Care Home: Herbert Street

Similar services:

• Charis

What the care home does well The unit provides an effective service for people who have been alcohol dependent and who want to achieve and maintain abstinence. The staff have a considerable range of skills and expertise that residents appreciate. One person told us, "I am learning all the time at Herbert Street and feel relaxed as it is a good atmosphere". Another person told us, "I have been very happy here for the last five and a half months and learnt a lot about myself and also received a lot of support". The building and facilities includes access for people with a physical disability, provides a pleasant environment for rehabilitation placements and meets the needs of the current residents. What has improved since the last inspection? One requirement was made at the last inspection and that was for the two kitchens in the unit to be refurbished and this had been complied with. What the care home could do better: Two requirements are made as a result of this inspection. These are for a required improvement in the way that administration of medication is recorded, to maximise safety for residents and staff in this area. The second is for a current record to be available in the unit that the electrical installation and portable appliances have been checked, to maximise safety for all. Two good practice recommendations are also made: for copies of key recruitment documentation for staff to be available in the unit, to assist evidence a robust recruitment procedure and for more detailed records of staff training to be kept in the unit, to assist the registered manager ensure staff training is up to date. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Herbert Street 2 Herbert Street London NW5 4HD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter Illes     Date: 1 4 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Herbert Street 2 Herbert Street London NW5 4HD 02079165013 02078135960 herbertst@rugbyhouse.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rugby House Project care home 9 Number of places (if applicable): Under 65 Over 65 0 past or present alcohol dependence Additional conditions: 9 The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home only Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Past or present alcohol dependence Code A Date of last inspection Brief description of the care home Herbert Street scheme is a registered care home providing a structured treatment programme for up to nine people who alcohol dependent and is part of the Rugby House organisation, which is a registered charity. The scheme offers a highly structured dependency treatment programme and aims to enable residents to maintain and support abstinence. Placements are for a period of up to six months, and are dependent on funding from statutory drug and alcohol services. Herbert Street is in North London NW5 in a residential area minutes from Queens Crescent shopping facilities and a bus ride from Kentish Town and Camden Town. Parking is limited. The building is purpose built in two separate units, a house and a bungalow. There are five single bedrooms in the house and four in the bungalow. The house and bungalow are on the same site separated by an attractive courtyard garden. The communal facilities comprise two shared kitchen/dining rooms and sitting rooms, laundry facilities and Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home courtyard gardens. There are three bathrooms and five toilets in the project. The current cost of the service is £691.50, information about the service, including inspection reports, is available from the registered manager and registered provider. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 12th June 2006. This unannounced key inspection took approximately six hours with the registered manager being present or available throughout. There were eight people living at the home and a ninth person was undertaking a preliminary visit to the unit during the inspection. The inspection was undertaken by the lead inspector although terms such as we, our and us are used where appropriate within this report to indicate that the inspection activity was undertaken on behalf of the Commission. Care Homes for Adults (18-65 years) Page 6 of 29 The inspection activity included: meeting and speaking to the majority of the people living in the unit; including speaking to two of them independently; detailed discussion with the registered manager; independent discussion with the senior practitioner who deputises for the registered manager and independent discussion with another practitioner. Further information was obtained from a current Annual Quality Assurance Assessment (AQAA) submitted by the home, survey forms returned from six residents, a tour of the premises and documentation kept at the home. 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 set out 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have up to date information and are able to visit the unit to allow them to make an informed decision about participating in a rehabilitation programme there. Peoples needs are properly assessed prior to admission to ensure that the unit can meet these and their rights and responsibilities are properly explained to assist with the rehabilitation process. Evidence: The home has an up to date service user guide that was seen. All residents are given a copy of the service user guide, which is called the Residents Handbook. We were given a copy of this handbook, which is detailed and gives clear information on what residents can expect from the service including a range of restrictions that the unit operates as part of its rehabilitation programme. Residents spoken to told us that they were given a copy of the handbook and found it helpful, especially when they first moved in. The files of three residents were inspected and these all contained detailed