Care Home: Glengarry Road, 72

What the care home does well The registered manager is committed, enthusiastic, motivates the staff team and keeps them focused. The residents have clear written, relevant information that helps them make an informed choice about coming to live at the home. This includes information about the terms and conditions of their accommodation and the tenancy agreement as well as the fees they will be charged, what they cover and any additional costs. Residents continue to be involved in decision making regarding their care and home issues such as house rules, choice of decor, furniture and the up keep of the home. The procedures and practice within the home respect residents` rights. They are supported to take responsibility for their own lives and maintain and develop appropriate relationships with their families and friends. Care plans, risk assessments and goals are all reviewed and evaluated. These reflect the residents` health and social care needs and give information about how the resident likes their care to be given. Good recruitment procedures and training ensure suitably qualified and competent staff are employed to meet the needs of residents. Residents` health, welfare and safety within the home are promoted and protected. What has improved since the last inspection? The home has complied with the requirements made in the previous inspection report and staff are now supervised regularly. This gives staff the support they need to help residents develop their full potential. There is a comprehensive induction programme in place for new staff and a comprehensive training program for staff. There is ongoing training and development that has resulted in improved standards of care and the promotion of good care practices. What the care home could do better: It would be good practice to introduce a running total system that is carried forward from month to month for PRN medication. Consider referring the resident with out family to a befriending service if this is what the resident wants and is appropriate. Consider putting curtains or a blind in the down stairs toilet to preserve residents and staff dignity. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glengarry Road, 72 Glengarry Road, 72 London SE22 8QD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynne Field     Date: 0 7 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 30 Information about the care home Name of care home: Address: Glengarry Road, 72 Glengarry Road, 72 London SE22 8QD 02086936743 02086936743 glengarrystaff@southsidepartnership.org.uk www.southsidepartnership.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southside Partnership care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 72 Glengarry Road is a care home providing personal care and accommodation for 6 people with mental health needs, some of whom are over the age of 65. There are currently two men and four women living at the home. Southside Partnership, a voluntary organisation, manages the service and Hexagon Housing Association owns the building. The home is in Dulwich, South London, close to shops, pubs, the post office and other amenities. The home is a three-storey building. Bedrooms are all single, and on the first and second floors. There is no passenger lift and the building is Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home not wheelchair accessible. There is a small garden to the rear. The fees for a place at the home are #861.44 per week. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was conducted by one inspector and an expert by experience. This took place on one day in August 2009. The inspection involved observing interaction between residents and staff during the inspection, speaking all six residents, the staff on duty and the manager. The registered manager returned a standard form, the Annual Quality Assurance Assessment to CQC formally CSCI and this was taken into consideration. He has kept us informed of any incidents and complaints as well what he hopes to achieve in the short and long term. The inspection also involved the case tracking of three residents care, the assessment of a range of the homes records, procedures and forms as well as observation and a tour of the premises. Comments from the expert by experience report have been incorporated into this Care Homes for Adults (18-65 years) Page 6 of 30 report. Their conclusion was the environment of the home had the feel of a happy and friendly home and it did not feel institutionalized. For example residents chose what meals they were to have and are free to make drinks and snacks when ever they want. The expert observed one resident preparing a meal and two others talked to the expert about how they participated in meal preparation, cleaning and shopping. There were pictures of the recent residents holiday on walls of their own home and in the living areas and residents spoke about this to them. They had concerns about the lack of advocacy and wondered about one resident who appeared to have no relatives next of kin, could be referred to a befriending scheme to give social support. Overall we found there was a good level of commitment displayed by the registered manager and staff to ensure they were meeting the needs of the residents and complying with the standards and the outcome for residents is good. This was confirmed by most of the comments we had before and during the inspection from residents and staff. We had some concerns about one residents placement there and their effect on the other residents living in the home and discussed this with the manager and staff. Residents said they were happy with the home and liked living there and did not make any comment about this resident. . 