Care Home: High Street (80) - Resource Centre - NYCC

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What the care home does well Staff at the centre encourage people to be independent and to make their own decisions wherever that is possible. This enables people to have control over their lives.Staff are respectful to people and sensitive in meeting their needs.This helps in making sure people receive care in the way they prefer.The way in which information is gathered and kept about people means staff can provide support in a way that people need and prefer.It also means staff have in depth knowledge and understanding about each individual person. Comments received from the people who stay at 80 High Street on respite care were positive.People made comments such as, "Telephone contact always made with parents when necessary.Care plans always up to date. Planned stays timed with young people of similar age". "My son has never been unhappy to go and stay at 80 High Street. Regards staff as friends and always has a wonderful time there". "Try and put peer groups/friends together. Always very warm and welcoming. Friendly staff. Liaising with family members. Always do their best to help and meet requests for respite preferences". "The care staff are always very good and kind and treat me as an adult. They have lots of things there i enjoy doing and have recently bought some new equipment for my self and my peers to enjoy." "Take good care of me". " Great fun to be with people who i have known for years. The food is very nice.we go out alot - go to the pictures and bowling. Staff are great i would like to say a big thank you to them it`s a great pleasure to come here". "The staff look after me well. Staff are nice i get on with them". Comments made from two relatives that were at the respite centre during the inspection were, "Fantastic, they (staff) always do the extra.Our son enjoys the outings.The food is very good. They enable our son to move on- become more independent. The continuity of staff and the fact that they take service users needs into consideration". What has improved since the last inspection? 80 High Street has made improvements to how people`s care plans are documented. They have made them more clear for staff to follow when providing direct care. This makes sure that people`s care needs are met whilst staying at the centre for respite care. What the care home could do better: Staff at the respite centre should have regular up to date training in safeguarding people from abuse. This makes sure that people staying at the respite centre are protected from harm. The lounge/dining area and some bedrooms are in need of re-decorating. Two of the kitchen cupboards need to be repaired or replaced. This makes sure that the centre is homely and maintained to a good standard for people who stay at 80 High Street for respite care. Staff should receive regular supervision from the management of the centre. This makes sure that staff work safely and effectively and carry out the jobs they are employed to do. Key inspection report Care homes for adults (18-65 years) Name: Address: High Street (80) - Resource Centre - NYCC Resource Centre 80 High Street Starbeck Harrogate North Yorkshire HG2 7LW     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: Irene Ward     Date: 3 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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: High Street (80) - Resource Centre - NYCC Resource Centre 80 High Street Starbeck Harrogate North Yorkshire HG2 7LW 01423883301 01423881498 Julia.Glenny@northyorks.gov.uk www.northyorks.gov.uk North Yorkshire County Council care home 8 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service Users up to 8 (LD) and up to 8 (LD(E)) up to a maximum of 8 Service Users Date of last inspection Brief description of the care home The Resource Centre, 80 High Street is registered to provide residential care for up to 8 adults aged between 18 and 65 years with a learning disability and up to 8 adults aged 65 years and above with a learning disability. The maximum number of places available at any given time is 8. The registered provider is North Yorkshire County Council. The centre offers placements exclusively to people and their families who require respite care. The accommodation is set on the ground floor and is located in a building that also houses the Community Resource Team offices and rooms accessed by other community groups. The centre is situated approximately 2 miles from Harrogate town centre. There are good local amenities within 20 minutes walk in Starbeck. On the 30th July 2009 the cost of one night at the centre was 179 pounds per night, this can be reduced following a financial assessment. People who use the service/relatives and other interested parties are able to have access to inspection Care Homes for Adults (18-65 years) Page 4 of 29 8 Over 65 8 Brief description of the care home reports by requesting them from the resource centre. 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: The Commission for Quality Care inspects homes at a frequency determined by how the service has been risk assessed.The inspection process has now become a cycle of activity rather than a series of one-off events.Information is gathered from a variety of sources, one being a site visit.More information about the inspection process can be found on our website www.cqc.org.uk This is what we used to write this report:We looked at information we have received about the respite centre since it was registered. