Care Home: Green Acres

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What the care home does well The service provides specialist support to people with autism and is accredited with the National Autism Society People have comprehensive person centred care plans and health action plans, which outline how their needs and goals are to be met. Staff know people`s needs well and their means of communication. The service has proactively implemented a range of communication methods to meet the needs of people with communication difficulties including, visual menus, activity timetables and objects of reference. During this visit good interaction was observed between people and staff . People are supported to participate in a range of educational, recreational and social activities. During this visit some people were attending college and they are provided with the opportunity to access local facilities such as leisure centre, shops, cafes and local social clubs. Staff are well trained and receive a wide range of training including, autism and challenging behaviour ensuring that they able to meet the needs of people living in the home. The service has obtained the Investors in People award in recognition of their staff training and development. The service has implemented a range of methods to seek the views of people and their representatives including, feedback surveys and home meetings, which are formulated in easy read formats. The home supports people to make decisions and choices in their daily lives including the meals they eat and what clothes they like to wear. The home provides a comfortable and homely environment, which is welcoming. What has improved since the last inspection? No requirements were made at the last key inspection What the care home could do better: The registered person must ensure that an application is made to the Commission to register a manager. A risk assessment must be completed in respect of the uncovered radiators in the home. It is recommended that written records of the monthly quality monitoring visits are maintained in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Green Acres 130 Nork Road Banstead Surrey SM7 1HP     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: Lisa Johnson     Date: 2 4 0 9 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 30 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 30 Information about the care home Name of care home: Address: Green Acres 130 Nork Road Banstead Surrey SM7 1HP 01737351358 02083353264 Chatsworthcare@talk21.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Gabrielle Smith and Peter Smith care home 6 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: 6. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home The home provides care and support to six adults with severe learning disabilities and specialise in caring for people with autism, challengng needs and complex needs. The service is owned by Chatsworth Care. Greenacres is situated in a residential area in Banstead Surrey. The has six bedrooms each with en-suite facilities. There are a range of suitable communal and garden facilities. Car parking facilities are available at the front of the house. Weekly fees range from £1500 to £2000. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This site visit was part of a key inspection. The visit was unannounced. We arrived at 9. 20am and left at 2.50 pm. The last key inspection was carried out 29th October 2007. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which was clear and comprehensive and gave us all the information we asked for. Reference is made to this assessment throughout this report. We sent out five surveys to five people living in the service to gain their views. All of these had been returned to us (assisted by staff ) to complete these. We received surveys from two members of staff and one was received from a health care Care Homes for Adults (18-65 years) Page 5 of 30 professional. During this visit we were introduced to three people that live in the service and discussion took place with the manager and three members of staff. During this visit we observed practises and looked at staff recruitment and training records, care plans, risk assessments, menus, complaint, accident/ incident records, quality assurance systems, medication administration policies, health and safety records and policies and procedures. We also reviewed other information that we have received since our previous including notifications. Care Homes for Adults (18-65 years) Page 6 of 30 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 7 of 30 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with accessible information that they need to know about the home and their needs are assessed prior to admission ensuring that the service will be able to meet them . Evidence: During this visit we looked at the information provided to people that use the service to see whether it is able to supply detailed information about everything that people or their representatives need to know. There is a statement of purpose and service guide which is produced in alterative format, which has been reviewed and formulated with pictures to make it accessible to people. There have been no admissions over the last year. The service has a clear admission procedure, which includes a comprehensive assessment carried out by a senior member of the management team. Other information is also obtained from the care manager,previous placement and any relevant health care professionals. A transition meeting takes place and a transition plan is drawn up by the home, which provides detailed information to be later incorporated into the care plan. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: Over the last year the services assessment of support needs has been reviewed and implemented to take in account their specialisation in autism and related complexities such as sensory and communication difficulties. A new transitional planning and practice tool has also been devised. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a plan of care in place for each person. Peoples needs and goals are met and they are able make decisions about their life. People are able to take risks as part of an independent lifestyle. Evidence: Each person has a person centred support plan in place, which is based on full assessment of needs. Care plans contained information about peoples health personal emotional, communication and social and life skills. The overall care plan is reviewed every six months and an annual review takes place,which involves the person if they wish to attend, families, friends manager, key worker and professionals. During this visit we sampled three peoples plans, which were detailed and comprehensive providing information and guidance to staff as to how people are to be supported. Goal plans are also reviewed by key workers every month and the service have introduced link in monitoring forms and daily reports, which ensure that peoples agreed goals are being met. Peoples long term dreams and goals have also been identified. These have been created on large