Care Home: Glen Pat Homes

What the care home does well We found that the home has continued to improve the outcomes of the care it provides for residents. There has been consistent and ongoing development of the care and support provided by the home. We found that both the statement of purpose and the service user guide provide clear information about the service. Both the service user guide statemen of purpose were available in accessible formats for residents. Residents are provided with information about the home so that they can decide if it can meet their needs. We looked at the initial assessments for two of the residents who had recently come to the home. These provided a detailed description of the residents needs. Residents told us that they had been involved in telling the home about the support they needed. Admissions are not made to the home until a full needs assessment has been carried out to make sure that residents receive the care they need. There has been continued improvement in the way the home identifies and meets the needs of residents. Care plans were highly personalised and reflected the import of residents. Residents are involved in planning their care that affects their lifestyle and quality of life. Residents told us they were involved in a range of activities both in the home and in the wider community. Residents had been supported to access day centres and colleges. Residents are able to engage in meaningful activities and be part of the local community. Residents told us they were able to share their concerns with the registered manager and staff of the home. The complaints policy was available in a number of accessible formats. This meant that residents could express their views and concerns in a safe and supportive environment. The home`s environment is adapted to meet the needs of residents. Residents told us they had been involved in choosing the colour scheme and furniture for their bedrooms. We observed a bedrooms were highly personalised. Staff have continued to be provided with a range of training and development opportunities that enable them to meet the needs of residents. Residents confirmed that they felt staff understood their needs. Staff records showed that they had been given regular support from management to understand the needs of residents. Staff receive the relevant training and support to enable them to deliver improved outcomes for residents. The new registered manager has made a number of improvements to the home. He has continued and developed the way in which residents are involved in how the home is run. Residents, relatives and professionals all provided positive feedback about how the home is managed. Effective management systems make sure that the needs of residents are met. What has improved since the last inspection? There were no areas for improvement identified at the last inspection. Last year an annual service review (ASR) of the service was completed. An ASR is a review of the service are now it is meeting the needs of residents. We found that Glen Pat Home had continued to provide good outcomes for residents. What the care home could do better: One area for improvement has been identified at this key inspection. It is recommended that staff receive training in relation to the Mental Capacity Act. This will mean that staff can respond to all the capacity issues that might arise for the residents. Key inspection report Care homes for adults (18-65 years) Name: Address: Glen Pat Homes 10 Elm Park Road Winchmore Hill London N21 2HN     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: Tony Brennan     Date: 2 0 1 1 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 32 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 32 Information about the care home Name of care home: Address: Glen Pat Homes 10 Elm Park Road Winchmore Hill London N21 2HN 02088059371 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): glenpat@blueyonder.co.uk Glen Pat Homes Ltd Name of registered manager (if applicable) Mr Premnath Radhakissoon Type of registration: Number of places registered: 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 Mr & Mrs Woodstock own Glen Pat Home. Mr Michael Woodstock is the responsible person for the home. The home consists of a large house in a quiet street in Winchmore Hill. The home is close to shops and public transport links. There are seven large single bedrooms, a dining and a sitting room. The home is appropriately furnished and there is a garden to the rear of the house. The homes stated aim is to support people with learning disabilities to live in the community. The home also aims to provide care and support service users who may have challenging behaviour, and to Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 7 Brief description of the care home support service users tailored to their individual needs. This report is available through the internet. Copies may also be obtained from the provider of this service. Care Homes for Adults (18-65 years) Page 5 of 32 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: The quality rating of this service is three star. This means that people who use the service experienced excellent outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. A new manager has recently been registered with the Commission. We sought to confirm that the home is managed to provide residents with best outcomes of care. Prior to the inspection the home had completed its annual quality assurance assessment. The annual quality assurance assessment provided us with information about the home and how it will seek to provide the best outcomes for residents. We also looked at any other information we have received about the home since the last key inspection. This included any information regarding incidents that home had told us about. We also looked at the registration report on registration of the new manager. The inspection took place over one day. We were assisted by Premnath Radhakissoon, Care Homes for Adults (18-65 years) Page 6 of 32 the resident manager, with the inspection. We spoke with full residents and three members of staff. We observed care practice and interaction between staff