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We sent surveys to people who receive a service and to staff who work at the respite centre. Care Homes for Adults (18-65 years) Page 6 of 29 One inspector visited the respite centre unannounced. This visit lasted over four hours and included talking to the staff and the team manager about their work and the training they have completed, and checking some of the records, policies and procedures the centre has to keep. A further visit was arranged so we could spend sometime talking with people who use this service. We also spoke with two relatives who were at the centre at the time of the visit. We looked at two peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people who use the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The site visits took place on the 30th July 2009 and 6th August 2009.One of the team managers and a resource worker were available to assist throughout the visits and available for feedback at the end of the inspection process. 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: Staff at the respite centre should have regular up to date training in safeguarding people from abuse. This makes sure that people staying at the respite centre are protected from harm. Care Homes for Adults (18-65 years) Page 8 of 29 The lounge/dining area and some bedrooms are in need of re-decorating. Two of the kitchen cupboards need to be repaired or replaced. This makes sure that the centre is homely and maintained to a good standard for people who stay at 80 High Street for respite care. Staff should receive regular supervision from the management of the centre. This makes sure that staff work safely and effectively and carry out the jobs they are employed to do. 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 9 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 10 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. Peoples needs are properly assessed prior to admission to the respite centre,this makes sure that peoples needs are met during their stay at 80 High Street. Evidence: The process for someone obtaining respite care at the centre continues to be the same as reported at the last inspection and has not changed.The senior resource worker confirmed that information is made available to anyone interested in respite care at the centre in the form of the service user guide before they are offered a service. Following a referral made by the Care Managers for respite care an assessment is carried.The manager of the respite centre and a senior resource worker arrange a home visit prior to any admission to the centre and complete an extensive assessment. Subsequently the centre then attempts to keep in contact with people who use the service and their relatives using the telephone and a newsletter until they are admitted for respite care. Two peoples records were looked at and both contained an assessment prior to the service commencing. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Assessments and care plans were complete and reviews regularly undertaken. This makes sure that the changing needs of people staying at the centre are continually met. It was evident from the care records that people make their own decisions about what they do from day to day when staying for respite at the centre. From assessments and care plans seen and from observations on the day it was clear that the centre continues to provide care to some people who have very complex care needs.The respite centre also offers emergency placements. No amendments have been made to the Statement of Purpose and the Service User Guide. A new brochure is to be designed for the respite centre. Contracts are in place and are available in written word and picture format, and fully inform people of their rights during their stay at the centre. Care Homes for Adults (18-65 years) Page 12 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. 80 High Street offers a flexible service that meets the needs of people who require respite care. The care provided is of a good standard and encourages people to make their own decisions about how they want their care needs to be met. Evidence: People staying at the respite centre looked well cared for and staff were seen supporting people during the day and it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. Each person has an individual care plan detailing their individual need and the actions that staff needs to follow to meet these. The care plan focuses on the person and contained information about every aspect of the persons daily life. The resource worker said that care plans have improved since the last inspection and are more detailed and are more person centered as to how people preferred their care to be provided. All areas of daily life such as peoples personal care and activities were covered in the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: plans.They also focused on special requirements such as peoples dietary needs and specific complex procedures that staff needed to follow,where staff have completed the necessary training. Peoples likes and dislikes are recorded.It was clear that staff at the the centre had taken all the necessary measures to make sure that people who require specialist interventions receive medical help when needed in making sure that their health is not put at risk. The care plan provided the reader with very good information, was easy to understand and gave a sense of the person. The plans are reviewed regularly. Also present were a range of risk assessments with the purpose of supporting people to be as independent as possible with safeguards in place. These were also reviewed regularly. We received five surveys from people who use the service. Comments were positive. People stated they can choose to do what they want each day and everyone said they knew who to speak to if they are unhappy, and all said staff treat them well. When people were asked What does the service do well? Positive comments were made such as, Telephone contact always made with parents when necessary.Care