Care Home: Haddon House

What the care home does well People told us they are happy living at the home, their comments included: ``I get to do the things I wants, activities I want``. ``I`m very happy here``. ``Nothing I would change``. ``I do lots of activities here, I am happy with whats on offer``. The people living there were asked what they wanted to do and where they wanted to go. Staff offered them choice throughout the day and supported them to do the things they wanted to do. People are supported to keep in touch with their family and friends so they do not lose relationships that are important to them. There is a choice of healthy food so that people are supported to keep well. Plans that explain how to care for the people living there are well written so that staff know how to support individuals in a way they need and prefer. Staff help the people living there to do as much for themselves as they can to be as independent as possible. Medication is now kept in locked cabinets in peoples bedrooms. This means that people can have their medication administered in the privacy of their room. Staff have training to help them understand how to protect the people living there from harm and understand how to help them keep well. Equipment in the home is often tested to make sure it is working and safe to use. What has improved since the last inspection? Management of risks to people has improved so that risks are more safely managed and people are as safe from harm as possible. People are encouraged to organise their own meetings and that staff only attend if requested. The medicine management has improved to safeguard the health and wellbeing of the people who live in the home. Staff have had more training so that they are better able to meet people`s needs. The frequency of staff supervision has increased so that staff receive this at least every other month to make sure they get the support they need. What the care home could do better: The service user guide should be improved so that people have all the information they need to help them decide if they would like to live there. The system to respond to maintenance requests should be improved so that people know their requests are being dealt. Improve the arrangements for retaining Criminal Record Bureau disclosure documents so that people can be confident the home has robust recruitment procedures in place. Make arrangements for staff to have further training in mental health. So that the staff team has increased skills and knowledge in the specific needs of the people they support. Key inspection report Care homes for adults (18-65 years) Name: Address: Haddon House 145 West Heath Road West Heath Birmingham West Midlands B31 3HD     The quality rating for this care home is:   two star good 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: Kerry Coulter     Date: 1 9 0 4 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 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) © 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 30 Information about the care home Name of care home: Address: Haddon House 145 West Heath Road West Heath Birmingham West Midlands B31 3HD 01214751681 01214751681 haddon@cttm.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Haddon House Limited Name of registered manager (if applicable) Ms Joanne Tuke Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 6 Date of last inspection Brief description of the care home Haddon House is a large detached house situated in the West Heath area of Birmingham. It is situated along a service road adjoining the main West Heath Road. The home has six single bedrooms, two of which are on the ground floor and four on the first floor all of which have en-suite facilities. The lounge and dining room are to Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 0 8 0 6 2 0 0 9 Brief description of the care home the rear of the premises. A toilet and shower room are situated on the ground floor. There is a bathroom on the first floor with a grab rail. There is room for parking on the front driveway and access to the house is via sloped wooden decking area, providing wheel chair access. There is a well maintained rear garden that also benefits from a wooden decking area that has a canopy roof. This provides an attractive seating area for people. A sloping ramp leads to a further small patio area and lawn. There is a range of garden furniture for the people to use. The home has access to a vehicle that staff use to take people out but the home also encourages use of public transport enabling people to access local facilities and Birmingham City Centre. Local amenities such as shops, banks and the GP practice are close by and the home has good transport connections via bus and rail services. A copy of the latest inspection report is available in the home for visitors who wish to read it. The service users guide does not include details of the range of fees to live at the home and so people would need to contact the manager for fee details. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over one day by one inspector. The home did not know we were going to visit. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. We sent surveys to all the people who live at the home and ten members of staff. Care Homes for Adults (18-65 years) Page 6 of 30 Completed surveys were returned to us by seven staff. We did not receive any surveys from people who lived at the home. We case tracked the care received by two people living there. This involved establishing individuals experience of living in the care home by meeting and talking with them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at parts of the home and a sample of care, staff and health and safety records were looked at. We also spoke with people who live at the home, the manager and staff. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The service user guide should be improved so that people have all the information they need to help them decide if they would like to live there. The system to respond to maintenance requests should be improved so that people know their requests are being dealt. Care Homes for Adults (18-65 years) Page 8 of 30 Improve the arrangements for retaining Criminal Record Bureau disclosure documents so that people can be confident the home has robust recruitment procedures in place. Make arrangements for staff to have further training in mental health. So that the staff team has increased skills and knowledge in the specific needs of the people they support. 