Care Home: Grovelands Farmhouse

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What the care home does well People who live at the home enjoy opportunities to take part in a range of activities. They enjoy good home cooked food. People are supported to maintain contact with family and friends. People are supported with their personal care in private in a way that promotes their privacy and dignity. People who live in the home benefit from the spacious and generally well equipped accommodation. They benefit from the support of a team of staff who are friendly and kind. What has improved since the last inspection? The Statement of purpose has been revised to ensure people who are considering moving into the home have access to up to date and accurate information about the service. Care plans have been revised and contain sufficient, up to date information to ensure people who live this home can be confident their individual needs are fully understood and will be met. Reviews are being carried out in consultation with the individual and other relevant parties. Risk management systems have been revised to ensure people`s opportunity for personal development is not restricted and they are not exposed to risk of harm. Peoples` religious needs and choices are known and recorded in care plans. The improved approach to providing care and support increases people`s opportunity to excercise choice and control over their own lives. Improvements to monitoring peoples` health ensures all their health care needs are understood and met. Accurate records are kept of all medication administered in the home, clear guidelines are available for staff to follow when administering medication to be given `as required`. The complaints procedure has been updated to ensure people know who to talk to if they are unhappy. Robust recruitment procedures are followed and all the required checks carried out before staff begin working in the home to ensure people who live there are safeguarded. Restraint policies and procedures are agreed with relevant external agencies to ensure no one is unlawfully deprived of their liberty. Staff are being provided with appropriate training in the relevant legislation. Quality assurance systems are being operated effectively to ensure the health, safety and well being of people who live in the home is promoted and the home is run in their best interests taking account of their needs, choices and expectations. What the care home could do better: Some improvement to the environment is needed to enhance the quality of life and promote the safety and wellbeing of the people who live in the main house. Key inspection report Care homes for adults (18-65 years) Name: Address: Grovelands Farmhouse Grovelands Tandridge Hill Lane Godstone Surrey RH9 8DD     The quality rating for this care home is:   one star adequate 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: Ruth Burnham     Date: 1 6 0 6 2 0 1 0 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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Grovelands Farmhouse Grovelands Tandridge Hill Lane Godstone Surrey RH9 8DD 01883744128 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): grovelands@consensussupport.com www.caringhomes.org THF Care Estates Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 8 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: 8 The registered person may provide the following category of service only: Care home only: to service users of the following category: 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 Grovelands Farmhouse is a care home providing personal care and accommodation for eight adults with learning disabilities between the ages of 18 and 65 years. The home provides for service users with complex needs, particularly those of a psychological nature. The home is owned by THF Care Estates Limited. The company operates other care homes, in Sussex and Surrey. The company also owns a working farm next door to the home. A range of daytime services for people with learning disabilities operate from the farm and service users living at the farmhouse attend for individually planned Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 Brief description of the care home sessions. The farmhouse is in a remote country location, accessible via a single-track road. There is no public transport route nearby so visitors to the home use their own private car or taxi service. The home is situated close to the junction of the M23 and M25 motorways. The towns of Oxted and Godstone are easily accessible by car, and the home has its own minibus. The scale of charges range from 1190.00 to 1610.00 pounds per week Care Homes for Adults (18-65 years) Page 5 of 28 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: one star adequate 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 site visit, which forms part of the homes key inspection was undertaken on 16 June 2010. We were in the home for six hours from 09:00 to 15:00. There are 8 people currently living in the service. Two people have recently moved into a newly refurbished, separate annex known as Primrose Bank which is divided into 2 apartments, the remaining six people live in the main house. We interviewed 2 people who live there and observed and spoke to the other residents during the day. We also spoke to 2 members of staff, the Responsible Individual and the senior team leader . We looked at most areas of the premises. We examined a number of records including staff employment records, daily records, risk assessments, medication records, reviews and care plans. Before the last site visit In January 2010 we sent surveys to people who live in the home; their advocates; members of staff; health professionals and care managers. Ten Care Homes for Adults (18-65 years) Page 6 of 28 surveys were returned: 4 from people who live in the home, all of which were completed by staff on their behalf, 4 from members of staff, and 2 from relatives, one relative telephoned us before our visit to tell us how delighted she was with the service her son has received since moving into the annex. Responses were largely positive. The last inspection took place on 26 January 2010. We found requirements made following that inspection are being addressed or have been met. Only one requirement remains outstanding in respect of improvements needed to the environment. There are no additional required developments at the end of this report. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? The Statement of purpose has been revised to ensure people who are considering moving into the home have access to up to date and accurate information about the service. Care plans have been revised and contain sufficient, up to date information to ensure people who live this home can be confident their individual needs are fully understood and will be met. Reviews are being carried out in consultation with the individual and other relevant parties. Risk management systems have been revised to ensure peoples opportunity for personal development is not restricted and they are not exposed to risk of harm. Peoples religious needs and choices are known and recorded in care plans. The improved approach to providing care and support increases peoples opportunity to excercise choice and control over their own lives. Improvements to monitoring peoples health ensures all their health care needs are understood and met. Accurate records are kept of all medication administered in the home, clear guidelines are available for staff to follow when administering medication to be given as required. The complaints procedure has been updated to ensure people know who to talk to if they are unhappy. Robust recruitment procedures are followed and all the required checks carried out before staff begin working in the home to ensure people who live there are safeguarded. Restraint policies and procedures are agreed with relevant external agencies to ensure no one is unlawfully deprived of their liberty. Staff are being provided with appropriate training in the relevant legislation. Quality assurance systems are being operated effectively to ensure the health, safety and well being of people who live in the home is promoted and the home is run in their best interests taking account of their needs, choices and expectations. Care Homes for Adults (18-65 years) Page 8 of 28 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home have access to up to date and accurate information about the service to help them decide it the home will be suitable for them. Comprehensive assessment policies and procedures ensure peoples needs are fully understood before they move in. Evidence: People who are considering moving into the home are provided with helpful information about what life is like there. The service operates in 2 separate premises on the same site. The recently opened annexe is a bungalow which consists of 2 apartments providing accommodation to 2 people. The annex is known by all as Primrose Bank. Information about the home is contained in the statement of purpose, a revised version of which was provided to the Commission following our last inspection, and the service user guides. One relative who responded to our recent survey said, My son has only been living at Primrose Bank since August 2009. He has settled in well and seems very happy. This is very much down to the staff involved and the manager Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: whos skills and care are of a highly satisfactory and efficient standard, long may it continue. In this instance the relative was referring to the senior team leader as the manager. Two people moved into the annex in 2009. Documentation relating to the assessment process is available. One relative told us how happy they are with the care and support now being provided and how happy their relative is since moving into the annex. One person moved in in August 2009, the other in November 2009. Thorough and comprehensive assessment procedures are in place to ensure the home can meet peoples needs before they move into the home. Documents seen show that pre admission assessments are carried out by a designated person on behalf of the company. Assessment documents seen for one person show that the process included a visit to the hospital, a brief observation in the hospital setting, discussion with hospital staff and the psychiatric consultant. Documents show that assessment reports were requested for speech and language, risk assessments, support plans, behavioural reports, medical history, incident reports, Psychiatric reports and Psychology reports. People who live in the main house have all lived there for a number of years, there have been no new admissions to the main house since our last visit. Care Homes for Adults (18-65 years) Page 12 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements in care planning mean that people who live in the home can be confident their individual needs are fully understood and are being met in line with their individual abilities, preferences and expectations. The improved approach to risk management in the home is increasing peoples opportunity for personal development whilst protecting them from risk of harm. Evidence: Relatives who responded to our recent survey were very satisfied with the service. One relative told us. The service provided has been excellent. I cannot thank the manager enough for all she has done to make sure he has the right carers to understand his needs. She has been so helpful and gone to great lengths to ensure that he is healthy and very happy with the people who look after him. There is nothing they could do better because they work so very hard and I am sure they will continue to do so in the future. Improvements implemented since our last visit mean that people who live in this Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: home can be confident their individual needs are fully understood and staff know how to meet them. We looked at 2 care plans in detail. We joined some of the residents in the main house at breakfast. We also talked to one resident in private. Care plans have all been revised and updated with a more personalised approach evident in the documentation seen. Files contain information about peoples likes and dislikes and how they prefer to live their lives. The new care plans have been formulated in consultation with people who live in the home. The new responsible individual and the senior team leader are working hard with staff to ensure a more person centred approach is taken to planning care and providing support to each person in line with their individual abilities, preferences and expectations. There is sufficient detail and guidance in care and support plans and risk assessments to ensure staff understand how to support people appropriately. Interactions observed between staff and people who live in the home show there is still some work to be done to ensure staff understand how to communicate with residents appropriately. This was discussed with the RI who told us that additional training is being arranged to support staff in making the necessary changes. The management have also worked hard to change the approach to risk management in the home to increase peoples opportunity for personal development whilst continuing to protect them from to risk of harm. Restrictions, other than those necessary to keep people safe, have been removed. People now have unrestricted access to food and items such as toothpaste, and are involved in the preparation of meals. Communal towels are no longer in use and hand dryers have been installed in bathrooms and toilets. Each person has a number of individual risk assessments on their files. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home enjoy opportunities to take part in a range of activities. People are supported to maintain contact with family and friends. Peoples religious needs are understood. A more enabling and personalised approach to providing care and support is increasing peoples opportunity to excercise choice and for personal development. Evidence: People who live at Grovelands have access to a range of activities. People who live in the main house work at the adjoining farm as well as attending adult education classes. In addition they undertake a range of leisure activities including trampoline, swimming, shopping trips and annual holidays. The main house has its own transport for the benefit of people who use the service. On the day of our visit people in the main house were going to work at the farm, or out to appointments. The two people who live in the annex each have their own transport, they are always accompanied by Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: two members of staff when they go out. Individual activity programmes and daily records seen show that activities are consistently provided. Information about individual interests are included in care plans which have been recently reviewed and updated. Peoples spiritual needs are known and support is available to attend places of worship if people so wish. Records seen and discussions with people who use the service and the responsible individual show that relationships with families and friends are valued by the Home and communication is good. Observation of interaction with people who live in the home reflects the work that the new management team has undertaken since our last visit. Staff are being encouraged and supported to adopt a more enabling approach to supporting people who live in the home by offering more opportunities for choice. For example there is now a bowl of fruit in the lounge from which residents help themselves. People are able to participate in choosing menus and preparing meals. People are able to have a drink or snack whenever they wish. A range of nutritious food is provided which people help shop for. There is a pictorial menu plan in the kitchen from which residents choose their meals. There are now regular residents meetings and minutes of these meetings show that people who live in the home are involved in how the home is run. People are now being supported to do their own washing. The dining room is very small and difficult for people to move around freely without disturbing others while they are eating. The kitchen only has a range style cooker rather than an ordinary domestic cooker. Discussion took place about plans to address these issues. The responsible individual told us of the intention to replace the range with a new cooker in the near future. Care Homes for Adults (18-65 years) Page 16 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported with their personal care in private in a way that promotes their privacy and dignity. Peoples health is promoted and access is provided to appropriate health care professionals as needed. People are protected from harm through the safe administration and storage of medication. Evidence: People are supported with their personal care in private in a way that promotes their privacy and dignity. The management are sourcing additional training and support for Staff to ensure they all understand how to communicate and support people who use the service in an appropriate and sensitive manner. Information is available in the home to show that peoples health needs are met. All files seen include up to date and comprehensive health action plans. There is evidence of consultation with GPs and other health professionals. Monthly reviews are carried out and recorded. People are supported to access the GP, dentist and other relevant health services. Records seen during our visit show that people who live in the home are protected Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: from harm through the safe handling of medication. A sample of medication recording sheets were inspected, these were up to date and well maintained. Guidelines for the administration of medication to be given as required are clear. Medication is stored securely in the home. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are listened to and know who to talk to if they are unhappy. People are protected from abuse. Evidence: A number of the people who live in this home have limited communication skills and are reliant on the knowledge of the people who work with them to recognise and take action when they are unhappy. Our observations during our visit indicate that people are generally content with the service they receive. One person is waiting to move into more independent accommodation and is therefore less happy with life in the home. There is an up to date complaints procedure. There have been no concerns brought to the attention of the Commission about this service since our last visit. People who we spoke to and relatives who responded to our recent survey confirmed they were happy with the service. A number of the people who live in the home experience challenging behaviours. Strategies are recorded and guidance provided for staff to help them manage these behaviours. Staff have received training in the Mental Capacity Act. People who live in the home are protected from abuse. Relevant checks are carried out on all staff before they begin working in the home. All staff receive training in safeguarding people. Care Homes for Adults (18-65 years) Page 19 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from the spacious and generally well equipped accommodation. Some improvement to parts of the premises is needed to enhance the quality of life and promote the safety and wellbeing of the people who live there. Evidence: A site visit to assess the suitability of the accommodation at the annex was carried out on 14th May 2009. An existing single storey building that was used as offices by the previous owner, located in the grounds of the main house, has been converted to provide accommodation consisting of two separate apartments, an entrance hall and a staff sleep-in room. Since that time a separate office has been created in an adjacent building. The annex is well equipped, decorated and furnished to a good standard. The two people who live there benefit from their spacious accommodation and well designed facilities. The main house provides accommodation for six people who each have their own bedroom. There are also spacious communal facilities although the room currently used as a dining room is very small. Decor in some areas of the main house is tired and would benefit from some attention to improve the environment of people who live there. Wooden flooring in some areas is shabby and does not look clean although it may just need polishing. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Work has begun on the garden, new paths are being laid. The responsible individual told us that work to make this area accessible for the use and enjoyment of residents is expected to be completed by the end of July 2010. People are being protected from risk of infection. Hand dryers have been installed in bathrooms and toilets since our last visit. There are 2 bathrooms and a shower room, these areas would benefit from upgrading to provide a more pleasant and homely environment for the people who use them. The paint on the ceiling in the ground floor bathroom is flaking. There are adequate laundry facilities, however this area needs redecoration and the location of the laundry means people have to go outside the house and enter the laundry through an external door to avoid taking dirty laundry through the kitchen. Care Homes for Adults (18-65 years) Page 21 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from the support of a team of staff who are friendly and kind. They are protected through robust recruitment policies and procedures. People can be confident staff receive appropriate training and are competent to provide the support they need. Evidence: People who live in the home benefit from the support of a team of staff who are friendly and kind. Throughout our visit staff were seen to be caring and supportive. We were able to attend a staff meeting during our visit. Staff welcome the changes that are happening in the home and are working hard to implement improvements. The annex is staffed completely separately from the main house. Here each resident is supported by two members of staff during the day and at night there are 2 members of staff on duty, one waking and one sleeping in on the premises. Although the location of the home is rather isolated, there are enough drivers on the staff team to ensure people are able to go out and about in the community. There is a stable staff team in the main house. This means staff know the residents well and they benefit from the continuity of care and support provided. Although staff are working hard to take on board the changes that are being introduced in how they Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: work with people who live in the home there is still some room for improvement in the way some staff communicate with residents. This has been recognised and the responsible individual told us that additional training is being arranged to support staff to relate consistently to residents as adults. There are robust recruitment policies and procedures in place to protect people who live in the home. The file for a new member of staff was seen. This showed all required checks had been carried out before they began working in the home. Training records seen show that staff are being provided with relevant training to ensure the are competent in their roles. Staff also engage in e leaning courses to update their knowledge. All new staff undertake an induction course. Care Homes for Adults (18-65 years) Page 23 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The new management team are making significant improvements in the service people receive. Quality assurance systems are now being operated to good effect to ensure people who live in the home can be confident the home is being managed in their best interests and their views are taken into account when decisions are made. The health and welfare of people is promoted through safe working practices. Evidence: Since our last visit the registered manager and the Responsible individual have left the company. A new Responsible Individual (RI) was appointed and began working to implement the improvement plan for the home in April 2010. The new RI and the whole staff team are working hard towards meeting all the requirements made in our inspection last report. Both staff and management are clear about where further improvements are needed and people who live in the home are benefiting from increased opportunities to influence how the home is run. Regular residents meetings have taken place when people are encouraged to express their views and wishes and be part of the decision making processes in the home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: A new registered manager is being recruited. Until this post is filled the senior team leader and the RI are taking responsibility for the day to day management of the home. Quality assurance systems are now being used to good effect to improve the service provided to the people who live in the home and identify where further improvement is needed. A number of recommendations from a recent independent audit of the service are being worked through. The new RI has not been in post long enough to effect all the changes necessary to ensure a consistently good service for residents. However the enthusiasm and commitment of the current management team has already improved outcomes for people who use the service with a more personalised approach to care planning and risk management and increased opportunities for choice and personal development. Work is progressing towards achieving compliance with all the requirements made following our last inspection. We have therefore not carried forward requirements into this report where significant progress has already been made. People who live in the home are protected through improved working practices. Staff have either already had up to date training in moving and handling, infection control, fire safety, basic food hygiene, health and safety or first aid or are booked to attend in the near future. Improved risk management processes minimise risk and promote the health, safety and wellbeing of people who live in the home. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 24 23 The registered person must ensure all parts of the care home are kept clean and reasonably decorated, and that gardens are well maintained and accessible. To promote the well being of people who live in the home. 31/03/2010 Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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