and residents. We toured the building and examine a number of records relating to the care, health and safety, and management of the home. We have also included in this report comments received from professionals and relatives as part of the homes quality assurance survey. At the end of the inspection feedback was given to the registered manager, and areas for improvement were discussed. We would like to thank the residents and staff who assisted us by answering questions about the running of the home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: What has improved since the last inspection? Care Homes for Adults (18-65 years) Page 8 of 32 There were no areas for improvement identified at the last inspection. Last year an annual service review (ASR) of the service was completed. An ASR is a review of the service are now it is meeting the needs of residents. We found that Glen Pat Home had continued to provide good outcomes for residents. 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 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience good outcomes in this area. This judgement has been made using available evidence included a visit to this service. The statement of purpose is an accurate description of the service provided and it accessible to residents. Peoples needs are assessed prior to admission to the home to ensure they receive the care and support they need. People understand how the home will meet their needs. Evidence: The statement of purpose clearly set out the aims and objectives of the home. We found that the statement of purpose was accessible for residents in pictorial and easy read formats. The annual quality assurance assessment stated, We provide a statement of purpose and service users guide in formats that residents can understand. The statement of purpose has been updated with the details of the new registered manager. We found that the needs of the residents who we case tracked were within a range of those specified in the statement of purpose. The statement of purpose also identified the skills of staff and resources that were available to meet the needs of residents. The home provides a statement of purpose that is specific to the Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: individual service and which is accessible to residents. The statement of purpose stated that staff would support residents to express their religious beliefs and cultural needs. The annual quality assurance assessment highlighted that the home has continued to develop links with the Hindu and Muslim organisations so that residents from these communities can be supported to practice their religions. The statement of purpose emphasise peoples right to be involved and active in their communities. We discussed this is issue with the registered manager. He demonstrated that he would respond positively to promote peoples diversity. Training records showed that staff had training on the quality and diversity topics. A professional had commented that staff, Appear to be good at understanding the individual needs of residents. We observed that staff related to residents in ways that showed their understanding of these issues. Residents are supported by the home to maintain their cultural and religious identities. Two residents who have recently come to live at the home told us that they had been told about the home and what it provides. We found that there was a detailed service users guide available to residents. It was available in easy read and pictorial formats. This made it assessable to both the new residents. People coming to look at the home had sufficient information about the home, so that they are confident their individual needs and preferences will be met. The two residents who had recently come to live at the told us they had discuss their needs with staff. One resident said, Staff are friendly. The annual quality assurance assessment highlighted that, We are request an assessment and care plan from the place of authority, to see if we can meet the prospective residents needs. We then visit and carry out our assessment of the persons needs. The registered manager explain that initial assessments were carried out with the involvement of prospective residents. We found that initial assessments of the two residents who had recently come to live at the home were detailed and focused on their individual needs. For example, the initial assessment for one of these residents highlighted that they have specific communication and behavioural needs. The initial assessments recorded the residents views and those of his family. Staff were able to explain how they communicated with him. We observed staff using British Sign Language to communicate with him. His consultant psychiatrist commented in the review of this residents placement, He seems to have settled in really well into the home. He told us, staff understand me. Admissions to the home made on the basis of a detailed initial assessments that makes sure the needs of prospective residents can be met. The annual quality assurance assessment stated that prospective residents are Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: encouraged to make visits and had short stays at the home prior to them deciding whether or not they wish to live there permanently. The registered manager explained that this allows both staff and residents to develop a relationship with the new person. Both the residents who had recently come to the confirmed that they had made visits or had short stays to see what the home was like. We found that these visits have been recorded in their assessment information. One resident told us, I came and saw the place and had a look around. Another resident said, I stayed a couple of times to see what it was like. People are supported to make an informed decision about whether the home can meet their needs. We found that the two residents recently admitted to the home had a contract in their files. This had been agreed with them prior to admission. We found that the contracts clearly outlined their rights and responsibilities. Residents told us that staff have discussed the contract with them. Contracts were available