assessment Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: information that the unit had received prior to the persons admission. This included a detailed referral form completed by the persons care manager and any specialist assessments undertaken prior to admission such as from any specialist detoxification unit a person may have attended prior to admission to this unit. In addition there were records of in house assessments undertake by the units staff, which again were detailed and comprehensive. Residents generally stay at the unit for up to six months and the files showed that assessing peoples progress on an ongoing basis was a key part of the persons programme. Residents told us that they had the opportunity to visit the unit before they were admitted to decide if they wished to undertake a rehabilitation programme there. During this inspection a prospective resident came for an introductory visit as part of their referral process. Each persons file inspected had a signed care contract that specified the care and support the person would receive and a separate housing licence agreement that specified the responsibilities of the housing provider and of the resident while they were a tenant at the home. Residents told us that these were agreed and properly explained when they moved in. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs and preferences, and how these are to be addressed, are agreed and recorded in the residents care plans to assist both the resident and staff maximise the rehabilitation process. Residents are encouraged to make decisions for themselves and any limitations to this process are recorded and understood by all concerned. Residents are supported to take appropriate risks as part of the rehabilitation process. Evidence: The units Annual Quality Assurance Assessment, AQAA, states, (We) formulate a holistic Personal Development Plan (PDP) with all the information available that is SMART and flexible. The three residents files inspected contained detailed care plans, an initial plan for when they were first admitted and a detailed and comprehensive plan that was developed with the individual in the first weeks that they are living at the unit. Residents are invited to write a life story which is then used by the person and staff to inform their care plan. This allows staff in the unit to make sure that they understand the things that are important to the person and their personal preferences, Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: including in regard to their beliefs, culture and sexuality. The care plans seen were detailed and included sections such as relapse prevention, physical health, emotional well being, relationships/ social networks and spiritual and cultural needs and preferences. Residents spoken to told us that they were very much involved in developing and reviewing their care plans as part of the ongoing rehabilitation process. The home operates a key worker system and key workers spoken to were knowledgeable about individual residents needs and preferences. Key workers write weekly reports on the persons progress and up to date copies of these were seen. When a person is approaching the end of their programme at the home a transition plan is agreed with the person to assist in this process and a copy of a plan was seen for one resident. One resident told us I have been very happy here for the last five and a half months and learnt a lot about myself and also received a lot of support. A major part of the units work is to assist and support people develop or re-learn the skills necessary to make positive decisions about their lives, especially when they move back into the community. Evidence that the home was doing this was clear from documentation seen and residents and staff spoken to. There are clear limits imposed when a person moves into the unit including such things as when they can go out into the community and these are relaxed as the person makes progress. The home operates a range of limitations on people that they agree to as part of their rehabilitation programme. These include random breath testing and urine samples and specific agreements to these, signed by the resident, were seen in the files inspected. There is also a clearly recorded process of dealing with any relapse or infringement of the rules with sanctions, that can ultimately lead to the persons programme being terminated at the unit. Residents told us that these had been properly explained to the them and they accepted such limitations as part of the rehabilitation process. Each file inspected contained an up to date risk assessment and risk management plan. Evidence was seen that these were developed as part of the initial referral process and reviewed and refined with the person throughout their placement. Evidence was seen that the risk management plans were signed by the person themselves and agreed with other referring or statutory agencies as required. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to engage in a structured rehabilitation programme at the unit that meets their needs and includes contact with the wider community. They are supported to maintain links with relatives and friends within the agreed boundaries of their programme and are also supported to enjoy nutritious meals of their choosing. Evidence: The homes Annual Quality Assurance Assessment, AQAA, states, Service users are encouraged to review their physical health in terms of diet, personal healthcare, fitness, cultural and spiritual needs and to explore and engage in appropriate support and leisure activities that support their recovery. The home operates an activities programme that residents must commit to take join in as part of their rehabilitation. This includes open groups such as a gender group and a relapse awareness group. In addition residents undergo a range of one to one sessions including with their key Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: worker. Thursday afternoons are free for residents to develop external links and activities and on the afternoon of this inspection, a Thursday, residents were seen to go out in the afternoon as part of this process. Residents may chose what they do at the weekend, as long as this is within the overall ground rules of the unit. Residents are expected to attend two external self help support type group meetings a week as part of their programme. Residents spoken to were very positive about their programmes. One person told us, They treat you like an adult, give you trust. Another person told us, There is always someone to talk to if you need it. The unit provides a service to people from different cultures and religions and peoples needs and wishes regarding these are respected. The unit has a clear equal opportunities policy, that is included in the residents handbook. People told us that the ground rules at the unit and within groups promoted equality and diversity. One person told us that if someone made an inappropriate remark, a slip up, this would be discussed appropriately and dealt with. However, the person went on to tell us that in their experience any ongoing discriminatory behaviour is not tolerated in the unit. One of the boundaries listed in the Residents Handbook states, While respecting and welcoming individual differences and choices, please remember that this is a mixed project and to dress appropriately. Women residents told us that they felt comfortable and well supported at the unit. Residents are encouraged to maintain relationships with relatives and friends while at the unit although within agreed boundaries that are clearly set out in the Residents handbook. Residents spoken to accepted this as part of their rehabilitation programme. Residents buy and cook their own meals with support from staff as appropriate. There are two kitchens in the home that residents have access to and appropriate storage facilities for the food that they purchase. Residents are supported and monitored with preparation of meals, including in purchasing and cooking food that meets their cultural preferences. The kitchens have been refurbished as required at the last key inspection and were seen to be appropriate to the residents needs. One kitchen is adapted to be accessible to people in wheelchairs. Residents told us that the importance of diet and nutrition is a key theme of the rehabilitation programme. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to meet their physical,and emotional health needs while living at the unit and they are appropriately supported to meet any personal care needs that they have. The units medication policy and procedures assist protect people while at the unit although an improvement is needed in recording regarding this. Evidence: The people living at the unit at the time of this inspection were independent with regards to their personal care although staff may sometimes give people a verbal prompt in this area if appropriate. We were told that if a prospective resident needed assistance with their personal care then this is explored at the time of referral to ensure their needs and preferences could be met. The registered manager stated that if a prospective resident needed any specific specialist assistance with their personal care or health care that was outside the skills of staff this may be supplied from outside agencies. A main aim of the unit is to promote peoples health through helping them to address their addiction and evidence found throughout this inspection showed that this is done Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: very well and is a major factor in our judgement that the home provides excellent outcomes for people in this area. Peoples physical, mental and emotional health care needs are assessed at the time of referral and detailed evidence to support this was seen on the residents files that were inspected. Care plans seen included sections on physical health and emotional well being. The majority of residents were registered with a local GP, who the registered manager stated was very supportive to the unit and had a good understanding of the rehabilitative nature of the work undertaken. If a person wishes to remain registered with their own GP and this is practical in terms of location etc this is agreed. Evidence was seen on residents files that they are actively supported to have a dental check up and any necessary treatment during their placement. The unit has an appropriate medication policy and procedures that were seen. An assessment is undertaken on admission to support people being as independent as possible with their medication. However, there are very clear rules about prescribed medication that are included in the residents handbook. These include that residents are required to be abstinent from certain prescription medication and if necessary need to negotiate with their GP for an appropriate alternative. We looked at the medication storage facilities that were appropriate. We also looked at the medication and medication administration records for two residents. These were generally satisfactory and indicated that residents were receiving their medication as required. However, their were identified gaps in some recording of administration of medication and a requirement is made regarding this. It was also not possible to easily verify that all staff that administer medication have received refresher training in this and a good practice recommendation is made about the unit having evidence of staff training generally in the Staffing section of this report. It was noted on peoples files that they are invited to specify their wishes in the unlikely event of their death, including if they choose not to specify their wishes. 