visual boards, that were seen on display Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: in peoples bedrooms. Staff surveyed said that they are always given up to date information about the needs of people they support and the ways of sharing information about people in the home works well. People have had an assessment in line with the legislation on the mental capacity act and deprivation of liberty safeguards, which we sampled during this visit. The front door which has to remain locked for the safety of people currently living in the service has been risked assessed, although the manager was advised to discuss this matter with the local authority in respect of deprivation liberty safeguard legislation. The service has achieved accreditation with the National Autistic Society and they have developed a range of communication methods ensuring that staff can communicate effectively with people and enhance their personal preferences and choices. During this visit we saw a visual staff rota to enable people to identify who is on duty. The service has introduced a range of easy read documents including, the service user guide, complaints procedure and minutes of home meetings are produced in easy read formats. The company has a quality action group which meets monthly to share information about communication methods. Care plans sampled identified how peoples choice making is to be supported. Staff spoken with during this visit had a good knowledge and understanding of peoples needs and preferences and they were able to provide examples to us where they assist people to make choices in their daily lives such as supporting them to choose their preferred clothing, meals and drinks. The service has implemented a range of comprehensive risk assessments, which are regularly reviewed. Read and sign systems were in place ensuring that these documents are read and understood by staff. Risk assessments sampled included, personal care, road safety, using transport and for behaviours which challenge, these were also supported by detailed and comprehensive strategies and guidelines. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples preferences, social, cultural, diverse ,religious and recreational interests and needs are met. People maintain contact with their family ,friends , representatives and the local community. People are supported to exercise choice over their lives and they are provided with varied and well balanced meals. Evidence: Each person has an individualised weekly activity schedule, which is outlined in their care plan. At the time of this visit some people were attending day services including college. Four people living in the service have been accepted for full time placements at a college for people with learning disabilities, which recently opened a new unit for people with autism specific disorders for a variety of sessions suitable to their needs and preferences. Visual boards were seen in in place for each person, which assists them to see and understand their daily activity programme and assists them to communicate whether they wish to attend a particular activity or not or choose to Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: participate in something else. People participate in activities in the local community including, the local leisure centre for gym, aerobics, swimming and sensory sessions. Some people go horse riding, receive aromatherapy, attend music and there are opportunities to go shopping and attend other local events such as church fetes. The home also has a supply of artwork materials and one persons care plan identified that they like water activities which they were observed participating in during this visit. Staff spoken with told us about some of the activities that people participate in a member of staff surveyed said, The home has activities that suit each individuals level of understanding. People surveyed said that they attend activities during the day, evening and at weekends. During this visit we were told us that people have membership at a local social club where they have the opportunity to have a drink and interact with local people. All people living in the service went to Hastings for a seven day holiday. The home arranges social trips to places of interest including, Brighton and London. The service has developed life books for each person, which we sampled during this visit,which contained photographs and information about peoples activities, holidays, family visits, social events and their individual achievements. People maintain links with their family and friends. Information supplied in the AQAA states that relatives are encouraged to visit whenever they wish and they are invited to annual review meetings. People are supported to send out invitations for special events and post cards and where appropriate they are supported to telephone or write to their families. The manager told us that weekly catch up calls are made to relatives where appropriate. The manager informed us that the service has applied for independent advocacy support on behalf of some people living in the service, although there is a waiting list. People and staff were interacting through out this visit and people were moving around the home without restrictions. One person was observed to spend some time in their room, which was respected by staff. People are supported to participate in household activities such as bedroom cleaning and hoovering. The service has a four weekly menu, which is based on peoples choices and preferences. The menu was varied and well balanced. A comprehensive list was maintained of each persons likes and dislikes. Menus are chosen by people using picture cards, photographs and objects of reference. The meal is chosen is displayed on the visual menu. During this visit we also observed a plate, which is magnetically fixed to the wall, which creates more visual meaning for people. The home is currently Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: increasing their range of food pictures to enhance this further. The home is able to cater for people with specialist diets. One persons care plan identified that they have a dairy intolerance and the manager explained to us how this persons needs have been accommodated. Advice and liaison takes place with a dietitian where this is required. Specialist crockery and cutlery is provided. Information supplied in the AQAA states that people have been supported to have an awareness of other cultures through themed evenings, which includes meals from other countries. Care Homes for Adults (18-65 years) Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met and their preferences for support are respected. The home supports people with their medication in a safe way. Evidence: Peoples health, emotional and personal care needs were outlined in a health action plan. A personal profile was also in place and information to tell staff About me and How to support me. Peoples preferred routines and likes and dislikes were documented, which were supported by clear guidelines. One persons care plan identified that they prefer to take a shower. The