plans always up to date. Planned stays timed with young people of similar age. Take good care of me. When asked is there anything else you would like to tell us? One person said, My son has never been unhappy to go and stay at 80 High Street. Regards staff as friends and always has a wonderful time there. Two relatives were spoken to and both spoke positively about the centre. They made comments such as: They (staff) enable our son to move on- become more independent. Through discussions with one of the team managers and the resource workers at the time of the visit and the contents of care plans it was clear that people are able to make choices wherever possible. Care Homes for Adults (18-65 years) Page 14 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. People who use this service are always able to make choices about their lifestyle and are supported by staff to carry these out. Evidence: People staying at the respite centre have the opportunity to attend various activities during their stay.Generally people only stay at the respite centre for short periods of time this can be for one night or up to four weeks. Therefore the centre tries to ensure that activities carried out at home are continued when they stay at the 80 High Street People have opportunities to pursue their interests and the respite centre supports people to carry out activities of their choice. Examples of the sort of activities people do were given such as people going to Ripon Community link and hydrotherapy.People are supported to attend various activities such as going out to the pub,Tropical World in Leeds,to go to the cinema or a nightclub. We were told that people are supported to Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: do whatever they want to do.One person at the time of the visit enjoys music and watching the Jungle book DVD. People spoken to on the second day we visited made positive comments about activities. They told us that they have the opportunity and are supported to go out and made comments such as, Great fun to be with people who i have known for years. The food is very nice. We go out alot - go to the pictures and bowling. There was a positive comfortable atmosphere and friendly banter between the staff and people staying at the centre. Five surveys were returned from people who receive a service. Most surveys received were positive, all stated they can choose to do what they want each day, all know who to speak to if they are unhappy, and all say staff treat them well. People made comments such as: Try and put peer groups/friends together. Always very warm and welcoming. Friendly staff. Liaising with family members. Always do their best to help and meet requests for respite preferences. The care staff are always very good and kind and treat me as an adult. They have lots of things there i enjoy doing and have recently bought some new equipment for my self and my peers to enjoy. When asked,what could the service do better? people said said, I would like to be able to go out more when i go to stay. To enable the right mix of people to access the community more. One relative who was spoken to commented when asked what does the centre do well? Our son enjoys the outings.The food is very good. The team manager said that people where possible choose what they want to eat each day. People are offered a varied and nutritious diet and are involved with the menu planning as they are asked what they would like to eat during their stay. People are encouraged to try different and new foods. Care plans looked at detailed how people spend their days. The team manager said that people are supported to attend activities that they already have in place.This included daytime activities.These arrangements are discussed with people who use the service and their family to ensure continuity during their stay at the respite centre. Care Homes for Adults (18-65 years) Page 16 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. Peoples personal and healthcare is provided appropriately and sensitively according to individual needs. Evidence: Everyone has a care plan, which details how they will be supported with their health and care needs.People staying at the respite unit usually access their own GPs and specialist services whilst they are at home. Harrogate General Hospital is used for Accident and Emergency services for people staying at the respite centre. There is a policy in place for the storage and administration of medication for all staff working in the respite centre to follow. People who are able to look after their own medication,are supported to do so by staff at the centre. A locked box is provided in their own room. However for those people who are unable to manage their own medication the centre has a medication system in place and procedures are followed accordingly. As this service is a respite centre, different medication systems maybe used according to what the person uses. Such as in bottles that medication has been Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: dispensed in or a medication system such as Nomad.The Medication Administration Records that were looked at show that everyone receives their medication as prescribed. Three peoples medication was checked with the team manager and all were correct. Medication had been given out to people that morning. All drugs checked were accounted for and balanced. Any changes made to medication are recorded in the medication section of peoples care plan. However one persons medication had changed and their record had been amended but the date this was done was not recorded. It was agreed on the day that this should be done as a matter of course. Otherwise the information could be confusing for staff as it was for the inspector, as to what the correct dosage of medication was for