in a number of easily accessible formats. This meant that it was assessable to residents. Contracts had been signed either by the resident or their representatives to show they agreed them. People have agreed and understand how the home will meet their needs. Care Homes for Adults (18-65 years) Page 13 of 32 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 service experience excellent outcomes in this area. This judgement has been made use of the available evidence including a visit to service. Care plans reflect the individual needs and aspirations of the people who use the service. People are consulted about their preferences and how they wish to be supported. People are supported to make decisions about their lives, and they know that staff will maintain their confidentiality. Risks to people are assessed to ensure their safety and independence. Evidence: We found that the home has made sustained a consistent improvements in the way it identifies and meets the needs of residents. Residents are involved in choosing how they will be supported by the home. The annual quality assurance assessment confirmed that care plans are drawn up in partnership with residents, their families and professionals. A relative commented that residents were, Being looked after, very well. We cased tracked three residents and how they care plans were detailed and were person centred. This meant that there care plans were based on how residents Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: wish to be supported by staff. Residents told us that they had been involved in preparing their care plans. A resident said, I am happy being here. We found that residents care plans also available in a pictorial format so that each resident could be involved in reviewing their plans. Care plans also referred to residents cultural needs. This included whether or not they wish to take part in religious activities. For example one resident who is of the Hindu faith had been supported to attend the local temple. We found that care plans were developed with the involvement of residents. We observed staff took time to understand residents and do things the way that they had been asked. Staff were observed to adopt individualised ways of communicating with residents. The home involves individuals in the planning of care that affects their lifestyle quality of life. Details of residents behaviour that might challenge the service were identified and their risk assessments and care plans. Actions to address and manage these behaviours were outlined in detail. This included giving guidance on how to respond to specific behaviours. We observed one of the residents was becoming anxious. A member of staff approached the resident and gave reassurance to them. We found that this was in line with the residents care plan. Staff spoken to understood the specific needs of residents with regard to managing these behaviours. Behaviour that may challenge the service are address sensitively to support and maintain residents well-being. We observed a staff worked with residents in a way that maintains their safety. Staff were able to describe how they prevented wrist to make sure that residents were safe and supportive to exercise control over their lives. Risk relation to behavioural issues were identified. We observed that staff engaged people are appropriately adult way. Risk assessments were found to cover all areas that affected residents daily life. Risk assessments identify specific risks facing residents. Risk assessment were detailed and based on the history of previous risk-taking. Any risks identified were in reflected in residents care plans. This assessment had been reviewed to make sure they reflected the needs of residents. Changes to the level of risk had been addressed. Comprehensive risk assessments that are reviewed regularly are in place to ensure the safety and independent of residents. Residents told us that they felt that staff kept confidential issues Private. There were clear policies on how confidentiality must be maintained. Both observations in discussions with staff showed us that they were sensitive and aware of the importance of maintaining residents confidentiality. Residents told us they had seen their records. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Residents know that their confidentiality will be maintained at all times. Care Homes for Adults (18-65 years) Page 16 of 32 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 who use the service experience good outcomes in this area. This judgement has been made using available evidence included a visit to the service. People are supported engage in a range of activities that meet their needs. People have community contacts and are support to maintain their personal relationships. People are supported have a nutritious diet that reflects their personal choice. Evidence: The annual quality assurance assessment explained that residents were encouraged to take part in a range of activities. Records showed that residents were being supported by appropriate college courses. Residents told us that they were participating in varied activities provided by the home as well as attending day centres. Records showed that residents had been supported to access local facilities such as shops and the park. Staff told us they regularly assist residents to plan trips out to the local area. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Residents spoken to David examples of activities that they had taken part in. These included going for walks, listen to music and going to the local shops. Records from residents meetings confirm that they had been consulted about activities that were to be provided in the home. Care plans identified peoples interests and hobbies. We observed that staff spend time supporting residents. Records and discussions with residents showed that they had been on a holiday this year. Residents are involved in meaningful activities of their own choice, according to their individual interests and capabilities. Daily notes and care plans confirm that residents were regularly involved in activities in and outside the home. This included household tasks such as general cleaning and washing up. One of the residents was observed to be tidying his room. With all that residents were involved in preparing the main meal of the day with staff support. Residents are involved in domestic routines of the home to further develop their daily living skills. The annual quality assurance assessment confirmed that residents were enabled to develop contacts in the local community. Daily records showed that residents were supported to maintain contacts with their family and friends. A residents spoken to confirmed that she had been supported by the home to maintain contact with mother. Residents have an opportunity to develop and maintain important personal and family relationships. The menu is prepared at a weekly meeting of all the residents. We saw minutes of these meetings that confirmed that residents suggestions for meals were recorded. Residents spoken to confirmed that they had been involved in preparing the menu. We found that the menu is varied and reflected the cultural diet needs of individuals. A residents said, The food is very nice. We observed that residents were able to enjoy their meal together in a relaxed atmosphere will stop we observed also that residents were able to have a hot drink when they wished. A variety of meals are offered that reflect the individual preferences of residents. Care Homes for Adults (18-65 years) Page 18 of 32 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 experience excellent outcomes in this area. This judgement has been made available evidence including a visit to the service. People are supported with their personal care needs in ways that maintain their dignity and independence. People are able to access the medical care they need. People are protected by safe procedures for handling medication. Evidence: The home is continued to improve and develop the way in which it meets the personal care and health needs of residents. Care plans outlined the support that residents require to maintain their independence when being assisted with their personal care. Spoke with residents who explained that staff provide support and encouragement to help them maintain their personal hygiene. The annual quality assurance assessment confirmed that where necessary residents will be supported with their personal hygiene. Staff explained that they remind and encourage people if they need support with their personal care. Care plans gave specific guidance on how the personal care needs of residents should be met. This included whether the resident wish to have the same gender care. Staff were able to explain how they supported people with their personal care. One resident confirmed that staff were, helpful and caring. Residents Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: are supported with their personal care in ways that reflects their varied individual needs and preferences. Medical needs had been identified as part of the initial assessments and were referred to in care plans and risk assessments. Residents notes recorded that they had access to opticians, dentists and chiropodist. Residents confirmed that they had been consulted about end of life issues. These were included in their care plans. Residents are supported to access the health care they need. Residents health needs are dressed to it ensure their well-being. We found that records for the administration of medication were complete. Records of medication received and returned were also complete. We checked the records of medication for two of the residents case tracked. These confirmed that they were receiving all the medicines they had been prescribed by their doctors. Residents care plans included a section on their agreement to staff to administer medicines. All residents had a detailed medication profile outlining the medicines they were currently taking and any possible side effects. The home has developed an effective medication policy that makes sure that medication is administered safely. There is clear guidance on the use of medication as part of managing residents behaviour. This outlined when it was appropriate to use this medication. Its clearly stated the types of behaviour that would indicate when it was appropriate to use medication to help residents manage their behaviour. Records of the residents case tracked also showed that the consultant psychiatrist had reviewed their medication. This made sure that they were receiving the appropriate medication to maintain their well-being. Medication is only used to manage peoples behaviour when it is clearly required to meet their needs. Daily Mail showed that health professionals have been consulted about the medicines that residents were receiving. Training records and discussions with staff confirmed that they had training on safe administration of medicines. Staff are trained to administer medication safely. Care Homes for Adults (18-65 years) Page 20 of 32 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 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 experience excellent outcomes in this area. This judgement have made it available evidence, including a visit to the service. People can be confident that their complaints are listened to and acted upon. People are protected by the homes safeguarding procedures from abuse and neglect. Evidence: The home continues to be brutal ways in which it listens to respond to residents so that the quality of the service is improved. Complaints policy provided a clear explanation of how to make a complaint and how it will be dealt with. It was available in both easy read and pictorial format. These were on display around the home. This makes the policy and accessible to residents. The two new residents recently committed to the home both confirmed that they had been given a copy of the complaints policy. One of them told us, You can talk to staff if theres something in that you dont like. they also confirmed that they had taken part in regular house meetings and had been able to discuss and resolve any issues. Staff explained that residents are in courage to discuss their views of the home. A resident told that, Staff are very friendly. the home maintains a record of any complaints. There had only been minor issues since the last key inspection. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: The home has a detailed policy on how it will make sure that its safeguards residents from potential abuse. This was available in easy read and pictorial formats. Residents told us they felt safe in the home. We observed that residents appeared relaxed around staff. Training records confirmed that all staff had received training in adult protection. Staff have spoken to understood the importance of safeguarding residents. They understood the signs of possible abuse and how they should respond to this. The registered manager explained that whistleblowing is also discussed as part of the homes induction training new staff. The registered manager explained that he discusses with staff issues regarding safeguarding in their team meetings and individual supervisions. The registered manager explained that he uses these meetings to monitor how staff understand safeguarding issues. There been no adult protection issues since the last key inspection. Residents feel safe and well supported by the home that has they are protection and safety is a priority. Care Homes for Adults (18-65 years) Page 22 of 32 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. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who live in the home are always provide a safe and homely environment that is personalised to meet their needs. The home is clean hygienic. Evidence: The home consists of a large house in a quiet residential street in Wnichmore Hill. It has seven the large bedrooms. It is located near to shops and public transport links. There is a spacious garden at the rear of the home. The kitchen is large and providing a base so that the seven residents are able to sit comfortably and eat their meals together and stop residents told us they were able to access all parts of the home. The homes environment meets residents needs and aspirations. We walked round the home and found that it was well decorated. It provided a safe environment that was adapted to the needs of the residents all bedrooms en suite. This consists of a shower, toilet and handbasin. There is also a laundry area. Residents told us that the facilities provided by the home met their needs. Residents spoken to were pleased with their bedrooms. We saw that each bedroom has been decorated and furnished in a way that reflected residents preferences. A Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: resident confirmed that he had been encouraged to personalise his bedroom choosing furniture and other items. The registered manager confirmed that he encourage residents to personalise their bedrooms. Residents like courage and supported to personalise their bedrooms. Appropriate measures are in place to prevent cross infection the home has detailed policies on the prevention of cross infection. The annual quality assurance assessments they should start a training on infection control. We found that training was confirmed this. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. A proactive infection control policy make sure that the risk of infection to residents is minimised. Care Homes for Adults (18-65 years) Page 24 of 32 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to the service. Sufficient staff, with the necessary skills and support are available to meet the needs of people. People are fully protected by the homes recruitment procedures. Evidence: We found that the rota showed that a consistent staffing level was maintained. The registered manager explained that he has kept the staffing level under review to make sure there is always a naff staff available to meet the needs of residents. Residents care plans highlighted that say is needed one-to-one care and support. We observed that enough staff were available to provide the support and ensure the safety of residents. Residents spoken to felt that there were enough staff to help them. Daily notes showed that staff had been provided to escort residents to appointments. We observed that support with activities was available. Staff spoke to told us that they felt sufficient staff were available so that they could support residents. The Rota showed that at evenings and weekends more staff were provided to support residents. The home has plentiful staff available at all times to support the needs, activities and aspirations of residents. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: We looked at the files of a number of staff who had recently come to work at the home. We found that this show that they had received a full induction. From looking at training records and talking to staff we were able to confirm that staff had all the statutory required training. Discussions with staff showed that they had a detailed knowledge of the needs of residents. Records showed that training has been provided on such areas as handling challenging behaviour and autism. This enables staff to continue to develop their skills and to support residents with these needs. A training plan was in place, this detailed how future training needs would be met to make sure staff continue to develop their skills. Residents are supported by star that have the necessary skills to understand and meet their needs. Training record showed that over 50 of staff have either level 2 or 3 in the National vocational qualification in care. As part of this training staff hired come in quality and diversity issues. Residents told us that they dont start understood how to meet their needs. Looking at staff files showed us that they have the relevant experience in working with residents who have learning disabilities. The home make sure that all staff receive relevant training that is focused on the delivery of improved outcomes for residents. We looked at two files of staff who had recently come to work at the home. These contain all the necessary documentation to make sure that these members of staff were safe to work with residents. Their employment records had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of residents. The staff group reflect the cultural backgrounds of residents. Residents said