Care Home: Hallfield Guest House

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What the care home does well All service users were given a service user guide, which had been produced in a picture and word format to help service users understand what they can expect from Hallfield Guest House. All the people who used the service said that they received enough information. Assessment and care planning procedures in the home were very good with potential users of the service encouraged to visit as often as they liked before making a committment to spend a night. The home offered comfortable accommodation, which was clean and well maintained throughout. The decoration and furnishings were of a high standard. The recruitment, selection and induction for new workers was good and included a probationary period of six months. This helped to make sure that only suitable people were employed at Independent Options. The training programme was comprehensive with support workers being given the opportunity to attend courses and put forward ideas for training that would meet their individual needs. The majority of the support workers had completed a National Vocational Qualification (NVQ) level 2 or Level 3. All the staff we received questionnaires from or spoke with said that they were being given training that helped them understand and meet the individual needs of people; kept them up to date with new ways of working and gave them enough knowledge about health care and medication. All the managers of the different services within the organisation had a professional qualification in either social work and/or nursing or an NVQ Level 4 in Management. The manager of Hallfield Guest House had completed the registered managers award. The organisation distributed surveys to the people who used the service and their relatives to obtain feedback on the support being provided. All their views and opinions were put together and a report was written which was given to everyone. This takes place each year. The agency had received the Investors in People Award and the Positive about Disability Award from Employment Services. The organisation also used the quality assurance system PQASSO (Practical Quality Assurance System for Small Organisations) and had achieved Level 3. The executive board met every two months. People were welcome to attend the meetings but could be asked to leave if there were personal or confidential items to be discussed. Members and the Chief Executive visited Hallfield on a monthly basis and wrote a report of their findings. Copies were available for the inspector to read. What has improved since the last inspection? The organisation had carried out a full review of each persons case file to ensure that all documents were up to date and relevant. There was now a standard format for all files to make sure that information was easily accessible. Assessment documents were now being typed up and saved on the computer which made them easier to amend, easier to read and looked more professional. All senior support workers and managers have had training on case management which had included training on Assessment, Risk Assessment and Support Planning. Themed weekends at Hallfield Guest House were continuing to be a huge success. Guests continued to make suggestions on what they would like themes to be. The organisation now had 2 volunteers to help people access more activities within the community and surrounding areas. Young peoples weekends had been started due to the increased number of younger people now using the service. Guests had begun to use the two new apartments which had been built on the lower ground floor for more independent short breaks. Guests liked to book in at the same time as their friends and used the adjoining apartments. Both the apartments had their own separate entrances but had an interconnecting door which could be locked or left free. The organisation was now using the `Whats Working / Whats not Working` tool with staff and the people who used the service to develop the support provided. The sub-committee which was made up of people who used the service and staff had reviewed the Complaints and Suggestions policy. This was to make sure that the policy could be understood by the people who used the service. It had now been printed and was being given out to people and would replace the existing one in the service user guide. Guidelines from the Infection Control Audit had been implemented which included an updated Infection Control Procedure and Policy. Infection Control was now part of the team meetings agenda and discussed at each team meeting. The maintenance files at both the office and the property had been reviewed and changed to make them easier to use. Additional health and safety signs had been put up around the property where there were hazards such as hot water and steps. Staff who held a National Vocational Qualification (NVQ) level 2 were now being offered NVQ level 3 as part of their professional development. NVQ level 4 in Care had also been introduced for the Senior Support workers. People who used the service were being involved in the recruitment and selection process of staff through their work as part of the Service User Sub-Committee. Members had worked on developing interview questions which would be tailored to reflect the type of service the person was being interviewed for. Independent Options had before our inspection been inspected by the organisation `Supporting People` who provided funding to the people who used the service. Although the managers had not yet received the report they had been informed verbally that their ratings had continued to improve. The managers were extremely pleased with their results.As part of the short breaks service there were plans to develop links with the Wai Yin Womens society to provide culturally accessible short breaks for the Chinese community. This would include recruiting and employing staff who would be able to act as an interpreter for the families carers and people who would be using the service. As part of the assessment process the staff will also link with a translator and translate the assessment documents. Training in the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS) was being provided. What the care home could do better: We have made no requirements or recommendations as we are confident that the organisation Independent Options has a culture of continuous improvement. Key