that person, when staying at the centre.The respite centre immediately rectified this on the day.The respite centre does not hold any controlled drugs for anyone at the moment. The needs of some people coming for respite care can be more complex. However staff at the centre have received all the necessary training to make sure peoples care needs and medical interventions can be met. As this is a respite centre those interventions will not be used regularly as they would be in a care home. Staff training has been regularly updated to ensure they maintain their skills. If any further advice is needed staff link up with health care professionals and relatives of people who use the service, in making sure that people who require such specialist needs are always met wherever possible by the centre. Care Homes for Adults (18-65 years) Page 18 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 who use the service have access to an effective complaints procedure. Although people would be better protected from harm, by staff having regular up to date safeguarding training. Evidence: A comprehensive complaints procedure is followed and is made available to people and any other interested parties. People who use the service are provided with a complaints procedure, which is produced in an appropriate format such as pictorial. Where individuals are unable to verbalize concerns, staff observe behaviors and body language to identify any dissatisfaction.There have been two complaints since the last inspection. All complaints have been logged and records were held of the investigations carried out and of the outcomes to the complaints made. There have been no complaints received by CQC (Care Quality Commission). People when asked were clear as to whom they would speak to if they had any concerns or worries. All said they would speak to staff at the centre. North Yorkshire County Council policy and procedures with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse were in place and the team manager demonstrated a good awareness of this. Staff receive training in adult protection and safeguarding issues during induction training and further training when required. However when looking at staff training records, these showed that senior Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: management of the centre had received training in safeguarding in January 2009. Records showed that twelve staff working at the centre had not received any recent training. Staff records showed that they had last carried out this training in June 2006. Since this inspection when it was highlighted, further training in safeguarding adults has been arranged to take place on the 17th September 2009 for six staff from the centre. There have been no safeguarding referral made since the last inspection. Appropriate recruitment procedures are followed, with references and Criminal Records Bureau (CRB) checks made to reduce the risk of unsuitable people working at the respite centre. Peoples finances were discussed and checked with the team manager. Monies checked all balanced and receipts are obtained for all purchases made during peoples stay at the respite centre. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 80 High Street provides a safe place for people to stay when coming for respite care. However, some parts of the centre need to be redecorated and refurbished in order to provide people with pleasant and homely facilities. Evidence: The respite centre provides sufficient accommodation for up to eight people who come for respite care, which is all on ground floor level.People staying at the centre all have single bedrooms. Both bedrooms and bathroom have been adapted and provide such equipment as ceiling hoists.There is a lounge/dining area and also a smaller lounge for people who want to spend some quite time.There is also a large kitchen. Two kitchen cupboard doors were missing and in need of being replaced. We were told that these had been missing for sometime. The decor in the centre especially in the lounge/dining room was starting to look tired and worn and there was some damage to the walls.Both the lounge /dinning area are needing to be re-decorated.Two bedrooms were looked at (named Lilac and Peach) both bedroom walls had been damaged and were also in need of being re-decorated. There is a large garden and patio area that can be accessed by wheelchair users from the lounge. The garden has had a ramp installed and has been paved and made safe so that people in wheelchairs can access all the outside areas of the respite centre Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: including the grassed area. All areas including the lounge, dining area, kitchen,bathroom and toilets were on the whole clean and free from any odours. The carpet in the lounge/dining area was stained although we were informed that arrangements had been made to have the carpets cleaned on the 3rd August 2009. Peoples bedrooms seen had been personalized with some various possessions people had brought with them for their stay at the centre. Surveys returned from people who come to stay at the respite centre told us that it was always kept clean. A range of maintenance checks is completed on a regular basis to make sure that the respite centre is safe and secure. Care Homes for Adults (18-65 years) Page 22 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. Sufficient staffing levels and proper recruitment procedures are followed meaning that peoples needs were being met and on the whole their interests are safeguarded. Although people would be better protected from harm, by staff having regular up to date safeguarding training. Evidence: Staffing levels were sufficient for meeting the needs of people who come to stay for respite care. The duty rota for that week showed that there