Care Home: Ford Road

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What the care home does well The service is run in the best interests of the service users and decisions within the home are made by them as much as possible. The attitude is very much `we can do` rather than `we can`t do` and staff support service users to be as independent as possible and to have as much control as possible over their lives. Service users are very involved in the drawing up of their care plans and the subsequent reviews; the care plans and associated risk assessments are very comprehensive and person centred. The home has a warm and friendly atmosphere and we saw staff working with the service users in a respectful, thoughtful and friendly way. Service users spoke of the staff and Ford Road in a very positive way, "I am very happy here", "I don`t want to live anywhere else" and "the staff are very good". What has improved since the last inspection? There was one requirement at the last inspection and this was regarding changing the manager`s name on the Statement of Purpose and this has now been completed. The home has continued to provide a very high quality service which is based on the rights and aspirations of the people who live at Ford Road. What the care home could do better: There were no requirements or recommendations identified at this inspection however the manager and staff team are committed to continue to look at ways of improving the service for people living at Ford Road. Key inspection report Care homes for adults (18-65 years) Name: Address: Ford Road 98a Ford Road Dagenham Essex RM10 9JP     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: Julie Legg     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 27 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 27 Information about the care home Name of care home: Address: Ford Road 98a Ford Road Dagenham Essex RM10 9JP 02085969377 02085969377 lindad@outlookcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Outlook Care care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 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 Code LD Date of last inspection Brief description of the care home Ford Road is a purpose built care home for 7 people with learning disabilities. The home is on a bus route and is within a 20-minute walk of the local railway station and is within easy walking distance of shops and other local community resources. The home is detached and situated in a residential are of Dagenham. Accommodation is in single rooms, with a separate lounge and dining room, a domestic style kitchen and utility room. The home is not designed for people with a physical disability, as there is no passenger lift to the first floor. The Statement of Purpose and the Service User Guide are issued to every prospective Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 7 Brief description of the care home service user and these documents can also be found on the service users notice board. A copy of the most recent inspection report is also available. The weekly fees for the home are available from Linda Davies (manager). Care Homes for Adults (18-65 years) Page 5 of 27 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 key unannounced inspection took place on Tuesday 8th December 2009. This inspection was undertaken by Mrs Julie Legg lead inspector for Ford Road. We arrived at the home at 11:00 and was met by a senior support worker who was available for the first part of the inspection. The manager joined us for the remaining part of this inspection and was available for feedback at the end. We spoke to service users, staff and a community nurse. We looked at service user and staff files including training records as well as other records and documentation appertaining to the service. We also took information from notifications which had been sent to the Commission. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: 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 7 of 27 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 8 of 27 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. The service understands the importance of prospective service users having the sufficient information to enable them to make a decision as to whether the home is right for them. Evidence: The home has a Statement of Purpose and a Service User Guide. Both are written in plain English and are also in a pictorial format to assist people who have difficulty in understanding words. The statement tells people about the staff team and the aims and objectives of the home. The guide talks about the house and advices people how to complain if they are not happy. A copy of the last inspection report is also available to them. We saw that people had a written Licence Agreement, as an individual contract/statement of the terms and conditions. The terms say what the fees are and tell the service users what their rights and responsibilities are. Both the manager and the service user had signed them. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: There have been no new admissions since the last key inspection (2006). However the pre- admission process for the service users who currently live at the home was carried out satisfactorily and included; an assessment of the service users needs and information was gathered from the person, their families (if appropriate) and health and social care professionals. The assessment focused on achieving positive outcomes for people and this included ensuring the facilities, staffing and that other services provided by the home would meet the ethnic and diverse needs of the individual. Prospective service users were able to visit the home and stay overnight and weekends, if they so wished; this helped the person to see if they would like to live at the home and for the service to be confident that they could meet their needs. Care Homes for Adults (18-65 years) Page 10 of 27 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. People who use this servcie are involved in decisions about their lives and are encouraged to play an active role in pla planning the care and support they receive. Evidence: Three care plans were closely looked at. Care plans within the organisation are focused on person centred planning, which aims to identify and provide person centred care. The key principle is that service users are in control of their lives and direct the service. It was evident