inspection report Care homes for adults (18-65 years) Name: Address: Hallfield Guest House 50 Hall Street Stockport Cheshire SK1 4DA     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: Jacqueline Kelly     Date: 1 6 1 2 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: Hallfield Guest House 50 Hall Street Stockport Cheshire SK1 4DA 01614566502 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): acharles@independentoptions.org.uk Independent Options (Stockport Limited) Name of registered manager (if applicable) Mrs Angela Ablus-Charles 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 registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 Date of last inspection Brief description of the care home Hallfield Guest House is a care home that is owned by Independent Options (Stockport) Limited and is one of two short stay homes that provide respite care to service users with a learning disability. Hallfield Guest House is registered to accommodate up to eight service users between the ages of 18 and 65 years at any one time. Service users are referred to as guests and are encouraged to see their break at the home as a holiday. The property is a large four storey detached building. Accommodation comprises of six bedrooms with en suite facilities, five are situated on the first floor and one on the Care Homes for Adults (18-65 years) Page 4 of 30 8 Over 65 0 Brief description of the care home ground floor. There are two self contained apartments on the lower ground floor both with there own separate entrances. There is car parking space to the rear of the property and garden areas situated to the front and side of the building. There is ramp access to the front of the property. Hallfield Guest House is situated close to the town centre with good access to cinemas, local shops, library and park. Stockport town centre, motorway network and public transport are easily accessible. There is a statement of purpose and service user guide. The service user guide is also produced in a picture format, which is helpful to the service users. Inspection reports were available on request. The fees range from £133.82 to £170.98 depending on the persons needs. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms we and us were used. We last inspected this service on the 26 March 2007. On the 27 March 2008 and the 16 March 2009 we carried out an Annual Service Review. This is a review of good and excellent services that takes place between key inspections. At the time we conducted the review we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. This was a key inspection for which twenty-four hours notice was given so that the manager would be available to take part in the inspection process. Time was spent at Care Homes for Adults (18-65 years) Page 6 of 30 the office premises of Independent Options (Stockport) Ltd and at Hallfield Guest House. We were accompanied by an expert by experience for the visit to Hallfield Guest House. We met the three people who were staying at the time of the inspection and we also met three of the staff team. The information we were given said that Hallfield Guest House had provided a service to eighty-one people in total over the past twelve months. The number of permanent support workers employed was twelve with six relief staff to cover for holidays, sickness and when extra staff were required to cover extra care needs. Before this key inspection we asked the manager of the home to complete an Annual Quality Assurance Assessment, AQAA, to tell us what they felt they did well, what improvements they had made and what they could do better. They were also asked to give us current information as to employment of staff and training provided over the past twelve months. The form had been completed honestly and it showed us the manager saw the service being provided the same way as we did. There was sufficient information about how the service was provided, what improvements had been made and what the service could do better. During the inspection we looked at the care files and care plans that were held at the main office. We also looked at the personnel, supervision and training records of the support staff. At our visit to Hallfield we saw the care plans for the the three people who were currently staying there. These were kept at Hallfield and locked away safely when the people were not staying at the home. We were also given other documents such as the communication book which contained a record of meals served, medication records and the food safety file. The support workers we met had worked for the organisation for fifteen years, twelve years and seven years. All said that they liked working at Hallfield Guest House. They said that they had plenty of training and received good support from the manager. Questionnaires were sent out to twenty of the people who used the short breaks service at Hallfield and fifteen to the support workers. We had returned to us eleven service user surveys and three staff. The information we received was mainly positive from both the support workers and the people who used the service. All the surveys from the people who used the service had been completed by relatives; comments we received on their behalf to the question what does the home do well were; the staff are very nice and I know them and they know me. A lot of them I have known for a few years which is good as I dont have to get to know too many new ones; I love going out and they do this a lot, they also let me use the telephone to contact friends and family. They take me on a low-liner bus, which not many people are willing to do. I like the food and we sometimes have take-aways. It is good that they have a monitor in the bedroom in case I need help during the night; look after me and make me feel welcome. Everything is first class and the staff are terrific. I prefer to call Hallfield a guest house as I look upon it as a holiday break; always friendly - very welcoming - lovely meals - have great days out - will always help; help me mix with others; they listen to client specifications and try to accommodate Care Homes for Adults (18-65 years) Page 7 of 30 listen to the client also if two clients dont get on they try not to put them together, very happy with the quality of care. The staff said to the same question what does the home do well; care for all of our guests and do our very best to meet individuals needs, support and make the person