending the Odell Day Centre, working at the recycling centre, day trips, and music club on thursday nights. People who live at favor House were very keen to talk about their lives and the things they do. They said they also go bowling and they Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: like listening to their cds. One person said they would like to have a disco for their forthcoming birthday. There are plans plans for a halloween party and a bonfire night at home. People say they are members of or will be joining advocacy groups locally. Holidays are planned and 2 people talked about going away for a short break next week to Bridgnorth to see the trams and trains. Other people said they had been to Butlins for their holidays. One person said they had been to Drayton Manor Park I went, I enjoyed it, I fed the birds there. We saw details in care plans about activities, how these are planned and agreed with people who live at Favor House. For example, we saw an agreement that has been signed by individuals who want to take responsibility for completing some household tasks. Staff surveys confirmed that visits and contact with family and friends is supported. The manager said in the AQAA that all service users vote in elections, all service users use public transport and taxi services. Their friends and family are invited into the home regularly and they can see them privately if they wish. People who use the service confirmed in surveys and during the inspection that contact with friends and families is supported. Records show that varied and nutritional meals are provided, and that people are able to choose alternative meals if they wish. On the day of the inspection people had chosen pork chops with fresh vegetables (broccoli and carrots) for the evening meal, with jelly for desert. One person said they preferred a pastie and this was arranged. Food available in the kitchen included a plentiful supply of fresh fruit and vegetables. People said they can help themselves to drinks and snacks at any time. People who use the service told us they had made blueberry muffins the day before and they were going to be shared at supper that night. Care Homes for Adults (18-65 years) Page 25 of 38 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Details of peoples personal and healthcare needs are clearly identified in care plans and health action plans. This makes sure staff know how to give care in a way that is preferred and consistent. Favor House has a medication policy and procedure for staff to follow so that all medication is administered and stored safely so that people are kept well and safe. Evidence: Health action plans are in place to help and support people with their health care and appointments. These plans sets out how their health needs are to be met. We saw information about how people communicate using objects of reference, and information on how to look after myself giving details of personal care support to be given by staff. Records show peoples weight is monitored regularly, with a graph to make staff aware and monitor and assess any changes. Health action plans give details of prescribed medication, medication record sheets, and monitoring forms. Further information to help staff give support includes potential sensitivities to medication such as the effects of strong sunshine, disabilities, and possible medication side effects. Regular checks are being made and information is used to guide Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: any changes to peoples support if it is needed. We saw that people have recently had health and medication reviews have been carried out. People have good access to medical support through their doctor, clinical psychologist, community health care team, speech and language therapist, dentist and chiropodist as required. The manager said in the services Annual Quality Assurance Assessment (AQAA) that specialist assistance i.e. psychologist is sought where needed for service users. All service users see consultant psychiatrist at least three monthly. Staff were observed supporting people in a respectful way, making sure that each persons dignity and self esteem was important. People confirmed in surveys that they are well supported, treated well by staff, and that staff are kind and helpful. Medication is well managed by staff at Favor House. Medication is stored securely and given to people at the right time and full records are kept which show this. A medication policy and procedure is in place and provide guidelines to follow should any medication error occur. These policies and procedures are reviewed regularly, with the most recent review completed in January 2009. The manager said in the services AQAA that all service users sign to agree to staff administering their medication, where they are unable to manage their own medication. All staff receive training in care and administration of medication; list of all staff able to administer medication kept in front of medication folder. Training records confirm that staff complete medication training regularly. We saw completed risk assessments to help and support people to manage their own medication. The manager identifies in the AQAA that the service plans to provide a lockable space in their room so people will be able to manage their own medication. We checked records for the administration of medication. All medication is being signed for when administered and there were no gaps in the records. We did find however that these records are currently kept altogether on a clipboard. The manager was advised that records should be stored more securely, with separators for each person who is receiving medication. The manager was also advised that photographs of everyone who is prescribed medication