service has developed comprehensive communication passports, which contained clear information about peoples means of communication detailing both their verbal and non and verbal cues. People are supported to exercise control over their personal care with the help of visual aids and prompts. People are registered with a local General Practitioner practise and information seen during this visit information seen indicated that people are supported by a range of health care professionals including, Community Team for People with Learning Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: disabilities (CTPLD) and psychology. Records were maintained of all health consultations and health screen checks that people have received including, visits to the chiropodist and dentist. We were told due to one persons dislike of attending the surgery for tests arrangements have been made for a health care professional to visit them at the home. Staff have received a wide range of specialist training and development ensuring that they are able to support the needs of people living in the service including autism and the service continues to work with the National Autistic Society and they have implemented a range of systems for behavioural or obsessional situations. During this visit we were told about a persons programme where they drink to many cups of coffee,which could result in a heath issue. This person has been supplied with a board, which shows cups and the person removes the cup each time that have had a coffee, which assists and promotes the persons independence and skills. Another person has a programme to support them with recognising and dealing with their symptoms of hay fever. Service delivery is based on equality and diversity. People have their own en suite bathroom and we were informed that personal care is given by staff of the same gender and people,s preferred name of address was recorded. During this visit staff were observed to be attentive, caring and addressed people in a respectful manner. During this visit we viewed the homes medication administration practises. Medication was stored appropriately. Records were maintained for the receipt and disposal of medication. Medication is dispensed by a local chemist using the monitored dose system (MDS). Staff receive medication administration training, which includes attending training at a college and internal assessments. A list was maintained of all staff that were trained and authorised to administer medication Medication profiles were in place for each person and their preferred ways of receiving their medication was recorded. Due to the current needs of people they have been individually assessed as not being currently able to self administer their medication Care Homes for Adults (18-65 years) Page 18 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. If people have concerns they know how to complain and they are safeguarded from abuse. Evidence: We looked at information provided to people, which tells them about how they can make complaints. During this visit we saw a copy of the homes complaints procedure,which included the timescale for investigating any complaints and the contact details for the Commission. The procedure is available in easy read format guide and there is also an accessible complaints form. Both formal and informal complaints are recorded. The service has received four complaints and information seen demonstrated that these had been investigated and the outcomes were recorded. A suggestions box is also available in the home for anybody to raise any concerns or suggestions anonymously. Due to the communication difficulties of some people they would not be able to make complaints but this would be observed by any behavioural changes. A person assisted to complete a feedback survey said, The staff know me well and they can tell if I am upset and I can show that I am happy by my behaviours and then my care team will try and find out why and change it if they can. Information supplied in the AQAA states that home consultation and key worker meetings also provide an opportunity for people to express their concerns. Their Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: preferred method of communication is used throughout these meetings. The service has safeguarding vulnerable adults from abuse procedures in place including the local authority procedure. During this visit we sampled three members of staff training records, which confirmed that they receive regular training. Staff spoken with during this visit were aware of their responsibilities should they ever witness or be made aware of any incident where the safety of people is compromised. Over the last year there have been no matters referred following the local authority safeguarding vulnerable adults from abuse procedures. Care Homes for Adults (18-65 years) Page 20 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. People live in a home that is in the main safe, comfortable, homely and clean. Evidence: The service is situated in a residential area in Banstead and provides a homely comfortable, well maintained and furnished place for people to live. There is a scheduled of planned maintenance and improvement plan in place. The stair carpet would benefit from being replaced, which the service has already identified as a matter for improvement. During this visit it was observed that the radiators in the home are not provided with protectors, therefore it is required that a risk assessment is carried out ensuring peoples safety and welfare. Since our previous visit a number of environmental improvements have taken place including, a conservatory extension and extension to the open plan kitchen. Several rooms have been decorated. Redecoration both inside and outside of the property have been recently completed. The service provides a television lounge, a large kitchen and separate dining room. There are also two further quiet lounges and we were informed that consideration is being given to converting one of these rooms in to a sensory room. There is a large accessible garden at the rear of the home, which is maintained to a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: good standard and is enhanced with garden furniture and patio for the use of people. There is also a swing. During this visit we viewed one persons bedroom, which was decorated furnished comfortable and personalised to a high standard. During this visit the home was observed to be cleaned to a high standard and was hygienic. Suitable hand washing facilities and equipment were available and cleaning schedules were in place. Infection control procedures are available and staff receive training. Care Homes for Adults (18-65 years) Page 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by staff that are competent and trained to meet their needs and they are protected by the homes recruitment policies and practises. Evidence: At the time of this inspection the registered manager was on duty with three members of staff. Information recorded on the staff rota verified that that there always three members of staff on duty during the