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 Care Homes for Adults (18-65 years) Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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. Prospective residents needs and aspirations are assessed, so that a service tailored to their needs could be provided. Evidence: We saw the statement of purpose and the residents guide, which includes the complaints procedure in the residents guide. This is in easy read format. These are regularly checked and updated to reflect the changes in the home and the organisation that runs the service and reflected all the recent changes. The last resident to be admitted to the home was just before the previous inspection in August 2007 when the home followed their procedures outlined in the statement of purpose and service users guide. The registered manager said a prospective resident was invited to visit the home with family members or friends to help them decide if the home could meet their needs. The registered manager and the deputy manager would follow this up by going to assess the resident and completing a full needs assessment and risk assessment to ensure the home could meet the prospective Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: residents needs before a place in the home was offered. Copies of the assessments, risk assessments and the care management assessment were seen on file. The resident was informed of the terms and conditions of their accommodation and tenancy agreements as well as the fees they would be charged, what they cover and any additional costs. We saw that there were on the residents files copies of the house rules and written contract that had been signed by the resident and the registered manager. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are consulted and supported to make decisions about their lives by staff and appropriate independent professionals. Potential risks are identified and residents are supported to take risks within a risk management framework. Evidence: We looked at three files of residents we case tracked. These were well laid out. We met all six residents and were able to speak to five at length. Residents said they said they were encouraged to make decisions for themselves. We heard a number of discussions through out the inspection that confirmed this. We saw from the three files we checked the residents are involved in the development of the care plans through staff support. When we arrived one resident opened the door to us, checked who we were filled in the visitors book. We sat in the lounge talking to the residents who were there. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: The care plans we saw give a description of residents individual behaviours, reactions and preferences and how the resident likes to be treated. The inspector saw copies of risk assessments that have been carried out. Care plans and risk assessments are reviewed with residents where possible every six months or sooner if necessary. Details of any changes to the risks are recorded in the care plans along with details of how to manage the risk. The home has internal reviews. The key worker of one resident told us they hold regular reviews and placement reviews. There were copies of the minutes of these on file. They would amend the care plan if necessary. We copies of care plan meetings and risk assessments in the residents files. One key worker we spoke to said there had been a series of meetings regarding one resident who had challenging behaviour and records of these and their outcomes were on the residents file. Copies of records of key work sessions with individuals were on residents files were seen on the files and these were more in depth and mainly about personal issues that the resident would not want to discuss in a residents meeting. We saw from the files that reviews take place once or twice a year depending on need and there is a twice-yearly meeting with all staff and residents present to evaluate how the home is meeting its aims and objectives. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents engage in appropriate, enjoyable and fulfilling activities and mix with the general community. Residents are actively encouraged to keep in touch with friends and family and develop appropriate friendships. Residents rights and responsibilities are respected. Evidence: We met all six residents during the course of the inspection and were able to speak to five at various times during the day. One resident in particular was very vocal and has strong opinions about the way things should be. They said Its so good here and they said they felt it was like a family. The day we inspected was a day when most of the residents were at home. One resident had planned to go to the local laundry to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: wash their bedding. Another resident who is independent had planned to go out but did not tell us where they were going as they are very private and totally independent. We saw residents had a good relationship with the staff of the home. They did things they wanted to do not just what the staff said although they were guided by the staff. One resident went to cook the lunch and asked us to join them. Residents have a menu but can decide what they want to eat on the day. Not all residents at the same time and not all residents ate the same food. Residents said they liked the food. One resident would binge eat or throw all the food away. There have been a number of review meetings with the resident, appropriate professionals and staff to find a way to address this. It has been agreed that the resident will have their own fridge and food cupboard and keep their foods separately. This behaviour is being monitored by staff. One resident has an agreement to go to the day centre that they have signed. Three residents told the expert about the day centre they attend three or four times a week. They also said they participate in activities such as bingo, board games and have meals out. Decisions about what activities residents were going to take part in were made in a variety of settings. Some decisions were made at