Care Home: Heron House

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What the care home does well People are given good information to help them decide if this is the right home for them. The people living in the home are assessed regularly to make sure the service is meeting their needs. People are supported to have an active lifestyle. They are encouraged and supported to do as much as possible for themselves. People said they like the food and we saw that there are lots of choices and differentmeals offered on the menu. People said they are listened to. Meetings to talk one-to-one are arranged for each person so that they can say what they want and if there is a problem. People are supported well to keep in touch with their families as much as they want to. The home meets the physical and healthcare needs of the people who live there. There is input from specialists and local GPs. There is a good range of training including autism awareness and managing challenging and potentially destructive behaviour. People are protected well by the homes policies and staff training in safeguarding. The home is very clean and people said they like it and they like their bedrooms. The staff working at the home are friendly and approachable. Some of them have had a lot of experience working with people with learning disabilities. The registered manager is committed to improving and providing a good service for the people who live at the home. Visiting professionals said in the surveys that the manager and staff work well with them and support the people living in the home well. What has improved since the last inspection? Each person has a copy of the contract in their folder to tell them what service to expect and what they are paying for. Staff have got to know each person and their assessments have been reviewed to reflect any changes. Everyone has a fully written support plan so that staff are aware of how to assist each person and this changes if the person`s needs or interests change. More staff now work in the home and people have been able to go out more. All the staff have now had the training that they need to meet each person`s needs. People have arranged their bedrooms with their belongings in the way they want them. Staff are getting to know the people living in the home and they are being supported to pursue their own interests. The manager and staff have listened to people`s families and now send a monthly newsletter to keep them informed. What the care home could do better: The manager needs to write a report from what has been said about the home by the people involved with it and then design a development plan outlining all the areas needed to develop the service provided in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Heron House St Augustines Sweechbridge Road Beltinge Kent CT6 6TB 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: Julie Sumner Date: 2 8 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 32 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 © (2010) 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 32 Information about the care home Name of care home: Address: Heron House St Augustines Sweechbridge Road Beltinge Kent CT6 6TB 01843830220 01843830228 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) : Family Care Homes Ltd care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. 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 0 6 0 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Heron House is a large house in a village called Beltinge which is between Canterbury and Margate. The home is close to the sea. There are some village shops nearby. The bus stop is right outside the house. Family Care Homes Ltd are the registered owners and have a number of other services in Kent. Five people with learning disabilities live in the home. The house has 3 floors. There is a lounge and kitchen/diner on the ground floor and 2 bedrooms. The second floor has 3 more bedrooms. All of the rooms have a toilet and 4 of the rooms also have a shower. There is a good size garden at the back with a lawn, flowers and a trampoline. To the front of the property there is parking for up to four cars. There is a 7 seater car that the people living in the home can use. The managers office and staff sleepingin area is on the 3rd floor. It costs about £1,250 to £2,500 a week to live here. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We visited the home without telling anyone we were coming so that we could get an idea of what the usual day is like for people living in the home. We were in the home from 1.30 in the afternoon to around 7:30 in the evening. The manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The home had not been open for very long when the AQAA was completed so it was not very detailed but it gave us some good information. We sent 5 surveys out to the people living in the home and 17 to the different people who are involved with them. We received 11 back which was a good response. We have used the information from them in this report. We spent some time with manager. We walked round parts of the home and had a look around. We spent some time with the people living in the home both in the main parts of the home and in individuals bedrooms. We generally chatted to the people living Care Homes for Adults (18-65 years) Page 7 of 32 in the home and the staff to find out what it is like to live and work at Heron House. We looked at various records and plans kept in the homes We had a look around in the house and outside. We looked at some of the policies and procedures. We looked at plans and records for supporting the people living in the home. We also looked at staff records like how many staff there are, what times they work and what training they have been given. What the care home does well People are given good information to help them decide if this is the right home for them. The people living in the home are assessed regularly to make sure the service is meeting their needs. People are supported to have an active lifestyle. They are encouraged and supported to do as much as possible for themselves. People said they like the food and we saw that there are lots of choices and different Care Homes for Adults (18-65 years) Page 8 of 32 meals offered on the menu. People said they are listened to. Meetings to talk one-to-one are arranged for each person so that they can say what they want and if there is a problem. People are supported well to keep in touch with their families as much as they want to. The home meets the physical and healthcare needs of the people who live there. There is input from specialists and local GPs. There is a good range of training including autism awareness and managing challenging and potentially destructive behaviour. People are protected well by the homes policies and