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to assess peoples needs and give them information before they move in so they can be confident the home can meet their needs. Evidence: The home had a service user guide available to people in the home. This was in a format that included lots of photographs so that it was easier for people to understand. The guide was not dated so it was not clear how up to date the information was. The manager told us the guide had been recently updated. We saw that further information needed to be added to the guide. It should include our full contact details, how much it costs to live there and make clear that people with mobility difficulties may not be able to access the first floor of the home. This will help to make sure people know what to expect from the home. No new people have been admitted to the home since our last inspection. The home currently has one vacancy.The manager told us the home had received two referrals but that one of these had been for an emergency admission. The manager told us that the home does not admit people until a full assessment of the persons needs has Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: been completed and so the emergency admission did not go ahead. The manager said that one person was currently being assessed for admission to the home. We were told that the manager had visited and met the person where they were currently living and that the person had an initial visit to Haddon House. The manager told us that the next step would be for the persons relatives to visit the home and for a full assessment of needs to be completed. This helps to ensure that people can be confident that staff will be able to meet their needs on admission. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems in place help to ensure that staff have the information they need to support people in the way they need and prefer. Evidence: The records of two people living at the home were sampled. These included an individual care plan. Care plans are records that are used to show what sort of help each person needs and how staff will provide that care. These stated the likes and dislikes of the person, their physical and mental health needs, dietary requirements, personal care and hygiene, leisure/social, contact with family and friends, psychological support, finances, domestic skills, cultural and religious needs. Plans detailed how people needed to be supported to maintain and develop their independence. Care plans had been regularly reviewed and updated. Plans sampled were generally detailed in content so that staff had information about how to meet peoples need. Staff practice showed they were aware of people needs. Relapse management plans were seen to be in place regarding peoples mental health Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: needs. These gave staff information about early warning signs that the persons mental health may be deteriorating and what action they need to take to ensure the persons well being. Throughout our visit people were seen to make their own choices and decisions about the things they wanted to do. One person spoken with told us she always made her own decisions. Regular meetings with the people that live there are held and these are recorded so that people can have a say in how their home is run. Meetings are chaired by people who live at the home. Minutes of meetings show recent discussions have included where people would like to go on holiday, menus, the environment and activities. The homes annual quality assurance told us that people are encouraged to organise their own meetings and that staff only attend if requested. The home has risk assessment records to guide staff in how to support people with activities that may involve an element of risk. Risk assessments sampled had been regularly reviewed. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here experience a meaningful lifestyle that meets their individual needs. Evidence: Discussion with people and records sampled showed that they are supported to do the activities they enjoy. A plan of activities that each person would like to do is completed on a weekly basis with them. Minutes of meetings show that some people are currently being supported by staff to go to the library to use the Internet and improve their computer skills. People have the opportunity to participate in a wide range of community activities. They go shopping, to the local gym, the pub, the cinema, shopping, out for meals, to the library and to local events. People told us they had recently been to a celebrity charity football match at Aston Villa Football Club that they had really enjoyed. Some activities are in groups whilst others are undertaken on an individual basis. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: In house activities include cooking, film nights, using the Wii Fit and social events such as cheese and wine evenings. People told us they were happy with the activities on offer. One person told us I get to do the things I wants, activities I want. Another said Im very happy here, been out shopping today, nothing I would change. One person told us I do lots of activities here, I am happy with whats on offer, I go to the cinema and am part of a walking group. People are supported to develop work skills. One person was meeting with a care professional when we visited to discuss their wish to work with children. Another person has recently been supported by staff to go to a local charity shop to enquire about doing voluntary work there. Throughout the day people were observed to be encouraged to be as independent as possible. They made their own drinks and some went shopping for personal items. Records showed that people help staff to prepare meals, do the food shopping, do their own laundry and tidy their bedrooms. It is an area of good practice that staff are working with people to prepare for them voting in the forthcoming general election if they choose to. Staff were being very mindful to give people information about all the candidates in their area without expressing their own personal opinions. Staff told us the home has an open visiting policy. One persons relative was visiting the home during our inspection. We saw they were made welcome by staff. Records showed and people said that they are supported to keep in contact with their family and friends so they do not lose relationships that are important to them. Menus sampled showed that a variety of healthy food is offered. People have the opportunity to try foods from a variety of cultures. Staff told us that the menu is agreed with people at the home. Fresh fruit was available so that the people living there could help themselves when they wanted it. Staff spoken with were aware of peoples food preferences. At lunch time there was a choice of food. Staff ate with people making it a pleasant social occasion. One person told us The food here is okay. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the personal care and health needs of the people living there are met. Evidence: Care plans sampled showed how the person needed support with their personal care and to meet their health needs. People at the home are generally quite independent with regards to their personal care. People were seen to be well groomed in an individual style. Records sampled showed that the home seeks input from other health professionals when this is appropriate. For example from the GP, Community nurses or Psychiatrist. Records sampled showed that the people living there had regular health check ups, for example with the dentist and optician. Records show that people at the home are weighed regularly. This helps staff to monitor peoples wellbeing as losing or gaining a significant amount of weight can be an indicator of an underlying health need. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Where people have specific health needs care plans are in place so that staff have information on the support the person needs to stay well. Staff spoken with told us they had received training that was specific to peoples needs, for example in diabetes. It is good that regular exercise is incorporated into peoples activity plans as this helps to promote a healthy lifestyle. One person has recently been unwell and records showed the home had sought medical advice. Their relative told us staff were wonderful, they were persistent when she was unwell and other health professionals kept saying there was nothing wrong. Medication is kept in locked cabinets in peoples bedrooms. This means that people can have their medication administered in the privacy of their own room. Staff who administer medication have received training to do so. The people living there are assessed as to whether or not they can manage their own medication or what support they might need to achieve this if they want to. A photograph of the person is kept with the medication administration chart (MAR) so that new staff would know who the person is. This reduces the risk of medication being given to the wrong person. Some people were prescribed PRN (as required medication) Individual protocols were in place stating when, why and how much of this should be given to the person. Copies of each persons prescriptions are kept so that staff can ensure that what is provided by the pharmacist is what has been prescribed by the doctor. 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. Arrangements ensure that the views of the people living in the home are listened to and acted on. The people living there are protected from abuse, neglect and self harm. Evidence: We have not received any complaints about this home in the last twelve months. The homes annual quality assurance assessment (AQAA)told us that the home had not received any complaints directly. The AQAA said that any concerns are usually dealt with and resolved immediately. The complaints procedure was available to the people living at the home and people said they knew how to make a complaint if they were unhappy about anything. Surveys we received from staff recorded that they knew what to do if people wanted to complain. A relative told us they would feel able to raise any concerns, they said The manager usually gets things sorted, its a good home. Discussions with the manager, staff and sampling of records show that the majority of staff have received training in safeguarding people from abuse. Three staff who had received only basic induction training were already scheduled to attend further training. Most staff have had training in in the Mental Capacity Act so they know how to ensure people are protected and their rights are respected. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: People are provided with a safe place to keep their money and most people look after their own with some support from staff. Care plans were in place stating the support that staff are to give. This included help with budgeting and supporting people to go to the bank. 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 adequate 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 safe and homely environment but some improvement is needed to make sure it meets their individual needs. Evidence: We looked at all of the communal areas in the home and some of the bedrooms. Decor was in good order. Peoples bedrooms that were seen were individual in style. There were photographs of people important to them and pictures that reflected their interests. Some people have their own fridge in their bedroom where they can keep drinks and snacks that they can have when they want them. Carpets in three peoples bedrooms were seen to be very worn in some areas. People told us they were happy with their bedrooms but would like new carpets. We were told that the carpets had been in a worn condition for some time. The homes maintenance records show the manager had reported this several times. Discussion with the manager indicates that she has received no dates when these will be replaced. Records showed there was other maintenance work required that had been requested but that had not been done. The provider should carry out a review of the maintenance procedures to make sure people are not having to wait for repairs to Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: their home. When we did our inspection last year we saw that the rear of the garden was fenced off and was not used. People living there had written to the provider to request that this garden area was improved. At this visit we saw that the rear of the garden was still fenced off. We were told that people had not received a response from the Provider regarding improving the garden. One person had recently completed the homes satisfaction survey, they said they wanted the garden to be done. Each person has an en suite shower and toilet. There is a shared bathroom upstairs so that people can have a bath if they want to. The home was generally clean, free from unpleasant odours and a comfortable temperature. We saw that one persons shower head was not clean and the manager made immediate arrangements for this to be replaced when brought to their attention. Discussions with the manager indicates that infection control audits are currently carried out. The manager said they had obtained a format for infection control audits and this would be introduced so that people can be confident their home is clean. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supportedby a trained, supported and supervised staff team who can meet their individual needs. Evidence: The majority of staff at the home have achieved a National Vocational Qualification in care. This means that people are supported by staff who have the right qualifications. Staff interaction with people during our visit was good and people were treated in a friendly and professional manner. One person told us staff are brilliant. One relative said they are wonderful. The manager said and rotas showed that there is usually a minimum of three staff on duty duringthe day. At night there is one waking night and one sleep-in staff. Bank staff are used to cover vacancies so that people are usually supported by staff they know well. The manager said the home also has social work students from a local university on placement at the home and they are also supernumerary to the rota. We saw that there were enough staff on duty when we visited to meet peoples needs. One relative told us there are always enough staff. The records of two staff were sampled. These included the required recruitment records to help ensure that suitable people are employed to work with the people Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: living there. Staff training records sampled indicate that in general staff have the training they need. This was confirmed by staff in the surveys they returned to us and in discussions with staff during our visit to the home. Staff spoken with confirmed they had received an induction to the home. At our last inspection discussion with the manager indicated that it was hoped to provide staff with more training regarding mental health and Deprivation of Liberty Safeguards legislation. This has not yet taken place, however the manager has identified a suitable mental health training course. We saw evidence that she has made a request to the HR department at head office for staff to attend this training. Discussions with staff and sampled records indicate that staff have regular meetings and receive supervision. This means that staff have a formal opportunity to keep updated with the changing needs of the people living there, and with best practice and be involved in the running of the home. 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. The management arrangements help to ensure that the home is well run for the benefit of the people who live there. Evidence: The manager is registered with us to manage the home. They have many years experience of working in care. They have a nursing qualification and have completed their NVQ level four and Registered Managers Award. This means they have the right qualifications and experience to manage the home. We spoke with two people who work in the home about the management arrangements. One told us I can speak to the manager if I have any concerns about anything. Another said the home has a friendly and supportive atmosphere. The manager completed and returned the annual quality assurance assessment when we asked for it. This was completed to a satisfactory standard and told us about the improvements the home had made and improvements they intend to make this year. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: A representative of the provider visits the home monthly and writes a report of their visit to make sure the home is being well managed. Reports showed that the people living there and staff are consulted with as part of the visit. People living there had completed comment cards that asked for their views about the home. We sampled these and found that people were generally positive in their comments. The comment cards would be a more useful tool if all the results from them were put into one report that could then be made available to people who live there. The fire procedure was produced using pictures making it easier to understand and was displayed in the dining room. Regular fire drills are held so that staff and the people who live there know what to do if there was a fire. An engineer regularly services the fire equipment to make sure it is working and well maintained. Staff test the fire alarms regularly to make sure they are working. Certificates were available to show that the annual test of the gas equipment had been completed and stated that it was safe to use. An electrician completed the five yearly test of the electrical wiring in 2006 and stated that it was in a satisfactory condition. Staff test the water temperatures weekly to make sure they are not too hot or cold, which could put the people living there at risk of harm. Records of accidents were available. Discussion with the manager indicates there is no formal system in place for auditing these. A system of auditing should be introduced. This would help to identify any patterns or trends so that action can be taken to reduce the likelihood of similar accidents. 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 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 The service user guide should be improved so that people have all the information they need to help them decide if they would like to live there. The system to respond to maintenance requests should be improved so that people know their requests are being dealt. Worn carpets in peoples bedrooms should be replaced so that people have bedrooms that are nice places to spend their time. A system of infection control audits should be introduced so that people can be sure their home will be clean. Make arrangements for staff to have further training in mental health. So that the staff team has increased skills and knowledge in the specific needs of the people they support. A report of the completed satisfaction survey should be completed and made available to people. This should include what action the home is taking to respond to peoples suggestions. This will help people to be confident Page 28 of 30 2 24 3 26 4 5 30 35 6 39 Care Homes for Adults (18-65 years) 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 that their views are being listened to. 7 42 A system of auditing the accident records should be introduced. This would help to identify any patterns or trends so that action can be taken to reduce the likelihood of similar accidents. 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. © 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. 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