that they felt staff could be trusted. Robust recruitment procedures are followed to make sure that residents are safe and well cared for. Staff spoken to explain that they had received regular supervision. They told us that this helps them to understand and meet the needs of residents. We found that supervision records show that staff were supported to understand and improve outcomes for residents. The registered manager explained that appraisals would be carried out to monitor staff and make sure they provide the care and support residents need. Staff are supported so that they are able to meet the needs of residents. is Care Homes for Adults (18-65 years) Page 26 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience good outcomes in this area. This judgement has been using available evidence, including a visit to the service. Effective management systems are in place to make sure that peoples well-being and safety is promoted. Peoples views of the service are sought and used as a basis for improvement. People who live at the home and staffs health and safety is always promoted. Evidence: The manager had recently registered with the Commission to manage the home. As part of the registration process and registered managers qualifications had been checked. It was found that they provided him with the necessary skills to manage a home for people with learning disabilities. The registered manager explained that he had a number of years experience and relevant skills to manage the home. As part of the registration process the registered manager has shown evidence that he has completed the National vocational qualification at level 4 in management and care. Records also show that he had a number of other qualifications relevant to his role. The annual quality assurance assessment and discussions with the registered manager Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: confirmed that he has a clear understanding of the key principles focus of the service. Staff and residents told us that the registered manager was approachable. Staff meeting minutes showed that he involves staff in the running of the home. The registered manager is supported by a number of senior workers. Staff were clear about their roles and how this contributes to supporting residents. Effective management systems are in place to provide the best outcomes for residents. The home has begun to respond to the Mental Capacity Act. For example, one resident had an assessment of their capacity to make certain decisions. Although staff were aware of this, they could not fully explain the implications of the Mental Capacity Act for their work. We looked at training records and these showed that training had been provided on the implications of the Mental Capacity Act. This was discussed with registered manager who agreed to make sure that staff receive training in this area. Staff need to be aware of the full range of capacity issues that may arise in their work with residents. The registered manager explained how the homes financial management systems maintain its viability. The registered manager explained how finances were managed. There are pros and accounting procedures in place to make sure that the homes resources are used in the best interests of the residents. The home has the necessary insurance cover. We saw there that there were up-to-date insurance certificates to confirm this. Financial systems make sure that the homes resources are used appropriately. The annual quality assurance assessment clearly outlined how the home would be developed to enhance the care and support residents. A system is in place to monitor the quality of service provided by the home. The resident manager explain that he can result quality monitoring on a regular basis. Residents are consulted about the how the home is run. Residents files contained copies of the most recent quality survey. The manager showed us that suggestions for improvement from this survey had been implemented will stop residents are consulted about how the home is run. Minutes were seen of meetings held with residents to discuss the quality of the service provided. Residents said they were our encouraged to discuss their views of the home with the registered manager and staff. Actions to improve the home had been agreed with residents or their families. There is a strong emphasis on being open and transparent in all areas of the running of the home. Is all procedures and policies were found to be in place the registered manager explained that policies were regularly reviewed. This had also been highlighted in the annual quality assurance assessment. The home has the necessary records in place to Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: support and ensure the safety of residents. The registered manager and staff spoke to explained that residents were supported to access their records. The registered manager explained that important changes in residents records were discussed with them. The procedure is and recording systems make sure that residents need is met. The registered manager explained that he made sure that safety risks to residents and staff are identified and assessed. Measures are put in place to provide a safe living and working environment. Records show that fire equipment was tested regularly and maintain. Drills were taking place regulation. The fire risk assessment provides a details of the potential risks of fire in the home. All health and safety policies were available. Certificates of gas and electrical testing were in date. COSHH guidance is in place, and chemicals were stored safely. Residents are aware of the safety arrangements and have confidence in the safe working procedures of staff. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 37 The registered persons should make sure that staff receive training on the mental capacity act and how this affects their work with residents. Staff should to be aware of the full range of capacity issues that may arise in their work with residents. Care Homes for Adults (18-65 years) Page 31 of 32 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. 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