day supporting five people. The manager told us that sometimes when they and the deputy on duty this provides five members of staff At night time people are supported by two waking members of staff. The staff team are of mixed gender, age and culture. People living in the service benefit from a stable staff that know them well and staff turnover has been minimal. A member of staff surveyed stated that staffing levels would benefit from being increased on day shifts to assist people being able to access their day activities. We were informed that eleven out of fifteen members of staff have obtained National Vocational Qualifications (Level2)or above. New staff receive induction following Skills for Care common induction standards including all mandatory training and some specialist training. Staff are not permitted to care for people until all required training is completed and required standards are obtained. There is also a six month Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: probationary period where a new member of staff would have a training needs analysis completed and individual training plan is put in place. The company places good emphasis on staff training, which was confirmed by information supplied in the AQAA, staff training records sampled, surveys and discussions held with staff during this visit. Staff receive both regular statutory and a range of specialist training. The company has their own in house training manager and interactive training sessions are carried including, autism, challenges of autism and meeting the challenging needs of autism. External training is accessed for specialist communication methods including, makaton. Training has also been conducted in equality, diversity mental capacity act and Deprivation of Liberty safeguards. Pain management training has also been recently added to the companys portfolio. Three members of staff spoken with during this visit told us about the training and development that they had received. Two members of staff surveyed stated that they feel they have enough support, experience and knowledge to support the needs of people that live in the service. A member of staff commented, The service always ensures that training is kept up to date and understand autism and challenging behaviour well. Staff recruitment is based on equal opportunities. During this visit we sampled three members of staff personal files, which contained the required information including, a fully completed application form, two written references and enhanced criminal records bureau checks (CRB) and one persons file contained a protection of vulnerable adults (POVA) first check. We were informed that if a member of staff is employed after the POVA first check and before receipt of the CRB arrangements are also made for them to be appropriately supervised. Staff are provided with the code of conduct ensuring that are aware of their role and responsibilities working in a social care setting. Staff receive regular formal supervision and appraisals,which was confirmed during discussions with staff records viewed and staff surveys that were returned Care Homes for Adults (18-65 years) Page 24 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. A registered manager needs to be appointed The home is well run in the best interests of people living there and their wellbeing, health and safety is in the main protected. Evidence: Since the last key inspection the previous registered manager has resigned and a new manager has been appointed. The manager has completed their application form to register with us. However the responsible individual is required to submit this to us. The Manager has obtained National Vocational Qualifications (Level 3&4) and the registered managers award (RMA). Information was supplied to us to indicate that have also attended a range of training and development. The manager is supported by a deputy who has achieved their National Vocational Qualification (Level 3) and is currently working towards National Vocational qualification (Level 4). During this visit the manager was observed to have an open approach and made themselves accessible to both people using the service and staff. Staff spoken with said that they felt supported by the manager, there was good communication, teamwork and regular meetings take place. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Systems are in place to ensure that the views of people, their families and other representatives are sought as part of the homes quality assurance systems. The outcomes of feedback of surveys viewed were analysed and the actions to be taken as a result of suggestions made take place. The home as formulated surveys for people using the survey in easy read formats. Due to the service having obtained the autism accreditation award an accreditation review process takes place every year. The service has also obtained the Investors in people award in recognition of their training and development of staff. We were informed that the responsible individual visits often and quality monitoring visits are conducted, although these were not available for us to see at the time of this visit. Further information was promptly supplied to us, which revealed that mini inspections are completed every six to eight weeks and we were provided with a copy of this document. However it is recommended that these reports are completed monthly, which should be maintained in the home to be available for inspection. Monthly health and safety checks are carried out and any matters identified are actioned. Staff training records sampled demonstrated that they receive statutory training including, first aid, fire awareness, food hygiene, moving and handling and health and safety. Records were maintained to demonstrate that regular water temperature monitoring is conducted. Hazardous cleaning materials were stored and locked away securely. The service maintains incident and accident records. Routine servicing and maintenance of facilities and equipment were up to date One health and safety matter was identified (refer to standard 30) Care Homes for Adults (18-65 years) Page 26 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 27 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 1 24 13 The registered person must ensure that a risk assessment is carried out in respect of the uncovered radiators in the home This is to ensure the welfare and safety of people living in the service 25/10/2009 2 37 9 The registered person must ensure the completed application is submitted to the Commission for the registration of the manager. This is to ensure that the person managing the service is fit to do so. 25/11/2009 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 39 It is recommended that quality monitoring visits by the registered person are carried out monthly and that records Care Homes for Adults (18-65 years) Page 28 of 30 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 of these visits are maintained in the home and available for inspection. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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