should be included with their medication administration records. This is good practice and helps to keep people safe by making sure they are given medication as prescribed. Ordering, disposal and audit records for medication were seen. Additionally, procedures advise that errors are to be reported to the Care Quality Commission (CQC). The supplying pharmacist carries out annual audits of all medication stored in the home, and this was considered to be satisfactory at the last visit. Care Homes for Adults (18-65 years) Page 27 of 38 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 are protected by the homes safe working practices and people can be confident the staff will give them the support they need to keep them safe. People are encouraged and supported to take risks in order to be as independent as possible. Evidence: There are systems and procedures in place to make sure that everyone who lives at Favor House is kept safe. Care records contained a number of risk assessments showing potential hazards and control measures to reduce or eliminate an identified risk. For example, environmental risk assessments are in place to keep people safe in the home. In addition we saw where a risk assessment had been completed to consider ways of keeping a person safe but maintaining their independence, when they are out in the community. We saw from the records that these risk assessments are reviewed regularly or as needs change. Staff are able to access the homes safeguarding policy. This policy tells staff how to recognise different forms of abuse and how to protect people. The service makes sure people are protected through their safeguarding policy, and by maintaining accurate records and daily notes. We looked at the complaints log and records show that no complaints have been received. This was confirmed by the manager. The Care Quality Commission (CQC) has not received any complaints about Favor House since the last inspection. We saw a copy of the complaints procedure displayed on the notice board and in individual files. The complaints procedure is available in word and picture format to make Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: sure it is accessible to everyone. Everyone who uses the service is given a copy of the complaints procedure and staff say they would support people to make a complaint should they wish to do so. Surveys told us that people would know how to make a complaint and that staff do listen to them. People we spoke to said they would know how to make a complaint. One person said when asked if they had any problems, not yet and confirmed they know how to contact the inspector if needed. Staff commented in surveys that they make sure clients are protected and kept safe, and they know about their rights. The service has a compliments folder and records are kept of letters and cards thanking Favor House for the care given to their relative. Compliments are many and include pleasure to have residents there at a recent family party. There are suitable finance procedures in place and a financial risk assessment has been completed to support people in the safe management of their financial affairs. The manager states in the Annual Quality Assurance Assessment (AQAA) that they ask service users regularly if they have any problems, they hold residents meetings, weekly key worker meetings. Staff have received training in adult protection. Staff training records confirm that all staff have completed safeguarding training. Staff spoken to and survey comments confirmed they would know what to do should they have any concerns. Care Homes for Adults (18-65 years) Page 29 of 38 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. People who live at Favor House enjoy a comfortable and homely living environment. The home is spacious and is kept clean and well maintained. Evidence: Favor House is located in a residential area of Kidderminster close to local amenities with access to the bus route into town. There is a large kitchen and lounge with bedrooms furnished to individual choices. The communal rooms are comfortable and well furnished and provide adequate space for shared activities. One person said they have their own bedroom - its a nice room. There is an enclosed garden to the rear of the property with easy access. People who live in Favor House took great pleasure in talking about the redecoration of the lounge that has been done since the last inspection. People proudly talked about how they had chosen the colour scheme, the wallpaper and the furniture. The lounge looks stunning, with its stylish decor and restful colours. A new carpet and TV completes the room. The hallway has been redecorated and new furniture added. There are plans to redecorate the kitchen within the next few weeks. There is a lovely homely atmosphere in Favor House, due to the way the residents and staff all work together. People said it is their home and staff work to help them live there. When asked what the home could do Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: better, one person said I am happy as it is. The building is clean and tidy. Policies and procedures for infection control are in place and staff are provided with disposable gloves and aprons. Paper towels and liquid soap are available in the communal bathrooms. Staff records show that all staff receive training in infection control. The manager states in the Annual Quality Assurance Assessment (AQAA) that regular maintenance is carried out by a contractor. All service users have locks on bedroom doors which they can use. Service users are able to take visitors to their bedrooms if they wish. Care Homes for Adults (18-65 years) Page 31 of 38 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the support they receive will be