Care Home: Hart View

What the care home does well The home is well managed and people who live there can make comments and suggestions, which are taken into account in the day to day running of the home. There is detailed information available about the home, which is given to people who are looking for a place in a care home to help them decide if it will be the right place for them. The manager carries out a detailed assessment of each person`s needs and the individuals visit the home for day, overnight and weekend stays to help them get to know other residents and staff. Each person living in the home has a detailed care plan, which is written with their involvement. Residents wishes are included within the care plan. Residents are supported to live their lives in an independent way in preparation for moving on to their own accommodation. Staff support residents to be independent for their health and personal care needs and offer support and encouragement where needed. Residents undertake a programme to take responsibility for their medicines as part of their rehabilitation and in preparation for living more independently. Residents can air their views openly and make complaints, comments and suggestions. There are procedures in place and staff are trained to recognise and report any signs of abuse or poor practice so as to help safeguard people who live in the home from harm or abuse. Staff are recruited robustly and all the appropriate checks including references from previous employers, Criminal Records Bureau disclosures etc are carried out and staff undertake training in relation to the needs of people living in the home. The home is clean, comfortable and homely and suits the needs of people who live there. What has improved since the last inspection? The manager ensures that a detailed assessment of each person`s needs is carried out before they are offered a place in the home. This helps to ensure that the home will be suitable for them. All of the appropriate checks are carried out before a person is employed to work in the home and staff undertake training around the physical and mental health needs of residents so as to be able to support them better. Staff have received training and information in relation to their responsibilities for safeguarding and protecting people who live in the home from harm or abuse. What the care home could do better: We did not identify any areas for improvement during this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Hart View 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU     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: Carolyn Delaney     Date: 3 1 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 27 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 27 Information about the care home Name of care home: Address: Hart View 4 Valkyrie Road Westcliff On Sea Essex SS0 8BU 01702433330 01702433330 hatview@sky.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: R Hart Care Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service: 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 disabiliies, or dementia - code MD Date of last inspection Brief description of the care home Hart View is a residential care home, which provides personal care only for up to a maximum of eight younger adults who have a diagnosed mental disorder. The aim of the home is to provide care and support so as to rehabilitate people so that they can live independently within the community. The usual period a person will stay in the home is two years however the period depends upon the needs of each individual. The home is an older style property, which is situated in Westcliff on Sea, close to local shops and amenities and the seafront. The fees for a place at the home range from £870 to £1170 per week. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 8 1 3 0 1 2 0 0 9 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 was a routine unannounced inspection which included a visit made to the home. As part of the inspection process we reviewed information we had received about the service since the last key inspection. We looked at notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they feel that they do well, how they evidence this and the improvements as a result of listening to people who live in the home. We sent surveys to the home to distribute to residents and staff and to complete and tell us what they think about the home. At the time of writing this report we had received six surveys from residents and five from staff. During the inspection we spoke Care Homes for Adults (18-65 years) Page 5 of 27 with four residents and three members of staff. The views and comments made by people were used to help us make judgements about the quality of service provided and have been reflected in the report. When we visited the home we looked at residents care plans and information available to staff to help them support residents. We looked at how staff were recruited to work in the home and how they were trained to support residents. We looked at how the home was managed and how residents were involved in this. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 7 of 27 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move into the home are assured that their needs will be assessed because there is a robust assessment process, which they are involved in. Evidence: The manager told us in the Annual Quality Assurance Assessment that before a person was offered a place in the home that people involved in planning care and finding places (Commissioners) were asked to provide any recent reports from social care, psychiatric care and probation service. They said that this information was reviewed so as to rule out any behaviours or conditions, which would prevent the home being able to meet the persons needs. The manager would then arrange to visit and assess the service user in their current residence and make a full assessment of their needs, providing them with a good opportunity to ask any questions about Hart View. They told us that it is at this stage that both the home and the service user will discuss their expectations and the service user will be advised of any home policies and procedures they may find inhibitive. When we last inspected the home we were concerned that there were no pre Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: admission assessments in place for people who had moved into the home and we made a regulatory requirement that a full assessment of each persons needs be carried out before they were offered a place in the home. The manager told us in an improvement plan that they would ensure each persons needs would be assessed in a three stage assessment, which would be completed once the individual had spent time in the home getting to know staff and other residents. Six residents completed and returned surveys to us before we visited the home. Each of the six told us that they had been asked if they wanted to move into