residents meetings, others were made at reviews and others individually in key worker meetings. Residents meeting are held once a month at the weekend to enable all the residents to attend. The residents discuss the menu, trips out and any concerns can be raised. Each resident has a chore to do on each day of the week. They discuss what chores need to be done and agree who will do them. If the residents have any personal concerns these would be discussed at key worker meetings. We saw records of key worker meetings that were signed by the resident and the key worker. Staff said the meetings were lead by the resident and what they wanted to get out of the meeting. Residents keep their bedrooms clean and do their laundry with the support of staff. One resident told us about their specific likes and needs around their bedroom and bedding and seemed quite controlling in the communal parts of the house as well. The registered manager and their key worker said they were aware of this and were addressing this as a concern by involving other professionals and the residents family where possible. Two residents are encouraged to collect their money from the post office with the support from staff and four are able to go themselves to collect their money. The home encourages residents to keep in touch with their families and families are involved in the home. One resident travels independently to the Midlands to visit family who live there. They are invited to reviews and kept informed. We were told the home has had an open day for family and friends to come to the home and find out how things work and meet all the staff and residents. One resident goes to see their Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: sister and another residents family come to visit them. There were records of these visits on the residents files. The expert voiced concerns about the lack of access to advocacy because they said staff put care quality commission as the agency to which residents voice concerns. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support, in the way they prefer and their physical and emotional needs are met. Residents are protected by the homes policies and procedures for dealing with medicines. Medication administration was found to be properly documented and is handled safely. Evidence: We checked three residents files. Two residents need help with personal care and other four residents only need support through prompting to look after themselves. Care plans contain information about how residents like to be supported in all aspects of their daily lives. As part of the residents daily living development plan, each resident is encouraged to take part in the running of the home and has household chores that they do on a regular basis. One resident has very strong views and can impose those views to the possible determent of the other residents. The registered manager, staff and in particular their key worker is working with this resident to stop this happening. A number of meetings and assessments have taken place and this is Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: ongoing at the present time. As well as care plans residents have life plans. These have been developed to include more information about the resident and there is End of Life Plan where appropriate and all the residents have drawn up Wills. Residents medication is stored securely in a locked medication cabinet in the staff office. We checked residents medication at random with a member of staff and saw how the residents medication is stored recorded and labeled. There needs to be an up to date medication policy available in the medication folder. One member of staff is responsible for the ordering of the medication. The home uses the blister pack system for general medication and PRN medication is dispensed separately. We saw there had been medication reviews but the information recorded on the residents medication information sheet needs to be reviewed and dated. All medication and residents medication files need to be audited and old out of date information archived. Any allergies the residents may have are highlighted and recorded on their medication charts. The registered manager audits the medication weekly and this was recorded on the residents medication chart but needs to be more robust. It would be good practice to introduce a running total system that is carried forward from month to month for PRN medication and any medication that does not come in the blister packs. One resident is self medicating and this has been risk assessed. They keep their medication locked in their room and are meticulous about taking it. This is checked daily by staff. One resident is diabetic and appropriate referrals and checks are made regularly and recorded in their file. The resident is very knowledgeable about their condition. Staff induction includes medication training and medication administration records. Then there is further training while working in the home. There was a copy of all staff signatures that dispense medication and information about the medications in use and this needs to be up dated. Care Homes for Adults (18-65 years) Page 19 of 30 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. There are safeguards in place to protect the resident from abuse, neglect and self harm. Evidence: There is a complaints policy and we saw one complaint by a resident has been recorded since the last inspection. This was around money for food and food generally. Their CPN set up a meeting and this was fully discussed and investigated at the meeting. An action plan was developed that the resident and home agreed to and a separate fridge and cupboard for their food was bought. Residents are able to raise any general issues or concerns in their monthly meeting and the minutes show that action is taken in response to any issues raised and followed up at the next meeting. The home follows the organisations Adult