staff training in safeguarding. The home is very clean and people said they like it and they like their bedrooms. The staff working at the home are friendly and approachable. Some of them have had a lot of experience working with people with learning disabilities. The registered manager is committed to improving and providing a good service for the people who live at the home. Visiting professionals said in the surveys that the manager and staff work well with them and support the people living in the home well. Care Homes for Adults (18-65 years) Page 9 of 32 What has got better from the last inspection Each person has a copy of the contract in their folder to tell them what service to expect and what they are paying for. Staff have got to know each person and their assessments have been reviewed to reflect any changes. Everyone has a fully written support plan so that staff are aware of how to assist each person and this changes if the persons needs or interests change. More staff now work in the home and people have been able to go out more. All the staff have now had the training that they need to meet each persons needs. People have arranged their bedrooms with their belongings in the way they want them. Staff are getting to know the people living in the home and they are being supported to pursue their own interests. The manager and staff have listened to peoples families and now send a monthly newsletter to keep them informed. Care Homes for Adults (18-65 years) Page 10 of 32 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Julie Sumner The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 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. Care Homes for Adults (18-65 years) Page 11 of 32 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 12 of 32 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 13 of 32 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. Admissions are not made to the home until a full needs assessment has been carried out. The home makes it clear to everyone what they are paying for. Evidence: The home has a statement of purpose, which includes a philosophy of care. There is a service users guide, which is well written and informative. It contains all the relevant information about the home and how care will be delivered. The guide has been developed into a format which is suitable for the service users. It contains pictures and symbols and is easy to follow and understand. We looked at two assessments. One assessment was for a person who has moved into the home quite recently. The assessments were clear and gave good information. A visiting professional commented in a survey that the home carry out thorough assessments. We saw that each person has a clear contract so that they and their representative know what services to expect and what they are paying for. Page 14 of 32 Care Homes for Adults (18-65 years) Care Homes for Adults (18-65 years) Page 15 of 32 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. The service recognises the right of individuals to make their own decisions and supports people in a positive way. Evidence: Each person has a care and support plan. The company uses a format that assists the staff to make the care plans easier to understand for the people living in the home. The plans have pictures and photos with the person in the photo so that it makes more sense to them. We looked at two folders and talked to the manager and staff about them. There was good detailed information in each of the folders we looked at. Most of the people living in the home are able to say what they want. The staff support them to make decisions by talking about the situation and offering choices. One of the people living in the home has a communication passport so that people can interpret what the person is saying by his facial expressions, gestures and behaviour. Staff said they are getting to know the people living in the home and finding out how they like to be approached and who they like to support them when making a decision about their life. They review the support plans every month and more frequently if there is a change in Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: need. We saw clear guidelines for staff about how people like to be supported. The folders include risk assessments. These are very detailed outlining every possible risk. They do also contain clear guidelines for the staff to support each person with the chosen activity. There are risk assessments for a wide range of activities both inside and outside the home and they include general day to day personal care activities like bathing and sport and leisure activities at different clubs. We found the care and support plans to be very thorough and they contained a lot of information. We discussed their accessibility with the manager and area manager. This was mainly because of their size and portability and because they are kept in the office which is upstairs. Both the manager and the staff told us that this was the best place to prevent them from being damaged, keep the confidentiality and that the staff were in and out of the office to refer to things or talk to the manager. The manager also said that it is essential for the staff to have a consistent approach with the group of people living there and that they were able to maintain this effectively. Staff said once they know what to do they continue and only need to refer to the plan if there are changes which they are alerted to. The comments in the surveys we received from visiting professionals were very positive about the approach of the staff saying that staff and managers have worked closely with service users to meet individual needs and they also said that they (care manager) and the family have been involved. Care Homes for Adults (18-65 years) Page 17 of 32 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. The people living in the home are involved in meaningful daytime activities of their own choice and participate in the day to day running of the home. People are supported well to maintain contact with their families and people who are important to them. Evidence: A variety of activities and occupation is offered to the people living in the home. People have different interests and these are incorporated into the activities that are planned. The staff talked about some of the events that the home had recently held and explained that some of the activities are based on these. They are currently planning a Halloween party and the house was covered in Halloween decorations some of which had been made by the people living in the home and some of them had been the result of shopping trips. We looked at two peoples activity timetables and also looked at the daily records which the staff keep to record what people have actually done. Three people were out shopping