Care Home: Hazelwood House

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What the care home does well People who live in the home lead active lives and staff provide the support they need to follow their interests and maintain contact with family and friends. The home works well with external professionals to ensure peoples` health and personal care needs are met. One health and social care professional told us: `The home maintains good communication with other agencies and facilitates good levels of social opportunity and interaction`. Residents have their own rooms and share communal areas and a large garden. The building is homely and comfortable and residents are encouraged to participate in decisions about the home and daily living activities. One resident told us: `I am happy here and like the people I live with`. What has improved since the last inspection? The home has an ongoing programme of refurbishment and decoration to ensure that the building is maintained for the benefit of the residents. What the care home could do better: The home has a new manager who is in the process of applying for registration with the Care Quality Commission. We did not identify any requirements or recommendations that would improve outcomes for people living in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Hazelwood House 22 Newbarn Road East Cowes Isle Of Wight PO32 6AY     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: Annie Kentfield     Date: 1 0 0 7 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 28 Information about the care home Name of care home: Address: Hazelwood House 22 Newbarn Road East Cowes Isle Of Wight PO32 6AY 01983280039 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: hazelwood@regard.co.uk The Regard Partnership Ltd care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 11. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home The home is a detached period property situated in East Cowes near to the Osborne estate where there are good public transport links to Newport, Ryde and the mainland. The home offers single room accommodation arranged over three floors with the most able people occupying rooms on the upper floors. There is a stair lift. Rooms have been decorated to residents individual tastes. There is one self-contained flat on the second floor, which helps promote a more independent lifestyle for one person. Communal areas comprise a lounge and dining room. Outside there is an enclosed garden mainly laid to lawn with seating and a summer house. The building is accessible. A large car park provides off road parking at the front of the home. Current fees and details of any additional charges are available from the home. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 11 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: We made an unannounced visit to the service on 10 July 2009; with one inspector, who was in the home from 11.30 am to 4.30 pm. Five residents, the manager and two members of staff were involved with the inspection visit and we also looked at care plans, medication records, staff training and recruitment records and some of the homes records for internal audits, health and safety and quality assurance. Before the visit, we received the Annual Quality Assurance Assessment; this is a selfassessment that provides us with information about the service, what they do well, and what has improved. We sent surveys to 10 residents, 6 staff and 5 health and social care professionals. We received completed surveys from 5 residents, 2 health and social professionals and 4 staff. Feedback about the service was positive in all of the surveys. Care Homes for Adults (18-65 years) Page 6 of 28 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 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 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not move into the home until they have had an opportunity to visit and the registered person has assessed their care and support needs. The process is person centred to meet the individual aspirations and needs of prospective residents. Evidence: The home currently has ten residents and there is one vacant bedroom. On the day that we visited a prospective resident was coming to visit the home for the first time. Since the last inspection there has not been any new residents moving into the home so we were not able to assess the process for new residents. However, the annual quality assurance assessment stated that the home has a clear process for new residents that includes lots of visits and overnight stays before people decide to move in. In addition, the AQAA says that the views and wishes of existing residents and staff are sought before a decision is made regarding new residents, and that the moving in plans for each new resident are made on an individual basis to meet the needs and wishes of the person concerned. Residents do not move into the home until the registered person has carried out a full assessment of care and support needs. We Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: were told that this is done in consultation with the prospective resident, relatives, advocate, care manager and any other significant people. This means that people can be confident that they can make informed choices and the home is able to demonstrate that they are able to provide the level of care and support that people need, before they move in. Prospective residents are given information about the home and we were told that this can be produced in a variety of formats to meet peoples communication needs. One of the residents has written their own service user guide and is happy for this to be made available to new residents. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to make their own decisions and choices about all aspects of their daily lives and play an active role in planning their care and support. Evidence: Each resident has an individual plan of care that covers personal details, life plan, care plan, and health action plan. We looked at the care plans for three residents: and these demonstrate that care plans are person centred, agreed with each resident and regularly reviewed and updated. Each resident has a key worker and residents meet with their key worker each month to discuss various issues including personal plans, life goals and ambitions and to review changes. Each care plan includes reference to equality and diversity and there are cultural guidelines in each care plan. The AQAA states that every resident has been supported to complete the cultural guidelines so that residents and staff are fully aware of individual preferences and choices. Five of the residents were involved in the inspection visit and we noted that residents are actively involved in menu planning, residents meetings, activity planning and household chores such as washing up and laying the tables for meals. Residents take Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: it in turns to choose the daily evening meal and there are photos of meal options to assist residents in making their choice. One resident has their own kitchen and is able to independently prepare snacks and drinks, other residents are involved in developing a vegetable growing patch in the garden. Every resident has their own personal book that they compile with their key worker; as a record of activities, visits with family and friends, and things they like to do. The AQAA told us that personal books also act as a memory book for some of the residents. Photographs are used as a record of activities and also as communication tools such as picture menus, activity prompts and to provide information about staff in the home and who is working that day. The AQAA told us that following requests from residents; two notice boards have been put up in the dining room with pictorial information about staff rotas, evening menus, dates of residents meetings etc to provide residents with easy access to information. Information in personal plans and discussion with staff and residents provided evidence that peoples rights to make their own decisions are respected. One resident told us that they are supported to maintain contact with family via the internet and another resident showed us photographs of a recent holiday they had enjoyed doing outdoor adventure activities of their choice. Records show that residents are supported to manage their financial affairs according to their skills and circumstances. Where appropriate, the home has arranged for residents to be supported by independent advocates. The home has procedures in place for managing personal monies belonging to residents and these are regularly checked and records audited. The manager told us that the home has a procedure in place so that any items of expenditure over a certain amount are agreed in consultation with a care manager or other representative of the resident. Each care plan contains details of any risks to residents with clear guidance for staff on how risks or events are to be managed. Care plans identify where residents need specific support from one carer with a plan of when 1:1 support is arranged each day. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to make choices about daily living activities and take part in a range of leisure and social activities. Practice in the home promotes equality and diversity for the benefit of the residents and ensures rights and choices are respected. Residents are offered a choice of meals and menus with attention given to providing a healthy and nutritious diet. Evidence: It was clear from our observations, from information in personal plans, and discussion with some of the residents and staff, that the home is pro-active in supporting residents to take an active part in the daily life of the home and to make decisions about what they would like to do. Each resident has a two year plan of their aspirations and goals in each area of daily life and these are reviewed with residents and key workers each month. We noted that these meetings are recorded in detail in personal plans. In addition, the manager told us that she keeps a wish book so that Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: individual goals are actioned and folllowed up. We saw an example of this with a resident who had said they would like to try horse riding and this had been arranged to take place on the day that we visited. Care records and personal diaries demonstrate that residents are supported to access community resources such as day centres and educational centres, local social and leisure events, and a range of holiday opportunities, as well as maintain contact with family and friends. Discussion with staff demonstrated a positive and energetic approach to supporting the residents to have a wide range of choices and opportunities to do things that they like to do. The AQAA stated that emphasis is placed on ensuring that each resident enjoys the highest quality of life and is encouraged to reach their fullest potential. The home has a stated policy to ensure that equality and diversity are promoted and incorporated into the practice of the home, we want to ensure that all residents have the same rights, and as far as possible, the same responsibilities as other members of the community, regardless of race, gender, disability, or sexual orientation. The manager told us that in practice this means ensuring that residents rights are promoted, staff receive appropriate training, and that residents are supported to access and discuss the homes policies such as how to complain, and other relevant policies. The home told us that residents are encouraged to have a varied and balanced diet and mealtimes are flexible to fit in with residents activities. Menus are decided each week and each resident takes a turn in choosing the evening meal. Staff told us that there is always lots of alternative choices and menus are provided in a pictorial format. Residents take their meals in a pleasant and homely dining room and all meals are prepared and cooked by care staff. The manager told us that residents assist with shopping and other household tasks, and we saw a rota for washing up and laying tables. We were told that daily routines in the home are discussed and agreed at regular house meetings. Residents can have a lunchtime snack of their choice and some of the residents make their own sandwiches each day if they are going out. Fresh fruit and healthy snacks are always available. The AQAA told us that some of the staff are in the process of doing some training in nutrition and health. The home has a large garden and some of the residents have been cultivating a vegetable growing plot. We were told that one of the residents has been involved in planting hanging baskets and outdoor plant pots and enjoys watering and caring for these plants. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience 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 care home have access to health care services and their health care needs are met with regard for privacy, dignity and respect. Residents receive their medication as prescribed and medication is safely stored and administered. Where appropriate, residents are being supported to look after their own medication. Evidence: When we looked at three individual plans we found that each resident has a separate health action plan that sets out in detail the way that residents health and personal care needs will be met. The plans have been agreed with the residents and also provide clear guidance for care staff on what they must do to support individual residents with their health care. The plans demonstrate that residents have regular contact with GPs, optician, chiropodist and specialist health care services. The plan also includes a communication passport with agreed details for how a resident prefers to communicate their needs and wishes. One care plan contained specific guidance on daily personal care and bathing/showering and recorded that regular weight checks take place at a day centre because of the need to have sit on scales. The weight records are regularly monitored Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: by care staff. Medication received into the home is checked and recorded each month and medication returned to the pharmacy is also checked and recorded. Medication is safely stored and there is an allocated member of staff on each shift who has responsibility for medication and holds the key to the medication cupboard. The manager confirmed that care staff have received training in the safe administration of medication and medication procedures are observed and checked every three months to ensure that residents are receiving their medication as prescribed. The manager confirmed that the home has storage for any controlled drugs - to meet current regulatory requirements. One care plan that we looked at contained a specific care plan for each medicine that had been prescribed to be given as and when required. The care plan also contained guidance on what action should be taken with regard to specific continence care for the resident. The AQAA stated that the home plans to improve outcomes for residents who have been assessed as able to self-medicate. Following a medication assessment, some of the residents have locked medication cabinets in their room - with the aim of residents developing independent skills for looking after their own medication and being independently self-medicating in the long term. Some of the residents take homely remedies (non prescribed medications) and each resident has a homely remedies record chart that has been agreed and approved by the residents GP. This is reviewed annually. The manager told us that the first aid box is checked weekly and the contents audited, also that staff have completed basic first aid training. The manager is planning to undertake a nominated persons first aid course. The AQAA told us that the manager tracks all health appointments each month to ensure that appointments are kept for residents. However, we have received a complaint from the representative of a resident because an important health appointment was missed. We were told that this had been overlooked in the daily diary of appointments. The complaint was dealt with by the home using their complaints procedure. The AQAA stated that staff in the home receive training in all aspects of health care such as epilepsy and dementia and health topics relevant to the needs of the residents Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: and receive training in safe practice in moving and handling. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of people who use the service are listened to and acted upon. Residents are protected from the risk of harm or abuse. Evidence: The home has a complaints procedure and this is available for people in easy to read formats. The AQAA told us that staff and residents discuss any issues or concerns during key worker meetings and residents views are listened to and acted upon. The complaints procedure contained an old contact address for the Care Quality Commission and the manager told us that this would be updated with the current address and telephone number. Two complaints have been received and these have been dealt with using the homes agreed procedures and records kept of correspondence and outcomes. Staff in the home are aware of the agreed procedures if they have any concerns about the safety or well being of residents and staff have access to written policies and procedures to guide them on agreed safe practice. Staff have received training and updates in safeguarding and also safe ways to deal with events such as challenging behaviour. The home have notified us of any events in the home that affect the safety or well being of residents and have demonstrated that they know how to respond and take Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: action to safely manage events or refer concerns to Social Services safeguarding service. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience 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 comfortable and homely environment that meets their needs. Maintenance and refurbishment is ongoing and the home is clean and hygienic. Evidence: The home is a large, period, detached house with a large garden that offers residents space and privacy. Residents have their own bedroom with a wash hand basin and one room has an en-suite shower. The manager told us that the home has a maintenance programme and one empty bedroom was currently being re-decorated, the kitchen is due to have non-slip flooring fitted and the bathrooms are due to be decorated. The AQAA stated that since the last inspection there has been refurbishment and decoration in the lounge, dining room, hallways and stairs. Residents are involved in choosing colour schemes and furnishing in their own bedrooms. There is a porch/conservatory area at the front of the house that is due to have some roofing repairs, this room is used as a games room by the residents. We met some of the residents in the communal areas of the home and in their own rooms. Bedrooms are personalised and reflect individual interests and preferences. Bedrooms and bathrooms are lockable to ensure privacy and staff always seek permission to enter bedrooms or bathrooms. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Residents have a good sized and comfortable communal lounge with a television, music player and DVD player, a dining room and a large entrance lobby with additional seating. The large garden has seating areas and a summer house for residents use. The building is accessible and has a stair lift to access the first floor. Two bedrooms are located on the second floor and these rooms are only suitable for residents who are independently mobile. The home employs a cleaner for 10 hours per week, however, residents are supported and assisted by care staff to take responsibility for cleaning and tidying their own rooms. There is a laundry room and kitchen that were clean and tidy and we looked at evidence of checks and procedures to ensure that these areas are maintained hygienically to prevent the risk of infection or cross infection. Staff have access to gloves and aprons and laundry is placed in appropriate bags. We noted that all areas of the home had pictures and photographs and decorative touches that were relevant and meaningful for the residents and contributed to the friendly and comfortable homely environment. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive support from staff that are trained and supervised in the work they do. Residents are protected by staff recruitment procedures that demonstrate that staff are suitable to work in the home with the residents. Evidence: The home employs nine care staff and a part-time cleaner. The manager told us that the home is in the process of recruiting two more staff. We looked at the recruitment records for three staff who have been employed since the last inspection. The home operates thorough recruitment procedures and there is evidence of pre-employment checks to demonstrate that staff are suitable to work with the residents. The AQAA told us that residents are involved in the recruitment and selection process of new staff. The manager told us that one resident was recently part of the interview process for a new member of staff. New staff follow an induction programme in their first week. The home has recently developed online E training for induction to care and some mandatory training in safe working practice such as food safety, health and safety and infection control. The AQAA told us that the home promotes and values a staff team who are skilled and knowledgable and staff are offered training opportunities and supervision and support. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The training matrix demonstrates that training is regularly updated in all areas of safe working practice and in addition, staff receive training in areas of care that are relevant to the needs of the residents, for example, dementia care, epilepsy, autism, maketon and other communication skills, learning disability, and some of the staff have received training in the Mental Capacity Act. Six of the nine staff have achieved an NVQ (National Vocational Qualification) in care at either level 2 or level 3 and other staff are working towards this. We spoke to two members of staff; one person had recently started and another had worked in the home for some time. Staff confirmed that they receive the training and support they need to carry out their work and support the residents. Supervision records demonstrated that staff receive formal supervision and their practice is regularly monitored, staff also have regular staff meetings. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not have a registered manager, however, residents benefit from an organised and consistent management approach to running the service. The service has effective quality assurance systems that measure how well the service is providing good outcomes for people using the service. The health and safety of residents and staff is promoted and protected. Evidence: The management of the home has changed since the last inspection and the home does not have a registered manager. However, the newly appointed manager has worked in the home for a number of years and was previously deputy manager. The previous manager has taken on an area management role and is responsible for supervising the new manager. We confirmed that the new manager is in the process of applying for registration with the Commission. This means that residents have not experienced major changes to the way that the home is organised and run. The manager told us that she is currently enrolled to achieve an NVQ in care at level 4 and will then enrol to achieve a management qualification. Observations and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: comments from residents and staff confirmed that the manager has an open and positive approach to running the home. We found that all of the records that the home is required by regulation to maintain and make available - were organised and accessible and also up to date. The home has systems in place to measure the quality of the service provided which include: residents meetings where issues are recorded and addressed, yearly care reviews involving care managers, key workers, residents and relatives, day service reviews, monthly inspections by a representative of the registered owner of the home to monitor the conduct of the home, regular staff meetings and staff supervision, satisfaction surveys sent to relatives, friends and health care professionals, key worker reviews with residents. Care planning for residents is person centred. This means that residents are involved in the care and support they receive and are supported to identify and achieve personal goals and aspirations. We received the Annual Quality Assurance Assessment (AQAA) when we asked for it. This was comrehensively completed with lots of examples of what the service does well and what they are planning to do to continually improve outcomes for residents. The AQAA demonstrated that the service places the best interests of the residents at the centre of what they do. The AQAA told us we ensure that we listen to the residents and the way they would like their home to be run. The AQAA stated that the home has policies and procedures in place to ensure that the health and safety of residents and staff is promoted and protected. We looked at records to confirm this: health and safety audits, medication audits, fire safety checks and drills, accident book, and records of equipment servicing, records were up to date. The home has a five star food safety rating (maximum rating). Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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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