Protection and Whistle Blowing policy, which conforms to Local Authority requirements. All staff has received vulnerable adults training. The organisation now refers staff to POVA as appropriate. None of the staff in the home have been referred for inclusion on the POVA list. The home has a policy regarding the protection of the residents finances. As part of the inspection the residents money and petty cash accounts were inspected and they were in order. A receipt must be obtained for all purchases and the amount spent Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: recorded in the residents accounts book. The member of staff supporting the resident when the money is spent signs this. Personal money and valuables are checked twice daily as part of the handover system. Care Homes for Adults (18-65 years) Page 21 of 30 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 home is comfortable with adequate private and shared space, toilets and bathrooms. Residents bedrooms promote their independence. The home is well maintained and furnished. Evidence: The home is clean, comfortable and homely with no unpleasant odours apart from one residents bedroom where the carpet was very dirty. The expert by experience who attended the inspection felt in general the whole of the home was clean and tidy but noted a strong smell of urine in one residents room. They were told by a member of staff that the residents carpet was to be replaced with vinyl. See below. There is a separate lounge and dining room and six single bedrooms. We noted the carpet on the stairs and landing was badly stained and looked very dirty. The registered manager said the home had replaced the carpet in the last two months in the hall, stairs and landing but one resident who had challenging behavior had soiled the carpet badly but denied doing it. They took advice and because it was new they were told they could not have it cleaned till it was several months old. We were given a tour of the building by two residents and the registered manager and were given permission by three other residents to view their bedrooms. The four bedrooms we saw were totally different and reflected the residents individual tastes Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: and styles. Residents choose their own furnishings and fittings for their rooms and this reflects their needs and individuality as well as promoting their independence. All residents bedrooms are lockable. The staff can use a master key if this is recorded in the residents risk assessment and in the event of emergencies. One bedroom looked very shabby and carpet very dirty. The resident told me they were going to have vinyl flooring instead of carpet. When we asked them about how they would decorate their it they said they did not want it decorated and it was fine as it was. There are three bathrooms and toilets that provide sufficient privacy and have appropriate fittings and equipment to ensure the residents safety. The expert noted that the down stairs toilet had an open window which allowed anybody sitting outside on the bench with the potential to see who was using the toilet. They felt this was not good for the residents and staffs dignity. We both noted there was no towel or dryer in the toilet so we were unable to dry our hands. The home arranged for an occupational therapist to conduct an assessment of the entire building takes place to make sure that the individual residents in the home have all the specialist equipment and adaptations they need to safely use the facilities and building and that issues such as the stairs in the building were evaluated. We were told that in 2007 the health and safety officer had come to do a mobility assessment of all the residents and recommendations made in that report had been met as a priority. One resident had been refereed to the physiotherapist and they had made a recommendation about their chair and this had been addressed. We saw that residents have specialist equipment as required to maximize their independence such as safety rails on the stairs, armchair raiser extension. There are communal and shared spaces that complement and supplement residents individual rooms. We saw the shared spaces are comfortable, safe and fully accessible for shared activities and for private use. The residents showed us the garden at the rear of the home. This was set out with a patio table and chairs. There is a small covered area where residents can go to smoke if the weather is poor. The expert was told the home has an independent person who comes in to look after the garden, and suggested this could potentially be a role for one of the service users. Saying this would allow for residents to control of their own environment. We noted the fire door to the laundry was fitted with a fire door guard as made a requirement in the last inspection report. Care Homes for Adults (18-65 years) Page 23 of 30 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. Appropriately trained staff meets the residents individual needs. The recruitment procedures followed are safe, thorough and comply with legal requirements. Formal supervision is now happening for all staff on a regular basis. Evidence: We met three staff during the inspection and were able to speak to all of them individually in private. One was the newest member of the team. They all said they had regular supervision every month and had their annual appraisal. At the previous inspection in August 2007 supervision was very spasmodic. We were pleased to hear and see evidence this had improved and was happening every two months in not more often. This was confirmed in the three staff files we viewed. Staff said they had been on medication refresher training and had gone through LADAF induction training when they started to work for the organisation. We were told the organisation has a training manager who has devised a training program. This is sent around to all the homes in the