Care Home: Heathcotes (Knollbeck)

What the care home does well People could have confidence the home was run and managed appropriately, because effective quality assurance systems were in place. People`s opinions were central to the home`s development and the home had ways of making sure they got this right. People had the information they needed to choose a home that would meet their needs. The ethos was for person centred care, so that people living there were empowered to lead full and active lives. They had an individual plan of care and they were involved in decisions about their lives. They played an active role in planning the care and support they received. People were able to make choices about their lifestyle and supported to develop life skills. They took part in valued and fulfilling leisure activities in the community and supported to maintain relationships with their family and friends. People were satisfied with their personal support. Staff acted on information in the individual plan of care to make sure people`s healthcare was maintained and supported people safely to help them with their medication. People felt their views were listened to and acted on and systems were in place to protect them from abuse, neglect and self-harm. The home was light and spacious. It was clean, hygienic and the environment was comfortable and safe. What has improved since the last inspection? This was a newly registered service and the first time they had received an inspection. What the care home could do better: People should have access to a computer and the internet, so they are able to take part in age, peer and culturally appropriate activities. The recruitment procedure needs to be more robust to demonstrate staff are safe to work with vulnerable people. The staff training programme needs to include the Learning Disability Award Framework. Key inspection report Care homes for adults (18-65 years) Name: Address: Heathcotes (Knollbeck) 9-11 Knoll Beck Crescent Brampton Barnsley S Yorkshire S73 0TT     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: Jayne White     Date: 1 5 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 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 29 Information about the care home Name of care home: Address: Heathcotes (Knollbeck) 9-11 Knoll Beck Crescent Brampton Barnsley S Yorkshire S73 0TT 01226270774 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): knollbeck@heathcotes.net Cotes Development LLP T/A Heathcotes Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of users who can be accommodated is 6 Whose primary care needs on admission to the home are within the following categories Learning Disablities - Code LD Date of last inspection Brief description of the care home Heathcotes is a care home offering personal care and accommodation to people who have a learning disability. The accommodation is for six people, all who have their own bedroom. There is a communal kitchen, dining area, lounge. The lounge leads out onto an enclosed garden area. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home There is parking to the front of the home. A service user guide is available for prospective people and their representatives. Charges start at £1475 per week, but are based on individual needs, therefore, an assessment is needed to determine the individual fee. Care Homes for Adults (18-65 years) Page 5 of 29 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 the first key inspection of this service, as it is a newly registered service. We visited the home without telling them. The visit started at 09:15 and finished at 15:15. Currently, the service only provides a service to one person. In the report we make reference to us and we. When we do this we are referring to the inspector and the Care Quality Commission. It comprised information already received from or about the home and a site visit. The manager completed an Annual Quality Assurance Assessment. This document gave the manager the opportunity to say what the home did well, what they had improved on in the last twelve months and their future plans. Information from the AQAA is included in the main body of the report. Care Homes for Adults (18-65 years) Page 6 of 29 Various aspects of the service were then checked during the visit including looking at a selection of records, policies and procedures and the persons care plan. Initial feedback from the inspection was provided to the manager and area manager. We inspected all the key standards. These are reported on under the relevant standards in this report. Care Homes for Adults (18-65 years) Page 7 of 29 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 8 of 29 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 29 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 had the information they needed to choose a home that would meet their needs. Evidence: In the AQAA the manager told us comprehensive assessments were carried out before a new person moves into the home. They visit them and collect assessments from other professionals. They said trial visits and transition plans were organised, with information packs and leaflets about the home sent to people prior to their visit. The manager said each person was provided with a service user guide and service agreement, which are available in pictoral formats. Further understanding is provided by going through the documents with people. He said capacity assessments are carried out to determine what capacity people have to make informed decisions about the home. In the event they lack capacity, extra support would be provided to ensure that best interest decisions are made at all times. Since registration the manager stated theyd improved the policy on emergency admissions, which had been revised and updated in October 2009. This told us the home understood the importance of having sufficient information about people before they moved into the home. