Care Home: Grantham Road, 57

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What the care home does well The manager continues to be committed, enthusiastic and hard working and motivates the staff team. The service promotes and is developing independence for residents who have learning disabilities and offers good individualised specialist care for residents who have challenging needs and high levels of support. The manager and care staff manages the challenging behaviour of the residents professionally and have a good understanding of how to defuse potentially volatile situations while treating the residents with respect and dignity. Residents are encouraged to participate in the running of the home and are consulted on issues that are relevant to them through service user meetings. What has improved since the last inspection? Staff training program has been developed and staff are being encouraged to take responsibility for their own learning and development program. Training records are more comprehensive and kept up to date. Residents take a more active part in the recruitment and selection process for staff at all levels. Residents have devised presentation ideas and questions during recruitment drives and participate in training events. What the care home could do better: Review the statement of purpose and service user guide. The signatures on the medication chart could be reviewed and up dated and audit the medication file to remove any out dated information. . Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Grantham Road, 57 Grantham Road, 57 Brixton London SW9 9ED     The quality rating for this care home is:   three star excellent 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: 1 6 0 4 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 29 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 29 Information about the care home Name of care home: Address: Grantham Road, 57 Grantham Road, 57 Brixton London SW9 9ED 02073260498 02073260498 info@southsidepartnership.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southside Partnership care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accommodated is: 5 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 57 Grantham Road is a Victorian terraced property in a quiet residential side street close to shops and public transport networks. The ground floor has the lounge, dining room and kitchen, two single bedrooms and a bathroom with toilet. The mezzanine has a bathroom with toilet, a separate toilet and the laundry room. The second floor has three single bedrooms and the staff office/sleep-in room. There is a small garden at the rear of the property. Parking near the home is restricted to resident permit holders only, although there is limited metered parking a few streets away. Grantham Road provides care and support for three men and two women who have a range of needs including autism, learning difficulties and challenging behaviour. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The staff team are a balanced mix of men and women reflecting the residents support needs. The registered manager said the current fees payable for the resident is in the range of #1233.35 to#1832.27 per week. Care Homes for Adults (18-65 years) Page 5 of 29 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 unannounced inspection was carried out in April 2009. The manager and senior carer facilitated the inspection. The inspection included a tour of the home and examination of records on care plans, medication records, the complaints book as well as records relating to staffing issues such as staff recruitment, training and supervision. We also checked relevant policies and procedures as well as building maintenance records and health and safety records. The manager sent further documentation to us after the inspection relating to staff training and records. We met all five residents. We were able to speak to two privately as well as speaking to three staff individually. One resident made a cup tea for us and we sat at the dining table speaking to three residents generally about their lives in the home. The manager Care Homes for Adults (18-65 years) Page 6 of 29 and two staff joined us. The residents and staff were very positive about the management of the home and their work. Members of staff told us about their experience of recruitment and working for the service. During the visit we were able to observe how staff interacted with residents and how residents responded to staff. The manager returned a standard form, the Annual Quality Assurance Assessment (AQAA), to CSCI. This was taken into consideration and used as part of the inspection process. There was an excellent level of commitment displayed by the manager and staff to ensure they were meeting the needs of the resident and complying with the standards. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience 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 checked the statement of purpose and the residents guide, which includes the complaints procedure in the residents guide. These need to be reviewed and up dated to reflect recent changes in the organisation and in the regulatory body. There have been no recent admissions to the home. Should a vacancy arise, the registered manager has said the home would follow the homes admissions procedure and the prospective resident would be invited to visit the home with family members or friends to help them decide if the home could meet their needs. A complete assessment would be based on personal history, care management assessment and a full needs assessment would be completed to ensure the home could meet the prospective residents needs before a place in the home was offered. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: We looked at two of the present residents files and saw that this was the procedure that was followed at the time they were admitted into the home. This included assessments from the residents care manager as well as the homes own assessments. The registered manager said prospective residents and their family would be invited to visit the home to look around and meet the present residents and staff. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are involved in planning their care with their key worker, the registered manager, appropriate professionals and family members. Potential risks are identified and residents are supported to take risks within a risk management framework. Evidence: We were able to look at two residents files. We were told the organisation has changed how it looks at care plans and is using the 6 Keys to Citizenship to make sure the care plans really capture all the elements in the residents life. The care plans continue to give a thorough description of residents individual behaviours, reactions and preferences and how the residents like to be treated. Each resident has a person centred plan and are written in an easy to read format. We saw copies of the residents monthly evaluation forums, which review the person, centred plan actions Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: and checks what care plan goals have been met. Risk assessments are reviewed and up dated at this time. These are evaluated by the key worker and the resident. All residents continue to have six monthly reviews or earlier if the need arises. The annual review is conducted by the residents care manager and includes the residents family members, key worker and any relevant professional involved in the residents development. Copies of these were on file. The staff we spoke to said the resident they key work for had reviews coming up and they were in the process of collating the past six months of key worker meeting and information. There were detailed guidelines and risk assessments on file on how the residents who have very challenging behaviour could be managed and supported safely. Staff showed us individual risk assessments, which had been carried out, monitored and reviewed by the staff with residents every six months or when the need arises. Details of any changes to the risks are recorded in the residents care plans, with details of how to manage the risk. Staff and residents said they went to reviews with the registered manager and they always asked other professionals and family members who are involved in the care of the resident to attend. Some families because of the distance they live from the home or because of age or illness are not able to attend but they are still given the opportunity and sent a copy of the minutes. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 five residents who came and went to a variety of activities through out the day during the inspection. We were told the residents have a choice of what they did. The registered manager said residents have a number of structured activities and are encouraged to choose what they do each day with the support of their key worker. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: This is recorded in their personal files. There is a copy of the residents program in the staff office and each resident has a more detailed copy of their program in their room in easy to read and picture format. Staff said they would go through it with the resident to make sure they understood where they were going. 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 while others were made at reviews and others individually in key worker meetings, which are held every three months with residents. One resident was doing their laundry because they always do it on that particular day and it has become an enjoyable activity as well as a daily living skill. Each resident has a cultural needs assessment and spiritual needs assessment on file. Because the resident have lived at the home for so long staff are aware of everyones spiritual and they review these with the residents and if need be find different avenues to address them. The registered manager and staff said three residents continue to have regular contact with their relatives. One resident said they went to visit their mother who is elderly at least three times a year because she is not able to travel and they go there by train with a member of staff for the day. They said they had been recently just before Easter and had enjoyed the day. They said they also speak to them every week on the phone. Another resident used to be able to go to their familys home for weekends if there is a special family occasion but because of ill health of their parent they are not able to do that now. They also travelled to Ireland to visit family there once a year but this was possibly not going to happen because of their parents ill health. This is causing them some distress because they find it difficult to understand. The registered manager said they hoped to be able to organise something suitable in place of the visit and were trying to find ways to help the resident understand the situation without causing them distress. The registered manager and staff all said they thought it was important for residents to keep in touch with family and friends. Relatives said they have regular contact with the home and some were more actively involved with the home than others. Unfortunately because of age or illness some relatives are not able to travel. The home always included them when sending out invitations. The registered manager said some relatives continue to act as advocates in decisions relating to social and health care needs of their relatives placed there while others were not able to do this. Staff and the residents meet to decide what goes on the weekly menu and residents choose from that. The choices are in the form of pictures to help the residents know visually what they are choosing. A copy of the menu choices is kept in the kitchen on the wall. There is a good range of food on the menu. The type of food is from past experience of food the residents like and which had a good range of food with healthy Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: options, such as low fat food and fresh fruit. The staff said that all the residents are encouraged to eat a healthy diet. We were told if, on the day the resident wants something different to what is on the menu, depending on what is in the house, the staff will try to meet the residents choice where possible. One resident has a special menu plan that has been agreed with the GP. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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: The three residents support plans in their files were being reviewed for the forthcoming residents reviews. We saw they contained 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. For example as mentioned earlier in the report, one resident enjoys doing their laundry and they always do it on a set day. These are discussed and agreed at the residents meeting, with residents stating what they want to do. Each resident has health action plan. All Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: residents medication is stored securely in a locked medication cabinet in the dining area of the home. We checked three residents medication at random with a member of staff. All medication stocks checked where in order. Any allergies the residents may have are highlighted and recorded on their medication charts. Homely remedies are signed as being able to be given by the GP and there is a letter on one residents medication chart, saying they can have a specific homely remedy. The registered manager said audits the medication weekly and this was recorded on the residents medication chart. The local pharmacist comes into the home every six months to check the medication and attends a team meeting to give the staff refresher training in medication. This indicated there were no issues that needed to be addressed by the home. Staff induction includes medication training and medication administration records and information about the medications in use. Staff said they have further training while working in the home as well as an annual medication refresher training to keep them up to date with any new medicines or procedures. The local pharmacist comes into the home every six months to check the medication and attends a team meeting to give the staff refresher training in medication. This indicated there were no issues that needed to be addressed by the home. There was a copy of all staff signatures that dispense medication but these have not been reviewed for several years and it would be good practice to up date them. Staff said medication was discussed at individual residents reviews as part of the health action plan and about whether it was appropriate or safe for the resident to administer their own medication and this would be recorded in the review report. Appropriate risk assessments would be done if it was thought a resident could administer their own medication. The home has on file copies of documents for four of the residents who live at the home that states how the resident would like to be treated with regard to ageing, illness and death. The registered manager said the home had contacted all the residents family members and their care managers about this. Where families had different expectations about what was possible, best interest meetings where held to try to find out what residents themselves would want. These have not changed but are kept under review. Some families were unable to face making a decision about this at this time and this has been recorded. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 selfharm. Evidence: There is a complaints policy and this is kept in a folder that is accessible to residents and their relatives. This is also in visual and easy to read form for all to understand. We were shown the complaints book. There is a complaint procedure in place, which is also in visual and easy to read form for all to understand. There were no complaints recorded. The registered manager said if they had any complaints he would follow the homes complaints policy and would deal with all complaints and treat them all with the same seriousness. The home has a copy of the Adult Protection and Whistle Blowing policy that conforms to Local Authority requirements. The Adult Protection and Whistle Blowing policy has just been written in an easy read with pictures and the organisation is waiting for it to be ratified be fore releasing it. We were told all staff have undergone training in restraint techniques which was one of their previous targets because all the residents in the home have some form of behaviour that challenges. We were able to check the residents money and petty cash accounts as part of the inspection when one member of staff was recording what had been spent by the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: resident that morning. These were in order. The staff explained a receipt must be obtained for all purchases and the amount spent recorded in the residents accounts book. The member of staff supporting the resident when the money is spent is the one who signs this. They said personal money and valuables are checked twice daily as part of the handover system. In the past there have been best interest meetings that the home have asked to be held, when there was conflicts of interest between the residents families and the residents wants and needs. These meetings included the resident, their family, staff of the home, care manager and other relevant professionals. There were copies of the issues were discussed and the outcomes on the residents files. The registered manager would always do this if they felt there was a conflict of interest and residents needed to be protected. To wards the end of the inspection a resident returned to the home from the day centre and came in to see the manager. As we spoke they made a disclosure about an incident that they said had happened the previous day. The manager asked them more questions about the incident using open questions in trying to find out more without putting what he thought might have happened into their head. As they were starting repeat what he was saying he decided to speak to them later and speak to the staff concerned. We have since been sent a report of the investigation, staff statements and the outcomes as well as the actions he has put in place. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience 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 bright and comfortable. The accommodation for both individual and shared use is furnished appropriately and maintained as well as possible given the nature of the high level of challenging behaviour in the home. Residents rooms are comfortable and are decorated to reflect their personalities. The standard of hygiene was very good with no unpleasant odours. Evidence: The home is in a street like any other home and it is suitable for the current residents. Its on several levels so would not be suitable for people with mobility problems. The home has a lounge, diner and kitchen, which together with a paved back garden form the communal space in the home. The lounge is separated from the dining and kitchen area by a sliding door, which can be opened to make the three areas into one continuous space. This also gives the home the facility for staff to sit in the dining