from examining the care plans that staff are very committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. Care plans seen evidenced that the service involves service users in the planning of care that effects their lifestyles and quality of life. Care plans were comprehensive; person centred and clearly set out service users health, personal and social care needs. Information was found that was specific to the religious, cultural and dietary needs of the service users and how these needs were to be met. All of the service users are given the choice as to attend a church service once a week, some of the service users have taken up this option. The information provided Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: in care plans was very detailed and individualised and clearly recorded and described how service users wanted their needs met. Care plans were written from the service users point of view and concentrated on promoting their Independence and aspirations. All of the service users are encouraged and assisted to do their own laundry and each care plan showed clearly how much support each service user required with this task. The individual service users progress is being recorded and reviewed.The documentation life pathway includes information in picture formats and photographs and identifies service users likes, dislikes, what tasks they can do and what task they require assistance with. One service user told us X takes me shopping and I buy my own clothes. A key worker system also allows staff to work on a oneto-one basis and contribute to the care plan for the individual. Care plans include comprehensive risk assessments which are regularly reviewed. Risk assessments were pertinent to each service users that maybe presented by the building, mobility, falling, use of transport and presenting behaviour that challenges. It was very apparent during the inspection; from observation, talking to service users and staff as well as looking at documentation , the service has a can do attitude and risks are managed positively to assist service users to lead the life they want. The attitude and practice of the manager and staff promotes opportunities for service users to remain independent, exercise choice and express their wishes and needs. Care plans are working documents and are reviewed on a six monthly basis or as and when required. Evidence was seen of reviews taking place, which involved the service user, family and representatives as well as other interested parties; health and social care professionals and advocate. reviews focus on finding out what has worked where progress has been made, achievements, concerns and plans for the future. Minutes of reviews held by the funding local authority were also evidenced on service users files. Daily case recordings notes were examined which were linked to the care plan and focused on the specific needs of the service users. Each service user has their own diary, which reflects the support that has been given an a day-to-day basis and how service users are involved in the life of the home; menu planning, shopping trips, cooking and domestic tasks as well as activities within the home and in the community. Care Homes for Adults (18-65 years) Page 12 of 27 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. People who use this service are encouraged and supported with their choice of lifestyle and relationships. Evidence: The service has a strong commitment to enabling service users to develop and maintain their skills, including social,emotional, communication and independent living skills.They are supported to identify their goals and work to achieve them. Service users are supported to undertake a variety of activities including going to see their favourite pop star participating in their favourite sport. Some of the service users benefit from one-to-one support, which allows them access to the community. Service users are supported to going shopping and access activities within the local community. Some of the service users attend a local day service and others attend a local college (English, computer for fun and painting and printing classes) and evening clubs. Trips to the cinema, local pubs and cafes are also enjoyed as well as trips Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: further afield; canal boats, Brighton and Hastings. Service users have enjoyed various holidays this year and they include: Euro Disney, Blackpool and Pakefield. One of the service users enjoyed a weeks holiday playing and watching snooker and another service user went on holiday with her friend who lives in another home. there were lots of photographs around the home, of trips, activities and holidays that service users have been involved with. During the inspection service users were observed being involved in doing their laundry, one service user was still in bed, another was watching the television and another accompanied us on our tour of the home. Two of the service users were out with the manager during the early part of the inspection. there was a range of activities thats service users could participate and had the freedom and choice to move about the home as they wished. The service seeks the views of the service users and considers their varied interests when planning the routines of the home. The service users are actively encouraged to develop and maintain family relationships and other friendships. All of the service users have some contact with family members, some more regularly than others; some service users go to visit their relatives and others come to th home and some go out for meals with their families. One of the service users has a friend who lives in another home and they meet up every Sunday as well as going on holiday together. The home provides meals, which are varied and nutritious and meet the dietary needs of the service users. There was plenty of fresh fruit and vegetables at the home and staff were seen preparing lunch, which consisted of a variety of sandwiches. Staff were very aware of service users likes and dislikes regarding their food. Service users are able to choose which food they would like to eat with the assistance of pictorial menus and they are encouraged to eat a healthy diet. Some of the service users are able to assist with food preparation and shopping. Care Homes for Adults (18-65 years) Page 14 of 27 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. People who