in Canterbury when we arrived at the home. Different activities had been planned around peoples preferences, like going to the bike club, but when it came to the day they all Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: decided to do something different and this was respected by the staff. The people spoke about what they had done when they got back and said that they had had a good time. We talked to the people living in the home and the staff about seeing their families. One person had just returned from a stay with his parents. Another person said he was looking forward to the Halloween party and his family were coming to that. They also told us about other themed parties and events they had had and we looked at photos of the most recent ones including a Hawaiian day. The staff and people living in the home talked together in a relaxed way and no body was excluded. We saw that the staff were responsive and listened to the people living in the home. The people living in the home can choose when they want to be in company or when they want to be in the privacy of their own room. Generally people have open access to all parts of the home except the office area. The manager explained that peoples bedrooms are locked when they are out to protect their privacy and belongings. The open plan style kitchen has a gate along the breakfast bar perimeter but this was not locked during the visit. Staff said it is only locked to protect people when there is no one to supervise the kitchen if they are busy with other activities. They also said that when they are preparing the meals only one person is in the kitchen supported by a member of staff so access is restricted then as well. The staff at the home prepare the meals. There is a menu plan and the choices of food offered is nutritious varied and healthy. People have a choice about what they would like to eat. The staff keep a record of the food that is being offered and what is chosen and eaten by the people living in the home. People told us that they liked the food. One of the people had prepared the evening meal with a member of staff. Care Homes for Adults (18-65 years) Page 19 of 32 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 know that they will have the support they need to stay healthy. Personal care and support is responsive to the varied and individual needs and preferences of the people living in the home. Evidence: All the people living in the home have support plans in place around their daily routines with regards to getting up and going to bed and personal hygiene. They explained the particular way that people like to have things done. We saw that care staff gave the people the support and assistance that they need while allowing them to do a much as possible for themselves. Each person living at the home has a key worker. Each person also has a health action plan in their folder. This has a record of any regular checks that are needed and how to support the person with their health care. We looked at two health action plans and could see that people are supported to attend health check up appointments and if there is something that the staff need to follow up that this has been done. Each person is registered with a local doctor and any area of concern related to health is referred to them. There is contact with specialist services when needed. We discussed how staff manage peoples behaviour with the staff and manager. We looked at the records and guidelines in two individual support plan folders. Each member Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: of staff has attended training and the manager checks for competency and monitors this with the staff through their one-to-one supervision meetings. The manager and staff explained that it is the homes philosophy to keep medication to the minimum. So medication is kept under review with the GP and consultant to make sure that people are only prescribed what they need. There is clear information about each persons medication in their health action plan including what side effects staff need to look out for. Medication is given using a monitored dosage system from the pharmacy. There are clear procedures for giving medication. All the staff who handle medication have had training and their competencies are checked. The people living at the home receive their medication as prescribed by their doctors. We looked at the guidelines for staff for when they need to give medication as required. The manager explained that the staff telephone her to discuss before giving as required medication if she is not in the home. Care Homes for Adults (18-65 years) Page 21 of 32 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 service has a complaints procedure that is clearly written and easy to understand. People in the home are protected by the homes policies and procedures. Evidence: The home have received no complaints since it opened in October 2008. There is a full complaints procedure in place and it is written in a format that might make it more understandable to people who use the service. The manager said that the people living in the home are encouraged to voice their feelings throughout the day. They also have one-to-one meetings with their key workers. We saw that the staff were attentive and listened to the people in the home and when they expressed any concerns or had any questions the staff responded straight away. Staff spoke about how they support people with communication difficulties to express themselves if they might have a problem. One of the people needs assistance with communication and has a communication passport to give some guidance on how to interpret how he expresses himself. There are clear guidelines in place for safeguarding adults. Staff were spoken to about safeguarding vulnerable adults procedures. They have had training in safeguarding and abuse awareness. They felt confident that they would report any concerns to the person in charge of the shift or the manager. They said they have good communication in the team. We spoke to some of the staff and they were clear about their responsibilities with regards to protecting the people in their care. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: There are safe procedures in place for looking after the finances of the people living in the home. The home has developed systems of managing each persons personal monies, which protects them from abuse. The home provides a safe place for the storage of monies and valuables. The registered manager is able to audit trail and account for the finances of the people living in the home. Care Homes for Adults (18-65 years) Page 23 of 32 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 home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is comfortable and safe. The people benefit from living in a bright airy and clean environment. Evidence: We looked around all of the home. The house has been totally renovated and refurbished to a high standard prior to it opening as a care home in October 2008. The home provides an environment that is specific to the needs of the people who live there. It is a pleasant and safe place to live and the communal areas and bedrooms are have ample space to allow people to move freely. The home is bright and airy. It is clean and tidy and smells fresh. The bedrooms have en-suite facilities. The people who live there are encouraged and supported to personalise their rooms and they have started to do this. People have put their own things in their bedrooms and are starting to make them look the way they want. We talked to some people in their bedrooms and they said they had what they needed and were comfortable. We looked at the laundry area which is small but has all the necessary equipment and people are helped to do their own laundry. Staff were aware of infection control Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: procedures and have attended training. Care Homes for Adults (18-65 years) Page 25 of 32 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. The people living in the home have confidence in the staff that care for them. Evidence: The company have a recruitment procedure that includes all safety and identity checks required by law for care homes. New staff have induction training that includes the Skills for Care common induction standards. Staff do not work alone and unsupervised until their criminal records bureau check has been processed and they have had essential training for health and safety. Staff talked about their roles in the home and about the shift times they work. There are thirteen staff in the team. We looked at the duty rota. We saw that there are enough staff to support the people in the home and so that people can do different things. We talked to the staff about how they plan their day. They use a shift planner and this includes all the appointments and activities that each person is going to participate in. We looked at this and could see that the people living in the home are supported to have an active lifestyle and all the staff know what they are doing each day. We saw that staff are motivated and attentive to the people living in the home. A good range of training is provided by the company including some specific training for staff so that they have the skills to support the people living in the home. We looked at the training records and discussed them with the manager. We saw that everyone has Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: had essential training for health and safety and they have also had training in autism, managing challenging behaviour and epilepsy awareness. Two of the senior managers of the company have become trainers in supporting and managing peoples behaviour. They have provided this training to all the staff in the team. Staff meetings are held for discussion about how to improve the service and what is going well. Staff have supervision by the manager to discuss their personal development and work and there is a plan for this in the office. Care Homes for Adults (18-65 years) Page 27 of 32 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 manager has good people skills, understands the importance of person centred support and has a clear understanding of how the home needs to develop. Evidence: The registered manager, Sharon Homewood, registered with the Care Quality Commission in October 2008 when the home opened. She has several years experience working with people with learning disabilities as a senior support worker in another home belonging to the Family Care Homes Company. This has provided her with the awareness of the company and its various policies and procedures. One of the senior support workers, has also worked for the company for 3 years, and has been promoted and transferred with the manager to Heron House and he is also able to give support and guidance to new staff as well as the manager. The staff member also takes on parts of the induction process for new staff. The manager is working towards completing her NVQ 4 and plans to have completed the managers award by 2010. There is an operations manager who has been in post since the last key inspection. She carries out unannounced visits to the home under regulation 26 to monitor and also provides a link between the senior staff, manager and directors of the company. We have Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: seen that good practice within the company is passed from home to home via the operations manager. We talked about the quality monitoring in the home. We looked at the folder which contained the companys policy and plans for monitoring the quality of the service. The manager said they generally talk to the people living in the home to see what they want and also the key workers have monthly meetings with each person. She said surveys have been sent out to families and this happened shortly after the home opened. The feedback they got was that families wanted to know more about what is happening in the home. The staff have started to send out monthly newsletters with photos. Two of these have been sent out so far and the families have said that they like and appreciate them. The manager said she is going to send out more surveys and include visiting professionals. The manager said that she intends to request feedback from people every six months. We talked about writing an audit report using all the feedback and their own assessments so that they can see where they think the service is at and what needs to be developed. The manager and area manager agreed that they would write a report for this and design a development plan to outline any planned improvements. All health and safety checks are carried out to maintain the building safely. Dates of all recent services and checks were included in the AQAA. The maintenance person carries out the regular fire safety equipment and emergency lighting checks. The home has also completed a fire assessment. Environmental risk assessments have been completed and the staff check the hot water temperatures routinely. An accident book is maintained. Policies are in place to strengthen safe practices. The staff have all attended essential health and safety training. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 30 of 32 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 Description 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 Description 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 31 of 32 Helpline: Telephone: 03000 616161 or 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 © (2010) 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. 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