feel comfortable during their stay; we always are seeing if things need improving, checking that the running of the property and standards of care and everything is running smoothly - so dont think we could do any better , but we welcome any suggestions; Hallfield guest house promotes independence of all the people we support. We provide short breaks for adults with learning disabilitys to have a valued and meaningful stay with us, gaining new experiences and trying new things during their stay. We take on board parents carers/guests feedback about Hallfield and work toward all stays being positive. The home is known for its theme weekends which all guests enjoy. There were only three negative comments; one regarding communication, one about empowering the guest to be more independent in their daily activities and finally the staffing level at key times could be better, staff do work as team but sometimes shifts are busy and do warrant extra support. There had been one complaint made to Independent Options which was upheld. Action was taken by the managers and required no further action by us. There had been no safeguarding adult referrals or investigations. Care Homes for Adults (18-65 years) Page 8 of 30 What the care home does well: What has improved since the last inspection? The organisation had carried out a full review of each persons case file to ensure that all documents were up to date and relevant. There was now a standard format for all Care Homes for Adults (18-65 years) Page 9 of 30 files to make sure that information was easily accessible. Assessment documents were now being typed up and saved on the computer which made them easier to amend, easier to read and looked more professional. All senior support workers and managers have had training on case management which had included training on Assessment, Risk Assessment and Support Planning. Themed weekends at Hallfield Guest House were continuing to be a huge success. Guests continued to make suggestions on what they would like themes to be. The organisation now had 2 volunteers to help people access more activities within the community and surrounding areas. Young peoples weekends had been started due to the increased number of younger people now using the service. Guests had begun to use the two new apartments which had been built on the lower ground floor for more independent short breaks. Guests liked to book in at the same time as their friends and used the adjoining apartments. Both the apartments had their own separate entrances but had an interconnecting door which could be locked or left free. The organisation was now using the Whats Working / Whats not Working tool with staff and the people who used the service to develop the support provided. The sub-committee which was made up of people who used the service and staff had reviewed the Complaints and Suggestions policy. This was to make sure that the policy could be understood by the people who used the service. It had now been printed and was being given out to people and would replace the existing one in the service user guide. Guidelines from the Infection Control Audit had been implemented which included an updated Infection Control Procedure and Policy. Infection Control was now part of the team meetings agenda and discussed at each team meeting. The maintenance files at both the office and the property had been reviewed and changed to make them easier to use. Additional health and safety signs had been put up around the property where there were hazards such as hot water and steps. Staff who held a National Vocational Qualification (NVQ) level 2 were now being offered NVQ level 3 as part of their professional development. NVQ level 4 in Care had also been introduced for the Senior Support workers. People who used the service were being involved in the recruitment and selection process of staff through their work as part of the Service User Sub-Committee. Members had worked on developing interview questions which would be tailored to reflect the type of service the person was being interviewed for. Independent Options had before our inspection been inspected by the organisation Supporting People who provided funding to the people who used the service. Although the managers had not yet received the report they had been informed verbally that their ratings had continued to improve. The managers were extremely pleased with their results. Care Homes for Adults (18-65 years) Page 10 of 30 As part of the short breaks service there were plans to develop links with the Wai Yin Womens society to provide culturally accessible short breaks for the Chinese community. This would include recruiting and employing staff who would be able to act as an interpreter for the families carers and people who would be using the service. As part of the assessment process the staff will also link with a translator and translate the assessment documents. Training in the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS) was being provided. 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 11 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 12 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 thinking of using the services of Hallfield Guest House received both written and picture information together with an assessment of need to help them make a decision. Evidence: The service user guide had been updated to include our new address and telephone numbers. Also included was the name of the new Chief Executive of Independent Options Christine Barker. The guide was printed using large letters, numbers and had pictures to help people understand what the service had to offer. An up-to-date Statement of Purpose was kept at the property for people to look at. DVDs and CDs were also given to people to help them make choices. Referrals were made to the service through Stockport Learning Disability Partnership or through other Social Service departments outside of the Stockport area. Once the referral had been received by Independent Options a home visit was arranged to talk about what the people needed and how these could be met. A visit to Hallfield was then arranged so that people were able to see the home and meet some of the staff Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: and other people who used the service. Other visits were arranged so that personal information and assessment forms could be completed to make sure that needs could be met and the person