use this service are supported in the way they prefer to ensure that their physical health and emotional well being are met Evidence: Service users at the home receive personal care and health care support using a person centred approach this support is based upon the rights of dignity, fairness, autonomy, equality and respect. Support that is given is flexible and consistent and is able to meet the changing needs of the service users. The use of the key worker system means that staff have in depth knowledge of services users health and personal care needs. Staff were seen to respond appropriately and sensitively when supporting service users. Each service user has a devised health plan, which identifies their health care needs including specialist health, nursing and dietary requirements. These are clearly recorded and act as an indicator of change in health requirements. There was evidence that service users are supported to attend health appointments with various health care professionals. On the day of the inspection two of the service users were having a review of their medication and another service user was being visited by a Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: community nurse. The community nurse told us that she was very satisfied with the care at the home, that the staff communicated with her regarding the service users condition and followed her instruction. Service users that display behaviour that challenges receive the appropriate health interventions, staff are very alert to changes in mood and behaviour and fully understand how they should respond and what action to take. One service users behaviour has improved; this was evidenced by the reduction of notification to the Commission, the daily recordings and our observations on the day of the inspection. The plan also identifies service users daily routines including the type of support that is required in relation to personal care needs; as to whether service users preferred a shower or a bath and at what time of the day they preferred. The service has developed efficient medication polices and procedures and practice guidance and this was evidenced during an inspection of the Medication Administration records (MAR). Where staff are involved in the administration of medication they have undertaken the necessary training. Quality assurance systems are in place to ensure that the homes policy is put into practice and this is also confirmed in audits undertaken by the homes manager and pharmacist. We look at MARs and found these to be in order and where PRN medication is prescribed there is a written protocol. Care Homes for Adults (18-65 years) Page 16 of 27 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 who use this service can be confident that any complaints or concerns will be taken seriously and that they will be protected because of the robust practices and procedures of the home Evidence: People who use this service and their relatives are given a copy of the complaints procedure. The procedure is available in pictorial and DVD format and is displayed in a number of areas within the home. the service keeps a record of any complaints and this includes details of any investigations and actions taken. The service views complaints and concerns in a positive way and uses outcomes to improve the service for people living at the home. The home encourages service users to express their views and concerns in a safe environment. Service users that were spoken to told us that they were happy living at the Ford Road but showed a good understanding of how to complain and who to. One service user told us I would tell Linda, she would sort it. The home has not had any complaints within the past twelve months but previous records show that complaints have been properly investigated. The service has its own safeguarding policy and procedure as well as the local authoritys procedure. The manager was clear when an incident needed to be referred to the local authoritys safeguarding team, during the past twelve monthd there has Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: been one safeguarding referral and this has been concluded. The service has a whistle blowing policy and staff know that if they speak out on poor practice they will be supported by the organisation. Staff that work at the home havr attended safeguarding training and training in responding appropriately to physical and verbal aggression. Staff that were spoken to showed a good understanding of their responsibility in keeping service users safe and reporting any suspicions or allegations. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in a safe, well maintained and comfortable environment. Evidence: We undertook a tour of the home including service users bedrooms (where permission was gained) and found the living environmwent to be appropiate to the needs and lifestyles of the service users. It is homely, clean, safe and comfortable and free from any malodours. Both the kitchen and laundry are designed to enable and promote the involvement of the service users in undertaking domestic tasks and as part of developing their independance. Appropriate risk assessments are in place to ensure the health and safety of the service users in undertaking domestic tasks. The kitchen was clean and food was being stored appropriately, the laundry area was also clean with all cleaning materials being stored appropriately and there was both written and pictorial instructions on how to use the washing machine. There are sufficent toilets and bathrooms that meet the needs of the service users and these were seen to be clean and in good order. All of the bedrooms are single and two of the service users invited us to see their rooms; they are of a reasonable size and are decorated and furnished to reflect the lifestyles of the service users. Some of the service users have chosen to have keys to their bedroom doors, which enables them Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: to have privacy and control over who enters their bedrooms. There are two seperate lounge/ dining rooms, both of these rooms and all other communal areas have recently been redecorated. Both of these rooms were being used during the inspection. The garden is a pleasant area for service users to use during the warmer months. the home is situated back off the road and there is CCTV fitted to the outside of the home, which assists with the safety and well