delivered by well supervised and skilled staff to help maintain their health and independence. People are supported by staff that have access to regular training and supervision, and are supported to do their jobs well. Evidence: Favor House has a committed and stable staff team and provides regular staff training. Staff complete mandatory training such as Health and Safety, Fire Safety, First Aid, Food Hygiene, Moving and Handling, Infection Control and Vulnerable Adults. Staff said that the training provided is very good. Training records confirmed that regular training takes place, including induction training for new staff. The manager said in the services Annual Quality Assurance Assessment (AQAA) that staff have clear job descriptions and understand the homes policies and procedures. Staff regularly update themselves on polices and procedures. staff have a annual plan of training required. All staff NVQ qualifications. Service users have been consulted on their involvement in staff training but none of them are interested at this time. Effectiveness of each training course now reviewed in staff supervision. Regular supervision is given to all staff. Service users are involved in staff selection. The AQAA tells us that Favor House has robust staff recruitment and selection Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: procedures. We looked at staff personnel files which show that appropriate safety checks make sure staff are suitable to work with vulnerable people. These checks include a Criminal Record Bureau clearance (CRB) and two written references. These checks are completed as routine and records are well maintained. All staff are required to work a probationary period. Time was spent talking with a newly employed member of staff who confirmed that recruitment procedures had been followed and all checks carried out. Staff surveys confirm that staff feel they are well supported. Care Homes for Adults (18-65 years) Page 33 of 38 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. The service is well managed and staff receive the leadership and support they need. Favor House monitors and evaluates the service provided to protect the health and welfare of people using the service. Evidence: The Registered Manager Margaret Rowles holds a relevant nursing qualification and has many years experience working with people who have learning disabilities. Margaret regularly completes training relevant to her position as registered manager. Recent training has included fire safety, Health and Safety, Infection control, and food hygiene. Margaret is supported by a deputy manager and who has also completed her Registered Managers Award since the last inspection. Both the manager and the deputy manager supervise care staff. Staff said that the manager is approachable and supportive. Surveys confirmed that the manager gives people enough support and meets with staff regularly to discuss how they are working. The Annual Quality Assurance Assessment (AQAA) was completed and sent to us when we asked for it. Discussions about quality monitoring took place with the manager. The Care Homes for Adults (18-65 years) Page 34 of 38 Evidence: current audit of the service includes checking records, environment, complaints received, finance and safety. Any actions that may be needed to address shortfalls will be specified. The resulting report forms an annual development plan for the service. This report includes views on the service from people who use the service, stakeholders and interested parties. Health and Safety is being well managed within the home through staff training, regular monitoring and safety checks. The Health and Safety folder contains copies of all policies and procedures together with a signing sheet for staff when they have read the information. An index to all policies and procedures makes access easy for all and shows that these are kept up to date and reviewed regularly. Records show that monthly checks of the fire safety system and equipment, water temperature and storage, fridge, freezers and electrical appliances are completed. Generic risk assessments are in place. Hereford and Worcester fire brigade recently carried out an inspection of Favor House and considered the premises to be satisfactory. Fire drills are carried out on a regular basis and details of everyone in attendance is recorded. Drills are supported with regular fire training that includes follow up sessions for new staff. This involves the completion of a questionnaire to check on individuals knowledge and skills. We checked maintenance records and saw that routine work is completed as needed within reasonable timescales. Details are also provided for all regular contractors, including photo identification. Care Homes for Adults (18-65 years) Page 35 of 38 Are there any outstanding requirements from the last inspection? Yes  No  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 36 of 38 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 Description 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 Description 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 20 Medication records should be stored more securely, with separators for each person who is receiving medication. This is good practice and helps to keep people safe by making sure people are given medication as prescribed. Photographs of everyone who is prescribed medication should be included with their medication administration record sheets. This is good practice and helps to keep people safe by making sure people are given medication as prescribed. 2 20 Care Homes for Adults (18-65 years) Page 37 of 38 Helpline: Telephone: 03000 616161 or 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. 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