was happy with the arrangements. Once all this had been completed a tea visit was arranged and if successful further longer stays were booked. The assessment forms had been produced with the help of the sub-committee which includes people who use the service. The completed assessment form is put on the computer so that it can be kept up-to-date easily and is available quickly for all the staff team, service users and relatives. All the people who used the service had an Individual Service Agreement which is the contract between Social Services and Independent Options and the person who used the service. Care Homes for Adults (18-65 years) Page 14 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. Assessments and care plans include peoples personal and social care needs and wishes so that they are provided for during their stay. Any activity is risk assessed to make sure people are kept safe. Evidence: We looked at the care/support plans of three of the people who used the service. All were found to have plenty of information that told the support workers about the needs, wishes, likes and dislikes, and a weekly time table of activities for the people they cared for. They also showed that the information had been reviewed and up dated as necessary. Parts of the care plan were written in a way to help people understand what was being said about them. During their stay at Hallfield Guest House people were encouraged to make their own decisions and choices, within their capabilities such as what they ate at meal times and what activities they did during their stay. Risk assessments were in place to make sure that the people were safe in whatever they choose to take part in. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Care Homes for Adults (18-65 years) Page 16 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. People are enjoying a good quality of life and are involved in a good range of activities during their stay at Hallfield Guest House. Evidence: The people who used the service lived with a relative or long term adult placement carer and used the accommodation at Hallfield Guest House for short breaks ranging from one night to two weeks. The service provided a break for both the person and their carer therefore they did not often receive visits from friends or family during their stay at Hallfield Guest House. Any activity they attended from home such as a day centre, adult education classes or employment was carried on during their stay at Hallfield. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Leisure activities were organised by the support workers at Hallfield Guest House. These took place in the evenings and at weekends for instance meals out, trips to local working mens club, swimming and cinema, themed weekends or whatever people were interested in. A computer with Internet access was provided for the peoples use during their stay. At the end of each stay a letter was sent home to parents/carers informing them of how the time had been spent. These were now being typed up rather than hand written which were better as they were easier to read. The support workers kept small amounts of pocket money for which a record was kept and a copy of the account was sent home at the end of the stay. The routines of Hallfield were for the most part set around the daily activities which the people took part in at home. At other times the support workers were flexible and respected peoples preferences. There was no set menu, as the meals were planned around the people who were visiting that week. Shopping was done at the local supermarket. Halal meat was purchased from an appropriate butcher to support those who required a Halal diet. The support workers when booking people in for their stays wherever possible matched people who had similar likes and dislikes, were of a similar age and had during previous visits formed friendships. Care Homes for Adults (18-65 years) Page 18 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. Personal support and health care needs are met according to their wishes and requirements. Evidence: Information received during the assessment covered the personal health care needs of the person. Specific details about particular illnesses and how the person needed supporting were included in the care plan for the support workers to read. The main carers were the people responsible for obtaining ongoing health care through GPs and consultants. The support workers followed the instructions provided by the parent/carers whilst the people were staying at Hallfield Guest House. The local GP to Hallfield would see anyone if they became ill during their stay. As with health care the parents/carers were responsible for clothes, hairstyles, make up and general appearance. All staff attended training on Empathy and Empowerment which provided them with experiences to get an insight into how it felt to receive personal support. These experiences included having their teeth brushed, smoking before attending to a Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: person and looking at the practice of putting cartoons on over and over again. An external trainer who was a qualified pharmacist had provided training for all staff. The training organisation had provided a booklet, certificate and an internal competency check list to be used by the agency. The manager of the service annually assessed the competence of the support workers. Medication was only administered in agreement with the support plan that had been signed by the person who used the service or their representative and the manager. Care Homes for Adults (18-65 years) Page 20 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. People using the service are protected by the complaints and safeguarding procedures and staff training. Evidence: The sub-committee which was made up of people who used the service and staff had recently reviewed the complaints and suggestions policy. This had now been distributed to the people who used the service and will replace the existing policy in the service user guide. There had been one complaint documented over the past twelve months which had been upheld and action taken as a result of the complaint. There were policies and procedures regarding personal finances with records kept and receipts provided. Training in the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS) was being provided. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hallfield Guest House provides a safe and comfortable place for people to stay that is well maintained, decorated and furnished to a high standard. Evidence: The home is a six-bedroom detached house with two self-contained apartments on the lower ground floor each with its own separate entrance. The apartments consisted of a lounge, kitchen, bathroom and double bedroom. There was an inter-connecting door between the two apartments which allowed access between the two or the door could be locked for more privacy. The ground floor of the house consisted of an entrance hall, lounge, dining room, kitchen and one bedroom. The bedroom on the ground floor had an en-suite facility and was large making it suitable for people who may use a wheelchair. The first floor had a further five bedrooms all with en suite shower, toilet and wash hand basin. There was also a bathroom for those service users who may like a bath instead of a shower. On the second floor there was a staff sleeping in room, which also doubled up as an office. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The front of the house, which faces onto a busy main road, had a small garden. The rear had a patio area and parking facilities for a small number of cars. The home was decorated and furnished to a high standard it was clean, tidy, bright and airy. Regular inspections of the fire alarms and of the emergency lights were carried out annually by qualified engineers. The organisation had implemented guidelines from the Infection Control Audit and had completed an infection control procedure and policy. Infection control was now part of the team meetings agenda. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who stay at Hallfield Guest House are supported by well trained, effective staff who have gone through a thorough recruitment process, so peoples needs are met and they are safe from possible harm or poor practice. Evidence: The majority of the staff team had a National Vocational Qualification (NVQ) level 2 or above. Senior managers have either a NVQ Level 4 in Management, Registered Managers award and/or a qualification in social work and/or nursing. Other core training such as moving and handling, health and safety, adult protection, food hygiene and medication was on going. The training programme included a structured induction which complied with LDA (Learning Disability Award) and ongoing training and development. All the senior staff had received training in care management so that more people could do the assessments and update them and the support plans. There was a three staged recruitment procedure in place that included a group interview, a panel interview with a minimum of two managers followed by a face to face personal interview with a least one manager. People who used the service were Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: involved in the interviews. The sub-committee (which included people who used the service) had been involved in setting the questions for the interview form. All staff including temporary workers and sessional bank staff had a contract of employment or a letter of appointment. Volunteers had to read and sign a volunteers agreement. All staff received a Staff Handbook that included information about the service and policies and procedures they must follow together with a copy of a Code of Practice. Staff files and Criminal Record Bureau disclosures were looked at. All the files contained the necessary information to make sure that wherever possible only suitable people were employed. One of the people who used the service helps present training for staff on Basic Signing. He was paid to provide this training and he had taken part in a number of sessions throughout the year. This training was now part of the training requirement for all staff working with people who used sign language. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was well run and a high level of consultation meant that people using the service could contribute to its development. Evidence: Since the last inspection of 2007 Ms Angela Ablus-Charles has been appointed as the manager was now registered with us. She had completed the Registered Managers Award and was skilled and experienced to manage the service. The registered manager was responsible for the short breaks service, which included as well as Hallfield Guest House a second respite care home 55a Beech Avenue. Ms AblusCharles was qualified, competent and experienced to run the service. The organisation used a quality assurance system that allowed people who used the service and others to have a say in the running of the organisation. Satisfaction questionnaires that were appropriate for the people who used the service were sent out annually. The results were given to all the people using the service. Managers also conducted, as a minimum, annual visits to people who used the service to review the support and monitor the performance of the support workers. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Other quality assurance procedures included Investors In People and Positive about Disability awarded by Employment Services. An annual report which included the organisations balance sheet and business plan was produced which was distributed to all the people who used the service, relatives and other interested parties. Ways of updating support workers on health and safety issues such as moving and handling and fire safety included formal training, team meetings, one to one supervision and written policies and procedures. The organisation had a detailed procedure for reporting of accidents. Hallfield met the requirements of the fire authority and maintained records in respect of fire safety at the home. As part of the short breaks service there were plans to develop links with the Wai Yin Womens society to provide culturally accessible short breaks for the Chinese community. This would include recruiting and employing staff who would be able to act as an interpreter for the families carers and people who would be using the service. As part of the assessment process the staff will also link with a translator and translate the assessment documents. Since the last inspection of 2007 there has been a change of Chief Executive and Responsible Individual which is Ms Christine Barker. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 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. 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