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: When we spoke to the manager he told us the person living at the home had been admitted as an emergency, so we checked the admission process against the revised procedure. There were gaps, but this had not affected the outcome for the person. When we spoke to the person they said they had received enough information about the home before they moved in, so that they could decide if it was the right place for them. They said, its a lot better than where I used to live, its more like home, I did make a good choice and its the right choice. Im enjoying it. Care Homes for Adults (18-65 years) Page 11 of 29 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 had an individual plan of care and they were involved in decisions about their lives. They played an active role in planning the care and support they received. Evidence: When we spoke to the person it told us staff respected their rights to make decisions and spoke with them about their lifestyle at the home. They told us that they chose when they woke up, whether to have a wash or a bath, what to wear, what they ate, what they wanted for breakfast and where this would be served etc. This was very positive and examples of this staff practice were observed throughout our visit. These were friendly and empowering in that staff encouraged the person to make all kinds of choices. The manager in the AQAA told us care plans were detailed and comprehensive and produced with the full involvement of the person. They said plans were person centred, live documents that were holistic in nature and covered mental, physical and social needs. He said comprehensive risk assessments were carried out and addressed Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: the risk to the person and others. He stated support plans were audited weekly, reviewed monthly, with risk assessments reviewed quarterly. He stated people were supported to make decisions. We looked at the persons plan to check the information in the AQAA. The care plan showed that they covered a wide range of the persons needs, with detailed person centred planning. The plans had guidance for staff about how to support the persons health and personal care and behavioural needs. It contained information about what the person could do for themselves and what support they required. This helped to promote their independence. The person had comprehensive risk assessments which covered issues such as risks associated with managing behaviour which may challenge, looking after their own medication and outings from the home. This told us the person had opportunities to take appropriate risks associated with leading everyday lifestyles. When we spoke to staff they could describe how the person made decisions about their life and when limitations of choice might be imposed to prevent self harm or neglect in the persons best interests. Care Homes for Adults (18-65 years) Page 13 of 29 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. Staff supported people to be able to make choices about their lifestyle and develop social, recreational and general life skills. They took part in leisure activities in the community and were supported to maintain relationships with their family and friends. Evidence: When we spoke to the person living there they told us how they made decisions about what to do each day and that they can decide what to do during the day and weekend. They described the activities they took part in and that they were happy with their daily routines. The person told us that they liked the staff. They said, its brill, treated like a prince, all the staff are brilliant - its a good idea to get involved, my bedrooms my space. I take responsibility for it being clean. They always knock on the door and if Id got something to do Id get up - looking at getting a job and going to college. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: They said staff assisted with laundry. We saw the person did not have access to a computer or the internet. In todays society this is one of the main ways in which people communicate and access to such was discussed with the manager. Throughout our visit we observed staff interactions with people, which were at all times respectful, empowering and friendly. When we spoke with staff they could describe the variety of activities the person took part in, which told us they led an active life. They described how the person could follow their preferred routines. This encouraged the person to have an independent lifestyle and encouraged them to make choices. People were supported to maintain and develop relationships. We checked to see if people were offered a varied and nutritious diet and menus showed that this was the case. The manager in the AQAA told us: Contact was maintained with family, friends and social workers through reviews. Each person was assigned a key worker. They had changed the activity plan and had it individualised in a format suitable to the person as a result of listening to them. Activity plans were reviewed weekly. They focused on healthy eating and living to promote peoples wellbeing. Financial systems had been fully reviewed in October 2009 and new systems implemented to safeguard peoples money. People were encouraged to access vocational activities or work placements. People were encouraged to take part in daily chores such as laundry, tidying their bedroom and general cleaning, with staff support to promote independence, inclusion and acquisition of self help skills. Some activities were encouraged to be undertaken together in a bid to encourage bonding and relationship building between people. Care Homes for Adults (18-65 years) Page 15 of 29 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. Staff acted on information in the individual plan of care to make sure peoples personal and healthcare support were met and supported people safely to help them with their medication. Evidence: When we spoke to the person living there they told the inspector they were happy with the way staff supported them. They knew the staff and said that they got on with them well. We observed staff working. They were helpful and supportive to the person, encouraging them to be independent. We saw that the persons clothes were clean, ironed and they looked presentable. Their attire reflected their personal preferences. This supported what the manager had told us in their AQAA. The manager in the AQAA told us: Capacity assessments were completed around personal and health care to ensure people were given adequate support. Each person had a key worker who will ensure personal needs are met and toiletries are available. Each person is registered with a GP, sees a dentist bi-annually and optician annually. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: The service have their own consultant psychiatrist who visits the home regularly to conduct clinics and give feedback. Referrals are made quickly and promptly for secondary services the service feels the person requires. Staff ensure peoples clothes are clean and ironed and they look presentable at all times. Also that the persons attire reflects the persons preferences. Systems were in place for receiving, storing, recording and administration of medication and only qualified members of staff are enabled to do this. A self medication assessment is completed for people and those able to self administer are given the opportunity to do so. We looked at the persons plan of care to check their personal and health care was being met as identified in the plan. We identified that it was, because it supported what the person and staff had told us when we spoke with them. They said they attended health appointments when necessary. This also supported what the manager had told us in their AQAA. The manager said they were implementing nutritional screening as an assessment tool for maintaining peoples health and ensuring their diet was appropriate to their needs. When we spoke to the person and staff it told us they were supporting the person to be able to look after their own medication in a safe way. A risk assessment was in place to formalise this process. This supported what the manager had told us in the AQAA. We observed the process taking place and thorough systems were in place to support the person. A drug audit was undertaken weekly. Generally, medication was stored safely, but medication requiring refrigeration would be better stored within a refrigerator used solely for medication, to promote safer storage. When the inspector spoke with staff, they said they had undertaken medication training. This was confirmed when we looked at their training record. Care Homes for Adults (18-65 years) Page 17 of 29 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 were able to express their concerns and had access to a robust and effective complaints procedure. Peoples rights were protected and there were procedures in place to protect them from abuse, neglect and self-harm. Evidence: When we spoke to the person living at the home they said they were happy living there. We observed a good rapport between them and the staff. They said, anything untoward Id tell someone - I phoned CSCI once. When we spoke to staff they described what they would do if anyone raised concerns about the home. There were gaps in this knowledge in safeguarding people. However, we saw on the training matrix formal training was planned in the next two to three weeks. Discussions with the manager confirmed he knew the procedures to follow in the event of an allegation. The manager in the AQAA told us: There was a complaints system in place to ensure people and other stakeholders are listened to. It is available in a simplified format that may be understood by people. This protects people from possible abuse or harm. We saw this on our visit. The complaints procedure is highlighted at the beginning of every service user meeting in order for people to be more aware of the process. Each person has a complaints log in their care plan to keep an accurate record of Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: issues/concerns. Records of complaints and the outcome of investigations are held on file and compiled centrally, so the home and the wider organsiation can learn from things that have gone wrong. All staff receive training on adult protection and are made aware of key policies relating to protection including, whistle blowing. All prospective employees are POVA and CRB checked before starting work. Policies on safeguarding vulnerable adults have been revised and additional guidance put in place and they have come up with more creative ways of ensuring that all staff fully understand safeguarding issues, such as discussions at staff meetings, supervision and using scenarios and role play. Safeguarding of vulnerable adults is always the first thing on the agenda at any staff meetings and also formulates part of the induction process. Care Homes for Adults (18-65 years) Page 19 of 29 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. The accommodation offered to people was of a good standard. People were supported to personalise and make their house homely in order to meet their specific needs. Evidence: When we spoke to the person living there they were satisfied with their living environment. They said, its more like home here (than the last place they lived) and my bedrooms my space. I take responsibility for it being clean. They always knock on door. When we looked round the home it was clean, bright and domestic in character. The physical environment was appropriate for the persons lifestyle and their needs and was clean and safe. The person living there could enjoy maximum independence in a discrete non-institutional environment. People had single rooms. The kitchen and laundry were designed to promote the involvement of people with domestic tasks as part of developing and maintaining independence. The bathrooms were homely and there were sufficient for people to have immediate access. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Outside there was a communal garden area with patio furniture. The manager in the AQAA told us: The handyman visits as and when necessary to ensure assets are maintained and repaired as required. People are given the opportunity to choose their own room, where possible. They are encouraged to individualise their room. All rooms are spacious, well lit, decorated and maintained. The entire building has been risk assessed and all identified risks have been minimised. The home has been fully refurbished and remains a safe, homely environment, which people and staff appear to be proud of. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported by an effective staff team who understand and do what is expected of them, but recruitment procedures needed improving. Evidence: We observed the relationships between staff and the person living at the home. This showed that staff had positive regard for them. They were informal but respectful in the way they spoke to and of people. This was very positive to see as the person responded positively to the staffs approaches. The manager in the AQAA told us: People were involved in recruitment interviews and have been empowered and supported to ask questions of candidates that mattered to them. Equal opportunities monitoring forms were sent out with each job application. Staffing levels reflect the needs of people. Staff were provided with relevant training and ongoing supervision, including comprehensive induction training. The home is part of a group and benefits from people employed in the following functional roles operations manager, regional manager, clinical behaviour specialist, training manager and management accountant. The recruitment of staff is designed to protect people, including application forms, a full employment history, two references, CRB and POVA checks. All staff are enrolled on NVQ within first six months in the job. Staff have a clear understanding of how they can progress in their careers, with a clear career path Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: laid out for them, thus giving them a sense of direction. The organisations training manager is to identify training needs and source appropriate training for staff. There is a full staff team (6), which puts people using the service first. This includes three female and two males. We asked staff about the training they had completed to ensure they were sufficiently trained to meet peoples needs. They said theyd had a brief induction, then two days intensive training. They commented, theyre on the ball with training, you know whats expected of you here. Theres more direction and its more professional, structured and flexible than last place of work. We all know the boundaries. We looked for evidence to confirm staff training. We saw on staff files staff had received induction training that covered health and safety, fire, control of substances hazardous to health, personal protective equipment, risk assessments, care plans, infection control and first aid. Certificates were in place for challenging behaviour, infection control, moving and handling and control of substances hazardous to health. The training matrix told us Skills for Care training was planned for 28.02.10 and behaviour that challenges, 17.03.10. We discussed with the manager about ensuring training was implemented for the Learning Disability Qualification award, to make sure staff were sufficiently trained for their role. We looked at two staff files to determine if the recruitment procedure was sufficient to protect people. We found these contained some of the information required including CRBs, application forms, proof of ID and two references. However, in one of the files a reference had not been sought from the last employer. The manager did this subsequent to the inspection and it highlighted there were gaps in the knowledge they had about the person that may not have protected people. Both files did not contain a full employment history for people and evidence of prior learning had not always been verified. Care Homes for Adults (18-65 years) Page 23 of 29 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. People could have confidence the home was run and managed appropriately, because effective quality assurance systems were in place. Peoples opinions were central to the homes development and the home had ways of making sure they got this right. Evidence: The manager was not yet registered with the Commission, but said he had submitted his application. He told us he holds the NVQ Level 4 in Care and was to start a Leadership and Management course at Level 4. The manager in the AQAA told us: Monthly service user meetings were to be held to ascertain peoples apsirations and understand their needs. Annual questionnaires are to be sent out to people and their relatives. All staff were fully trained in health and safety, infection control and five of them in food hygiene, which all interlink with providing a safe environment. We saw this when we looked at their files. Records were kept of cleaning and maintenance. The home has a defined leadership structure. Medicines are audited weekly, support plans monthly. The home has an annual plan that clearly identifies its goals within the next 12 months and quality assurance Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: systems were now firmly in place. The annual plan is divided into four key areas company objectives, risk management strategy, safeguarding vulnerable adults and other service specific objectives. All maintenance of equipment was up to date. The AQAA contained clear and relevant information that was supported by a wide range of evidence on our visit. The AQAA told us about changes they had made to improve the service and where they still need to make improvements. The service had sound policies and procedures, which were reviewed regularly. However, we discussed with the manager that policies and procedures were not in place for guardianship or pressure relief and they needed to do this, in case it would be necessary to use them. The home worked to clear health and safety policies. Staff were aware of the policies and were trained to put theory into practice. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 1 34 19 Where a member of staffs last employment involved working with vulnerable adults, a reference must be obtained from them. So that people are protected by the homes recruitment procedures. 16/03/2010 2 34 19 The recruitment process 16/03/2010 must include a full employment history with written explanations of any gaps in that employment and documentary evidence of any relevant qualifications and training. So that people are protected by the homes recruitment procedures. Care Homes for Adults (18-65 years) Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 People should have access to a computer and the internet, so they are able to take part in age, peer and culturally appropriate activities. Staff should obtain the Learning Disability Qualification Award to provide underpinning knowledge about the needs of people they care for. 2 35 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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