area when residents are in the lounge and provide non-intrusive care. The home has two bathrooms with toilet, and an additional separate toilet between five residents. These facilities are located within easy reach of residents bedrooms and both bathrooms have hand-held shower facilities and both have recently been redecorated. Laundry facilities Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: are good and accessible. The premises were found to be clean, hygienic and free from offensive odours throughout. The garden is on two levels and completely paved over. We were shown the garden by one resident and they said they had recently planted the tubs with flowers and put the hanging baskets up after the winter. There is a table and chairs so that residents can eat outside and otherwise enjoy the space. We were able to see from the report Grantham Road has an annual health and safety report. This is undertaken by an independent body to make sure that the house is safe for the residents to live in. At the last health and safety assessment there were no recommendations or requirements. Its accessible, safe and generally well maintained. We were told the residents are choose the home is decorated and furnished. They have recently chosen the colour they wanted the lounge to be painted and were very pleased with the result. Residents are also encouraged to decide how they want their bedrooms to be decorated and choose the type of paintings, posters, furniture, bedding, curtains or blinds they wish to have. Three residents showed us their bedrooms and all were very different and individual to that resident. One resident who said they had chosen the colour of their bedroom and put up pictures of his family and friends. One room was in need of some decoration because the resident has some challenging behaviour that means they are destructive at times. There are support plans in place to divert this behavior but at times it is not always possible. The registered manager has referred this resident back to the behaviour therapist. The premises were found to be clean, hygienic and free from offensive odours throughout and the home has thorough policies and procedures in place to control infection. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training needs of all staff is formally identified and planned during supervision and at their annual appraisal. Appropriately trained staff meets the residents individual needs. The recruitment procedures followed are safe, thorough and comply with legal requirements. Evidence: The registered manager was not at the home at the start of the inspection so the first part of the inspection was facilitated by the senior carer who we met at the last inspection. They are very experienced and has worked for the organisation for a number of years. They said they still enjoyed working in the home and with the residents. The registered manager arrived a short time later. We met six staff during the inspection and were able to speak to three individually in private. They all said they had regular supervision every month and had their annual appraisal. We were told by the manager that any changes in legislation are discussed in supervision as well as team meetings. This was confirmed in the four staff files we viewed. All the staff have obtained a minimum of an NVQ 3. Staff said they had been on medication Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: refresher training and had gone through LADAF induction training when they started to work for the organisation. The registered manager said the organisation has a training manager who has devised a training program. Thus is sent around to all the homes in the organisation. Staff have a learning and development portfolio and are encouraged to take responsibility for 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 manager said he was involved with the recruitment of staff for the home and organisation. He said they use 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 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team is lead by a capable, experienced manager who runs the home well and puts the resident first. Working practices and associated records ensure that the health and safety of residents is promoted Evidence: The registered manager has an NVQ Level 4 and RMA Award and has been at the home for the past four years. He demonstrated during the inspection his good understanding of the residents and staff. He was recently given the opportunity to develop his skill in management by acting up in a senior management role with in the organisation. Team and residents meeting are held regularly and recorded. Residents and staff said they had confidence in him and he was approachable. All the records checked were clear and well kept. There was a clear audit trail of how the residents best interests were being met by having best interest meetings involving Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: all the relevant professionals. There is 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. We saw records of the homes health and safety and equipment checks and audit. The records viewed indicated the homes health and safety services and equipment have been checked, serviced and maintained at the appropriate intervals apart from checking water temperatures. There are written policies and arrangements for maintaining safe working practices in place, including appropriate risk assessments. The company updates these on a regular basis. We checked the fire records and precautions. There was a copy of the fire certificate, floor plan and risk assessment on file. There are records of the break alarms are being tested weekly and fire-fighting equipment has been checked regularly. As stated earlier in the report we saw copy of Grantham Road annual health and safety report. This is undertaken by an independent body to make sure that the house is safe for the residents to live in. At the last health and safety assessment there were no recommendations or requirements. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Review the statement of purpose and service user guide to include the up dated information of the organisation and regulatory body. Audit medication folder and remove all out of date information. Up date the record of staff signatures and initials. 2 20 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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