organisation. The organisation has an induction checklist for support staff that the managers must follow to ensure all staff have the same induction standard. Staff have a learning and development portfolio and are encouraged to take responsibility for Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: their development. We saw a copy of the learning and development calendar. This is colour coordinated to indicate what type of training it is. Foe example, such as if its mandatory, management, race, equality, corporate induction or other training. The manager is also sent reminder when staff are due to have training. The number of courses the organisation has is impressive. The staff at the home have attended a wide range of training to help them with their work supporting the residents. The new member of staff told us of their experience during his recruitment and induction program. They said they were nearly out of their probationary period and hoped to much more training. They said they were very impressed with the training program and training offered. Two other staff we spoke to told us about how they hoped to develop professionally within the organisation. They all said they felt very supported by the manager. The deputy manager had recently left and a number of staff were applying for the position. We were told the manager is involved with the recruitment of staff for the home and organisation depending on their availability. The organisation uses a competency based interview when recruiting support workers and managers. Staff are only appointed after CRBs are in place and two references have been received from their previous employer. New staff are given a job description, a contract and must have medical checks. All staff are given a copy of the staff handbook. The organisation holds an induction day for all staff that join the organisation. This gives all new staff a general induction into the organisations policies and procedures. This gives them an over view of the organisation including their vision and values. There is an induction checklist for support staff that the managers must follow to ensure all staff have the same induction standard. New staff undergo a six month probationary period and take part in a twelve week LDQ induction training, as well as having core and mandatory training. The registered manager would assist a new member of staff develop an individual development program to make sure their induction and development training was relevant to the needs of the residents. Even when staff transfer within the organisation, references are still taken up. Care Homes for Adults (18-65 years) Page 25 of 30 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. Residents benefit from a home that is well run and managed. The registered manager is qualified and experienced and runs the home well. Working practices and associated records need to be more robust to ensure that the residents health and safety and well being is maintained. Evidence: The registered manager who has completed both the Registered Managers Award and the Care NVQ Level 4 qualifications and has been the manager of this service for around eight years and has around twelve years experience in this field. We saw records of staff and residents meeting that are held regularly. All the records we saw were clear and well kept. There was a clear audit trail of how the residents best interests were being met as well as by having best interest meetings involving all the relevant professionals. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The organisation has a quality assurance monitoring system in place, which systematically gathers feedback from the residents and other professionals and enable their views to continually influence service development. The organisation has been inspecting the home under Regulation 26 of the Care Regulations 2001 and keeps copies in the home which we saw. Residents said they would speak to their key worker or the manage if they were not happy. There a business plan that is reviewed each year that states how the home aims to improve over the next year. The homes managers have regular meetings with senior and executive management, to discuss and plan the homes requirements. The home has policies and procedures in place around health and safety. The records we saw indicated the homes health and safety services and equipment have been checked, serviced and maintained at the appropriate intervals. There is a fire procedure in place. The break alarms are being tested weekly and fire-fighting equipment has been checked regularly. Fire drills have been carried out with residents at various times of day on different days, ensuring all staff have taken part in fire drills over the course of six months and there is a record of the date and time drills have been carried out. The organisation has recently updated the procedures for carrying out a comprehensive risk assessment with services. House risk assessments as well as COSHH risk assessments are in place. Copies of the reports and records of the checks are kept at the home. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 20 It would be good practice to audit and achieve the medication file to ensure there is only up to date information stored in it. Residents could help in the garden and have more control over their environment. The home needs to make sure there is a hand towel in the small downstairs toilet or look at fitting a hand dryer. The home needs to ensure there is a hand towel or a hand dryer is installed in the small downstairs toilet. The home needs to find a way of ensuring the residents and staff dignity is not compromised by having a blind or curtain at the downstairs toilet window. The home needs to take further advice about cleaning the carpet in the hall and stairs. 2 3 4 5 26 27 27 27 6 30 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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