the home and that they had been given enough information before they moved in to help them decide that it was the right place for them. When we visited the home we looked at the information about the home, which was made available to people before they made the decision to move in. We saw that there was detailed information about the home, the daily routines and what a person could expect when they moved in. There was information about staff skills and qualifications, how care would be monitored and reviewed and how a person may complain of they were unhappy. We looked at the arrangements for assessing the needs of people before they were offered a place in the home. We saw that there was detailed information collated from social workers, Psychiatrists, Community Psychiatric Nurses and other health and social care professionals involved in supporting each person. We saw that the manager had carried out a detailed assessment of the persons needs with their involvement. We saw that as part of the assessment process that each person visited the home for day, overnight and weekend visits so that they could meet other residents and staff to help them decide if they liked the home. We spoke with three people who had moved into the home since the last inspection. They all confirmed that they had their needs assessed and that they had visited the home to see if they liked it. One person told us Its great I really like it here. Care Homes for Adults (18-65 years) Page 11 of 27 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. People living in the home can make decisions about their daily lives and take responsible risks as part of living independently. Evidence: The manager told us in the Annual Quality Assurance Assessment that from the initial stages of the assessment process that residents were given assurance that their individual preferences and needs would be of paramount importance. They said that they had found that identifying and discussing specialist interests was a good way of starting to build a therapeutic relationship. They told us that when formulating the initial care plan all information obtained in the pre-admission assessment was taken into account, as were the current views of all involved health care professionals, family and advocates if applicable. They said that the initial plan would involve consultation between the manager, resident and appointed key worker and would be reviewed every 1 to 3 months depending on the individuals needs. The manager said that when considering what service users will do with their time the Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: only standard request of Hart View is that they keep themselves active, both physically and mentally to avoid both boredom and deterioration in mental health. Each of the six residents who completed surveys told us usually make decisions about what they do each day. They told us that they can do what they want to do during the day, in the evening and at weekends. When we visited the home we saw that each person had a care plan and that this included details of decisions residents make about their daily lives such as how they spend their free time, choices about work and college etc. We saw that as part of the rehabilitation process residents were encouraged to take appropriate risks. Residents are encouraged to participate in their local community and to enjoy amenities available so as to enrich their lives. We spoke to four residents and and they told us that they can make decisions about their daily lives. One person said We buy our food and cook meals and decide when we want to eat. During the inspection we observed residents to come and go as they chose and some residents went out to meet friends. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy a lifestyle which suits their needs and prepares them for living more independently in the community. Evidence: The manager told us in the Annual Quality Assurance Assessment that they considered vocational and educational development major factors when helping people to formulate their care plan and weekly activities programme. They told us that particular attention was given at the assessment stage to previous and current employment, learning, hobbies and pastimes. They told us that most residents attended the local adult education college and all have expressed interest in plans for future education options. They said that at all residents were actively encouraged to pursue outside interests and were given initial information and subsequent updates on what was available from local Health authority, private and voluntary organisations. and, although this could cause some initial anxiety, they saw it as a vital step towards Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: integration of people into the local community. They said that homes location in regards to community services, facilities and leisure activities was superb and that they make excellent use of this. The manager told us that whilst they were situated in a quiet residential road they were just two minutes walk from one of the towns busiest and most diverse streets and that residents regularly frequented the range of restaurants, cafes, shops and leisure activities and were actively encouraged to do so whenever and in the company of whomever they wish. They told us that they encourage friendship and development of peer groups within the home. Residents we spoke with and those who completed surveys told us that they had opportunities to go to college, work, and to access leisure facilities within the community. One person told us The home is good, I like living here. I work part time and I go to College. Staff treat me well, I am happy and I have no complaints. I go to College and do computers, and maths, nothing I can think of that they can do better. We saw that each person living in the home had a plan for activities, education and or work. Some residents were attending adult education courses in mathematics, English and computer studies. Care Homes for Adults (18-65 years) Page 15 of 27 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. People living in the home are supported for their assessed health and personal care needs in they way they have chosen and agree to in line with their treatment plans. Evidence: The manager told us in the Annual Quality Assurance Assessment that Hart View respected residents privacy at all times and ensured that any personal care or discussion was carried out in complete privacy in a location of their choice. They told us that they considered themselves to run a flexible home in relation to timing of daily activities, such as going to bed, laundry, shopping etc but take into account practices agreed with and by residents in group meetings and one to one discussions. They told us that they encouraged residents to make their own decisions regarding clothing and personal appearance but do remind them to consider the cost effectiveness and affordability of their purchases and suitability of what they choose to wear in respect of the days weather. The manager told us that residents physical and mental health was monitored closely. They said that all residents were advised and supported to have annual health checks and were given advice and support to manage on-going medical conditions. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: They told us that they had a fully monitored process for residents to progress through so that they would be able to take responsibility for their medication before they leave the home to move on to more independent living within the community. They told us that there were procedures for the monitoring of stock and administration of medicines and that staff undertook training. People who move into Hart View do so to prepare themselves for moving on to live more independent lives within the community. Residents living in the home at the time of the inspection were self caring for their personal care needs. Some residents needed prompting to maintain good standards of personal hygiene and where this was so it was recorded as part of their plan of care. Each person in the home had a plan of care in relation to any physical and mental health conditions such as epilepsy, schizophrenia and alcohol or substance misuse. Residents views about their condition, treatment and progress were obtained and recorded in each plan and these were reviewed on a regular basis. Residents were encouraged and supported to take responsibilities for their health and welfare as part of their rehabilitation programme. We spoke with residents during the inspection and they told us that they went to see their doctors and to the chemist to pick up medicines. They told us that staff were available to go with them if they needed. As part of the preparation for moving out of the home residents completed a programme of working to wards becoming independent for managing their medicines. The programme was completed in stages according to each individuals capacity and compliance and staff assessed risks to each individual as part of the process. Care Homes for Adults (18-65 years) Page 17 of 27 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 living in the home know that their complaints will be taken seriously and that they will be safeguarded from abuse because there are policies and procedures, which staff adhere to. Evidence: The manager told us in the Annual Quality Assurance Assessment that all staff, residents, advocates and families were made aware of the complaints procedure and the homes commitment to honest and thorough investigation of complaints without prejudice. They told us that all residents had been given a copy of the complaints procedure and all processes were explained. They told us that whilst there had had no formal complaints made that they had dealt with some minor ones and they felt that the handling of these situations had resulted in the swift resolution of the problems to all parties satisfaction. They told us that residents were encouraged to choose who they wished to speak privately and were given a number of platforms to discuss anything they wished, including residents meetings, reviews, one to one sessions and care plan reviews. The manager said that they were fully aware that residents, no matter what their history and present situation, were vulnerable people simply by the fact that much of their independence, privacy and dignity may have been lost during their illness. When we last visited the home we raised concerns that some staff had not received training in relation to safeguarding people from harm and that they were not aware of Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: their responsibilities such as reporting allegations to the local social services safeguarding team. We made a regulatory requirement that arrangements be made to help ensure that people living in the home were safeguarded. The manager told us in an improvement plan how they were to address these issues. They told us that all staff had undertaken training around safeguarding and that they had been provided with information in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. This information helps staff to identify where people may lack capacity to make appropriate decisions and the action they should take in these instances so as to ensure that decisions are made in the persons best interests. Each of the six people who completed surveys told us that they knew who to speak to if they were unhappy. Five of the six said that they knew how to make a complaint. Each of the six members of staff who completed surveys told us that they knew what to do if someone had concerns about the home. When we visited we looked at the arrangements for receiving and dealing with complaints and safeguarding people from harm or abuse. We saw that there was a detailed and clear policy and procedure, which described how a person may complain and what they could expect in terms of how issues were investigated and responded to. Residents also had information and contact details for other support agencies such as local advocacy services, Citizens Advice Bureau, Rape Crisis and CRUSE Bereavement. Staff told us that there had been no complaints made since the last inspection. They told us that minor issues were resolved promptly. We spoke with four residents and they told us that they did not have complaints about the home. They told us if they did they could speak to the manager or a member of staff. One person told us I am very happy here I have no complaints. Another resident told us Its ok here and staff are good, I have nothing to complain about. We looked at the arrangements for safeguarding people from abuse. Three of the people who completed surveys told us that staff and managers always treated them well. The other three said that staff usually did. We saw that all staff had undertaken safeguarding training and three members of staff we spoke with told us that they would report any incidents to the manager, Care Quality Commission and the safeguarding team in Southend. There had been no allegations or concerns raised about the home within the previous twelve months. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean, safe, homely environment which suits their individual needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that they believed that the high quality of Hart Views decor, facilities, furnishings and location contributed hugely to the satisfaction of our residents. They told us that all furnishings purchased were designed to be practical whilst maintaining a homely feel. They told us that all bedrooms were adequately heated and ventilated. They said that all furnishings and facilities provided were of a high standard and included a large flat screen television with a full satellite television, a high quality stereo system, two washing machines and an industrial tumble drier. Each of the six residents who completed surveys told us that the home was always fresh and clean. When we visited the home we carried out a brief tour of the premises. All areas were clean and free from unpleasant odours. We saw records for regular maintenance, repair and replacement of furniture, equipment and any other installations needed in the home. We spoke with four residents. They told us that they liked the home. One person told us This is nicer than any other place I have lived in. Care Homes for Adults (18-65 years) Page 20 of 27 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 living in the home are supported by staff who are recruited robustly, trained and supported to be able to meet their assessed needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that when considering new staff at Hart View great emphasis was placed on both their qualities as an individual and their ability to work well within a team. They told us that their recruitment process covered all requirements and that written references, Criminal Records Bureau disclosures and PoVA checks were all standard and the recruitment process would not progress past the early stages without them. They told us that they also had a process, initiated by the local council, which checks all documents from foreign nationals regarding immigration status. They told us that this had directly led to three members of staff having their employment terminated after supplying forged incorrect documents. The manager said that all staff, manager included, were on probation for the first six months of their employment and were monitored closely during this period. They told us that all new staff were expected to complete a structured training course during their first 12 weeks employment. This covered common induction standards 1 to 6 and includes work sheet assessment of progress. During the interview process staff were Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: advised that they would be expected to either have or be prepared to undertake training to a standard of at least National Vocational Qualification in social care to at least level 2. When we last visited the home we found that not all staff had been recruited robustly and that checks including references had not been obtained before a person commenced work. We were also concerned that staff did not have training in relation to the needs of residents. The manager told us in an improvement plan how they were to address these issues. They told us that all checks would be carried out before a person was offered employment in the home and that training around supporting people with mental health problems had been sourced and that all staff would be undertaking this. Each of the six staff who completed surveys told us that checks such as Criminal Records Bureau disclosures and references were obtained before they started work. They told us that their induction covered everything they needed to know to do the job when they started. They told us that they received training, which was relevant to their roles, helped them understand and meet the individual needs of people and kept them up to date with new ways of working. Four of the six residents who completed surveys told us that staff and the manager always listened to them and acted on what they say. The other two said that they usually did. When we visited the home we looked at how staff were recruited and trained so that they met the assessed needs of people living in the home. The manager told us that before a person started work in the home that satisfactory references from previous employers, Criminal Records Bureau disclosures and Independent Safeguarding Authority checks were carried out. As part of the recruitment process potential staff were interviewed so as to further determine their fitness to work in the home. They were introduced to residents and the manager monitored how they engaged and interacted with them. We saw records for training, which staff undertook. There was a comprehensive training programme that included supporting people who have mental health problems, dealing with aggressive behaviour as well as training in relation to controlling the spread of infection, safe handling and administration of medicines, care planning and managing risks to individuals health and safety. Staff also received training to be able to support residents to participate in activities to keep them occupied and stimulated. We saw that staff met regularly with the manager (supervision sessions) to discuss ways of working and any training or development needs. Care Homes for Adults (18-65 years) Page 22 of 27 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 home is well managed and residents views are considered and acted upon so it is run in their best interests. Evidence: The manager told us in the Annual Quality Assurance Assessment that they have been a qualified Registered Mental Health Nurse for over 19 years and had worked in almost every area of mental health. They told us that they had extensive experience of working with this client group in both hospital and community settings and have specific knowledge of the local health authoritys structures, facilities, processes and personnel. They told us that Hart View had been open for almost 2 years and in that time they appeared to have gained a very good reputation leading to many recent referrals. The manager told us that there were all the relevant policies and procedures in place for maintaining and managing the home effectively. As part of obtaining the views of people who live in the home we asked them what they felt the home did well and where, if any, improvements could be made. Three people made comments. They told us what the home did well. They told us that the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: home was Well managed with very good staff. One person said They look after you and communicate well with you. Another person commented They build you up for the next stage into the community. Only one person identified an area for improvement. They told us that more could be done to Try to encourage community spirit. When we visited the home looked at how the manager obtained their views of residents so as to monitor and improve the experiences for them. We saw that residents were asked to complete surveys if they were happy with the care they receive, how staff support them, meals, their accommodation etc. Residents are asked if they feel that any improvements could be made. We saw that residents made positive comments about the home. We saw the minutes from weekly meetings with residents, where they discussed living in the home and topics such as outings and plans for festivities etc. We looked at records and saw that there were up to date certificates for checks made to fire detecting and fighting equipment, gas and electrical systems and equipment so as to ensure that these were maintained in safe working order. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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