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 living at the unit are protected by the homes complaints procedures, which they are aware of. They are also protected by the homes safeguarding adults procedures, that staff are aware of. Evidence: The annual Quality Assurance Assessment, AQAA, states, All our residents are made aware of the complaints procedure when they are inducted into the project. We saw a satisfactory complaints procedure displayed in the lobby and a copy in the residents handbook. Residents told us that if they had any issues or concerns they would either raise the issue in one of the meetings or speak to their key worker; they indicated they were confident issues raised are taken seriously. This was also confirmed by feedback in surveys returned to us by residents. There had been no complaints recorded in the unit since the last inspection and none have been received by the Commission in that time either. The unit had a copy of the L.B. of Camdens safeguarding adults policy and staff told us that they had read the units own guidance on safeguarding. Staff also stated that they had received training in this area, although it was not possible to easily verify if this training was up to date. A good practice recommendation is made about the unit having evidence of staff training generally in the Staffing section of this report. However, staff spoken to were able to describe appropriately the actions they would Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: take if an allegation or disclosure of abuse was made to them. The unit had an appropriate whistle blowing policy that was seen. No safeguarding issues had been recorded at the unit since the last key inspection and none have been reported to the Commission in that time either. 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. Improvements have been made to the physical environment and the unit provides suitable accommodation for people living there while they undertake their time limited rehabilitation programme. Evidence: The unit consists of a main house and a bungalow that are joined by a courtyard. There are five residents bedrooms in the main house, adequate bath, shower and toilet facilities, a lounge that is also used as a meeting room and a staff sleeping in room at night and a residents kitchen. In addition the staff office is situated in the main house. The bungalow has four residents bedrooms, adequate bath, shower and toilet facilities, a lounge and a residents kitchen. The bungalow is accessible for people with a physical disability including the kitchen. The central courtyard is pleasant with garden seats and table, a water feature and allows disability access to the bungalow from a separate entrance to the street. A number of residents showed as their bedrooms and stated they were very happy with them. These were comfortable, well decorated and had obviously been personalised by the person occupying them although it was noted that they did not contain en-suite facilities or a hand wash basin. Residents stated that the bath, shower Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: and toilet facilities within each part of the building met their needs. Our judgement is that this is acceptable only because of the short stay nature of the unit. At the last key inspection a requirement was restated that the kitchens in the unit must be refurbished. The home had sent confirmation that this had been completed prior to this inspection. We were informed that some maintenance was outstanding at this time, including to the central heating system but that this was in hand. We were unable to see proof of a current portable appliance testing certificate or current electrical installation certificate at this inspection and a requirement is made regarding this in the Management and Administration section of this report. Residents are supported to keep the unit clean and tidy as part of their rehabilitation programme. The unit also had suitable laundry facilities that met the needs of the current residents. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A staff team with a range of qualifications and competencies, in sufficient numbers, support people living in the home. The homes recruitment policy assists in protecting people living in the home although an improvement in records kept in the home would assist evidence this. People are supported by staff who have access to a range of appropriate training although more robust records in the home would help in monitoring this. Staff receive formal supervision to assist in further meeting the needs of people living in the home and in their own personal development. Evidence: At the time of this inspection the staff team comprised a registered manager, senior substance misuse practitioner, who deputises for the registered manager, and two full time and one half time substance misuse practitioners. In addition the unit has three support workers and a bank of six more support workers who sleep in at night. The staff rota was seen and accurately reflected the staff on duty on the day of the inspection. The rota showed a minimum of two staff on duty from 9 am to 4 pm, a minimum of one staff from 2pm to 9.30pm and one sleeping in staff at night. The registered manager is included on the rota. There is also an on call management system that we were informed by staff worked well. The staff ratios were judged to be sufficient to meet the needs of the current residents. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: All of the practitioners have achieved the national vocational qualification (NVQ) level 3 in care and hold a range of other relevant professional qualifications. Staff turnover is fairly low at the home although the senior substance misuse practitioner told us she had only been in post for ten days. The registered manager told us that the unit and provider organisation operates a robust recruitment procedure and evidence at previous inspections has demonstrated this. However, he went on to say that copies of the recruitment documentation for the senior substance misuse practitioner to evidence the recruitment procedure was still in the process of being sent to the unit from the provider organisations head office. We were also told that the only other staff recruited to the unit since the last key inspection were support workers and that their recruitment files were kept at the head office as they also worked in other provider organisation units. As a result of this we were unable to easily verify the robustness of the recruitment procedure in place since the last key inspection. A good practice recommendation is made that copies of staffs recruitment documentation, including proof of identity with a recent photograph, two verified references and evidence that a current criminal records bureau (CRB) check and protection of vulnerable adults (POVA) clearances are kept at the unit. Staff spoken to told us that they are offered regular training to equip them to undertake their role. Evidence on some staff files seen supported this with training certificates including in safeguarding adults, infection control and food hygiene. Evidence was also seen of a rolling programme of training provided for staff by the provider organisation. However, there was no easy system available at the home for the registered manager to be able to check what staff training each staff member had undertaken or when staff needed refresher training. A good practice recommendation is made about this. Evidence was seen from records in the home that staff receive regular and meaningful supervision. This includes all staff receiving individual line management supervision every two weeks. In addition group supervision is also held every other week by an independent facilitator. Staff spoken to independently stated that they found the supervision offered by the home to be very helpful in assisting residents and in their own professional development. 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. Residents benefit from the clear management systems used by the home. This includes their views being regularly sought in a variety of ways regarding the quality of life they experience and the results of this are acted upon. Health and safety procedures assist in protecting people living at the home, staff and visitors although further attention is needed to evidence the electrical installation and portable appliance testing is up to date, to maximise this protection. Evidence: The registered manager has a range of qualifications and skills to enable him to undertake his role effectively which includes achieving the registered managers award, a national vocational qualification (NVQ) level 4 in management and care. Residents and staff gave positive feedback about him and his management style. The registered manager told us that the senior substance misuse practitioner post, the post that also deputises for him when he is away from the home, had only just been filled, and that this should assist him significantly with his management duties. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: Evidence was seen that the home monitors the quality of the service in a variety of ways and acts to implement improvements. This included by the positive use of the key worker system, feedback from reviews, community meetings, regular monitoring visits by a senior manager from the provider organisation and a formal questionnaire at the end of each persons placement. The registered manager writes a quarterly report on the progress and outcomes the home has achieved and we were given a copy of this, which assisted to evidence the high quality of service offered by the unit. The homes annual quality assurance assessment (AQAA) told us that the home has a high number of successful outcomes and receives positive feedback from residents and past residents. At this inspection a range of satisfactory health and safety documentation was seen however an up to date electrical installation certificate and portable appliance certificate could not be located and a requirement is made regarding this. We were informed following this inspection that work was underway to address this. The homes fire log was inspected and showed that the fire fighting equipment was serviced on a regular basis, weekly safety checks on fire equipment were being carried, that regular fire drills were being undertaken, and the home had a current fire plan and fire risk assessment. 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 20 13 The registered persons must 12/06/2009 ensure that arrangements are in place for the recording, handling, safekeeping, safe administration and disposal on medication received into the care home. This must include recording the reason why if a person has not received prescribed medication on any occasion that they should have done. This requirement is made for the protection of both residents and staff. 2 42 13 The registered persons must 17/06/2009 ensure that unnecessary risks to the health and safety of residents are identified and so far as possible eliminated. This must include evidence that the home has a current and satisfactory electrical installation Care Homes for Adults (18-65 years) Page 27 of 29 certificate and portable appliance testing certificate. This is to ensure that protection to all that use the home is maximised. 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 34 Copies of staffs recruitment documentation, including proof of identity with a recent photograph, two verified references and evidence that a current criminal records bureau (CRB) check and protection of vulnerable adults (POVA) clearances should be kept at the unit to evidence the robustness of the recruitment procedure.. Copies of staff training records should be kept at the unit to assist the registered manager ensure that all statutory training is up to date and to monitor when refresher training is needed. 2 35 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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