were three members of staff on duty both in a morning and afternoon for three people that were staying at the centre.The team manager said that rota was based on how many people were in on respite care at anytime and what peoples needs were.The centre would then staff accordingly in making sure they were able to meet peoples needs at all times. At night for that week there was one staff on waking night duty and one staff sleeping in each night. Again the night staffing arrangements are based on how many people are staying at the centre and what peoples needs are. The staff records of three staff one which was recently appointed were looked at.These showed that all the necessary pre- employment checks had been carried out prior to the new workers starting in post.All records showed completed application forms, two Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: written references, CRB (Criminal Record Bureau) checks had been obtained.The human resources department at County Hall carries out all of the recruitment checks. Records of staff supervision were seen. Not all of these were up to date. One staff had last received supervision in November 2008. The local authority provides all the mandatory training that is required. A range of other training has been completed by staff such as multi sensory,service plan,preventing/managing challenging behavior,emergency aid,back care awareness,palliative care and fire training are just some of the training staff have attended. Safeguarding training had been undertaken by senior management of the centre who had received their training in safeguarding in January 2009. However twelve staff working at the centre had not received any recent training. Following the inspection we were told that arrangements had been made to address this. Four staff have completed the National Vocational Qualification (NVQ) Level 2 and eight staff holds NVQ Level 3 and three staff are working towards completing NVQ Level 3.The registered manager holds NVQ level 4 and the registered managers award. She also has the D32/D33 assessors award. Staff meetings are held regularly and minutes of meetings were seen at the site visit. Surveys returned from people who stay at at the centre and people spoken to during the visit made positive comments about the staff at the centre such as: Try and put peer groups/friends together. Always very warm and welcoming. Friendly staff. Liaising with family members. Always do their best to help and meet requests for respite preferences. The care staff are always very good and kind and treat me as an adult. Take good care of me. Relatives who were spoken to were also positive about the respite centre and said, Fantastic, they (staff) always do the extra.Our son enjoys the outings.The food is very good. They enable our son to move on- become more independent. The continuity of staff and the fact that they take service users needs into consideration. Care Homes for Adults (18-65 years) Page 24 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 benefit from a well managed service in which their needs and wishes are put first. Evidence: The manager of the home has worked at the respite centre for sometime now. The registered manager holds National Vocational Qualification (NVQ) Level 4 and the registered managers award. She also has the D32/D33 assessors award. The centre has a good and effective management team in place.The ethos of the respite centre is open and positive. People who use the service,two relatives and staff all commented highly about the respite centre. Regular staff meetings are held and minutes are taken. Respite residents meetings are also held the last one held was on the 12th July 2009. There are Quality Assurance systems in place. Surveys were currently being sent out to people to ask them about their views of the service. A service improvement and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: development plan has been completed for 2009/10 which covers environment, staff development,catering,activity,communication with service users. 80 High Street is also looking at developing talking books, which will introduce the service they offer to people. All accidents are recorded as required and an accident book is maintained in line with the requirements of Data Protection. Peoples personal finances were checked at this site visit. Monies checked at the time of the visit all balanced and receipts are obtained for all purchases made. Information provided from the AQAA Annual Quality Assurance Assessment and the examination of selected health and safety documents show that regular checks to fire safety equipment are regularly undertaken. Care Homes for Adults (18-65 years) Page 26 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 27 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 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 20 Any amendments made to peoples medication such as dosage,should be dated and signed in the medication record by staff. This makes sure that the person staying at the centre receives the correct medication and staff have the correct instructions when dispensing medication. Staff at the respite centre should have regular up to date training in safeguarding people from abuse. This makes sure that people staying at the respite centre are protected from harm. The lounge and dinning area and some bedrooms are in need of re-decorating. Two of the kitchen cupboards need to be repaired or replaced. This makes sure that the centre is homely and maintained to a good standard for people who stay at 80 High Street for respite care. Staff should receive regular supervision and support to carry out their jobs safely and effectively. 2 23 3 24 4 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. 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