being of the service users and staff. The physical design and layout of the home enables people to live in a safe, well maintained and comfortable environment. Care Homes for Adults (18-65 years) Page 20 of 27 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 who use this service are supported by staff who are trained, skilled and in sufficient numbers. Evidence: Staff rotas were inspected and they correlated with the staff members on duty and on the day of the inspection there were sufficient staff on duty to meet the needs of the service users. There is good staff retention and some of the staff have worked at the home for some time; this affords continuity of care for the service users. the service has a permanent staff team and uses its internal system of bank staff to cover shifts when required. The staff team are culturally diverse and this reflects the local community in which the home is situated. We observed the staff interacting with the service users; staff spoke to service users in a friendly way explaining something in more than one way and then checking that the service user understood. In discussion with staff they demonstrated that they were very knowledgeable as to the needs of the service users. Two staff files were closely looked at, both of these files were in good order. Both files had a completed application form and proof of identity as well as two written references and Criminal Records Bureau (CRB) checks had been obtained prior to the person commencing work. All new staff complete a comprehensive induction Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: pragramme and the service sees this as vital to the success of staff recruitment and retention. One member of staff that was spoken to stated the induction was very thorough, I even got to meet the Chief Executive and she was interested in what we had to say. It makes you feel really valued that you are not just seen as a number. Training is given a high importance within the service and it is focused on delivering improved outcomes for service users. Outlook care has a very comprehensive training programme in place and management prioritise training and facilitate staff to undertake external qualifications beyond basic requirements. The service also has internal development training, to complement formal training as part of an ongoing training plan. recent training has included first aid, food hygiene, manual handling medication, mental capacity act, fire training, equality & diversity, protection of vulnerable adults and person centred planning. All of the staff have either NVQ 2/3 and some members of staff have completed the LDAF qualification. The manager and deputy manager have completed training in supervision and appraisal. Staff files indicated that they are receiving regular supervision, yearly appraisals and staff meetings are taking place, this was confirmed by members of staff. During the inspection we spoke to two members of staff who spoke positively about the manager and working at the home. One member of staff who recently joined the organisation stated I really love working here, we work as a team and the manager is really supportive. Staff were also observed positively interacting with service users. Service users that were spoken to spoke highly of the staff Y is lovely, she takes me out, they are all nice, they help me do things. Care Homes for Adults (18-65 years) Page 22 of 27 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. People who use this service are supported by a competent and qualified manager who ensures that there are effective quality assurance systems in place so that the service is run in their best interests. Evidence: The registered manager has been in post for three years. She has previous management experience and has extensive training; budget management, supervision, managing conflict, makaton, effective communication, NVQ 4 in social care and the Registered Manager Award. She has recently undertaken the DOLS training and has attended a recruitment workshop. Staff that were spoken to during the inspection spoke very positively about her she is a very hands on manager, she is very supportive. The manager is very knowledgeable as to the service users needs and through observation it was apparent that the service users felt very comfortable with her. A health care professional told us that the manager is approachable and provides a good quality service. The manager demonstrated a clear understanding of the key principles and focus of Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: the service based on the organisational values and priorities. the service has a strong focus on person centred thinking, with service users shaping the service wherever possible. The management has a strong ethos of being open and transparent in all areas of running the home. All of them work continuously to improve the service to provide an increased quality of life for the service users with a strong emphasis on promoting human rights. The manager ensures that staff follow the policies and procedures of the home and that they have access to relevant training and documentation. Spot checks and quality monitoring systems provide evidence that practice reflects the homes policies and procedures. Staff and service user meetings, questionnaires, supervisions and care plan reviews also contribute to quality assurance within the home. We looked at a wide range of records including fire safety, health and safety checks, gas ,electric and found these to be detailed and up to date. Fire alarms are tested weekly and staff and service users participate in fire evacuation procedures. There are robust financial systems in place which safeguards the management of service users money and valuables. Wherever possible service users are supported to administer some of their own finances such as going to the bank and drawing out money. Working practices within the home are safe and the service pro actively monitors its health and safety performance. Regulation 37 notifications as required under the Care Home Regulations 2001 are sent to the Commission as necessary and Regulation 26 visits are also being undertaken. The manager ensures that she is up to date with current and new legislation and both she and the staff have undertaken training on the Mental Capacity Act 2005. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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