Care Home: Highfield Road

Similar services:

• Thorndene
• Insight - Eastchurch
• Southfields
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well Someone from the home comes to see people who are thinking about moving into Highfield Road, so they can make sure whether the home will suit them or not. The home is well run and has a friendly atmosphere. Staff make sure that people who live there are happy and listen to what they want. If people are unhappy, staff sort it out. People enjoy living in a comfortable and homely house. They have a bedroom each and can choose which colours to have it and how to arrange their things. Residents are given the support they need in the way they want it. Staff are polite and friendly with them. They are able to make up their own minds about what they do. Residents can be themselves and have lots of chances to socialise with other people, enjoy their hobbies and learn more things. Residents are able to see their family and friends when they want to. They can choose what to eat and the meals in the home are good. Residents make their own care plans with staff, to make sure that staff are clear about how to support them. Residents are given help to see a doctor if they need to. There are enough staff in the home to support residents when they need it. Staff are trained and supported to do their jobs and the manager checks that this happens. Staff understand people and fit in with what they need. Residents are looked after and safe. What has improved since the last inspection? Since the last inspection, the patio area outside is better; it is neater and residents are able to look after more pot plants. This is important to residents as it is the only outside space that the home has got. Some repairs have been done in the home, including fixing a leaky roof and redecorating a bedroom. Residents property is safer, because now, if they give things to staff to look after, this is written down. Residents money is safer. This is because, when people agree to pay for their holidays and the costs of staff who need to go with them, this is written down. In future staff will make sure that residents next of kin, care manager and someone from the organisation agree with this as well. What the care home could do better: Residents would be safer if staff contacted the fire and rescue authority about how often to test the fire alarms and emergency lights, how to write this down and if the fire alarm goes off by accident, and how often to have fire drills so people get used to what to do in an emergency. People would enjoy living in the home more if it was repaired, redecorated and lookednicer. It could be safer for residents if there were more emergency buzzers to call staff if they needed to, especially at night. It might be better for some people if the way that staff listened to see if they had any problems was changed. The organisation would be better at making sure things were running properly in the home if they visited more often and made sure written guidelines for staff were kept up to date. It might be safer if staff wrote down more things about what they do to support residents, how they keep them safe, how they sort things out if someone is unhappy, the names of staff who are at work and how they make some checks before they get the job. When someone from the home comes to see people who are thinking about moving in, it would be better if they wrote down their name and when they visited. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Highfield Road 29 Highfield Road Dartford Kent DA1 2JS     The quality rating for this care home is:   two star good 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: Helen Martin     Date: 0 6 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 33 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 33 Information about the care home Name of care home: Address: Highfield Road 29 Highfield Road Dartford Kent DA1 2JS 01322229600 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) : DGSM yourChoice care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Highfield Road provides care and accommodation for up to eight people with a learning disability. The home is situated in a residential area, close to the centre of Dartford, with all the usual town amenities and public transport. All service users have single bedrooms arranged over three floors, which is accessed by stairs; there is no passenger lift. Communal areas include a lounge, quiet room and dining room. The home has a patio and a small car park to the rear of the property. The service provided is part of the Dartford, Gravesham and Swanley Mencap Care Homes for Adults (18-65 years) Page 4 of 33 Brief description of the care home organisation. The building is owned by the Hyde Housing Association, who maintain the internal and external parts of the premises. The homes organisational structure consists of a manager and staff, including two seniors, who operating a roster provide twenty-four hour support. Full information about the fees payable and the service the home provides are available from the manager. Care Homes for Adults (18-65 years) Page 5 of 33 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: Highfield Road provides care and accommodation for up to eight adults with a learning disability. The home is best suited for people with few mobility problems. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This Key Unannounced Inspection included a visit to the home in Dartford on 6th May 2009, where the Acting Manager, two Support Workers and several Service Users were spoken with. Currently the Registered Manager is on secondment in a different area of the organisation. Some judgements about the quality of the service provided were taken from observation and conversation. Some records and documents were looked at Care Homes for Adults (18-65 years) Page 6 of 33 together with the premises and facilities of the home. The last Key Inspection was undertaken on 11th May 2007 and an Annual Service Review was completed on 19th May 2008. An Annual Quality Assurance Assessment, AQAA, has been received from the home. Any other information received since the previous Key Inspection has been reviewed. All of the above have been included within this inspection process and some of the gathered evidence is mentioned in this report where appropriate. What the care home does well: What has improved since the last inspection? What they could do better: Residents would be safer if staff contacted the fire and rescue authority about how often to test the fire alarms and emergency lights, how to write this down and if the fire alarm goes off by accident, and how often to have fire drills so people get used to what to do in an emergency. People would enjoy living in the home more if it was repaired, redecorated and looked Care Homes for Adults (18-65 years) Page 8 of 33 nicer. It could be safer for residents if there were more emergency buzzers to call staff if they needed to, especially at night. It might be better for some people if the way that staff listened to see if they had any problems was changed. The organisation would be better at making sure things were running properly in the home if they visited more often and made sure written guidelines for staff were kept up to date. It might be safer if staff wrote down more things about what they do to support residents, how they keep them safe, how they sort things out if someone is unhappy, the names of staff who are at work and how they make some checks before they get the job. When someone from the home comes to see people who are thinking about moving in, it would be better if they wrote down their name and when they visited. 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 9 of 33 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 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from an assessment by the home before they decide to move in. This gives a good opportunity to see whether the home is suitable to meet their needs, although residents would be better protected if the assessment was signed and dated by the person undertaking it. Evidence: Most residents have been living at the home for some time and have benefited from an assessment before they moved in to make sure that their needs could be met by the home. One more recent resident was assessed together with information from local authority before they moved in. A record of the assessment by the home is kept in their care plan, although it is not signed or dated. In order to fully protect residents, the Provider is recommended to ensure that all pre admission assessments are signed and dated. Care Homes for Adults (18-65 years) Page 11 of 33 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. Residents are supported to make choices and decisions about their lives; they benefit from being involved in their care planning. Residents changing needs and the support they receive from staff could be better reflected in written care plans. Residents are supported to take risks and to be independent, although this together with the action taken by staff could be better reflected in written records. Evidence: The home aims to develop individual plans of care for each resident and to identify the action required from staff to meet residents personal, social and health care needs. Residents are involved in their care planning. They can choose how they would like their care plan to be presented. One resident has chosen a pictorial format, whereas another prefers a written document. In addition to residents Person Centred Plans, there are also care plan files available for staff. Care Homes for Adults (18-65 years) Page 12 of 33 Evidence: One care plan looked at included biographical details, an activities programme and records of appointments with health care professionals together with other information. However the format, designed to identify the action required from staff to meet the individuals needs, has not been completed. This is in the process of being developed. Although the individual concerned is a newer resident, they have been living in the home for some time. Regular monthly reviews by staff were undertaken until December 2008. Another care plan looked at included biographical details, records of appointments with health care professionals, details about medication and reviews by the local authority together with other information. This resident has, with support from staff, created their own pictorial Person Centred Plan. This is clear, easy to follow and contains a lot of good individual information about the person concerned. However there is little information about the detailed action required from staff to meet the individuals needs. Residents changing needs are reflected in notes written in individual books by staff on a daily basis. Although some are written in detail, some are not and while entries indicate AM or PM, they do not always specify the actual time that events occurred. The Provider is strongly recommended to review all care plans to ensure that, detailed information about the action required by staff to meet residents identified needs is included; all information is up to date; daily notes are detailed and recorded with the specific time of events and entries. Residents are supported to take risks as part of maximising their independence. Staff are aware of the action needed to reduce these. One resident has been supported over time to travel independently using public transport. Risk assessments were undertaken and written down, although these have not been updated and do not reflect the current situation. One care plan file contains a range of comprehensive risk assessments, although there are no records of reviews or updates. Another care plan file identifies issues that may be a risk to the person concerned, although the action needed to be taken by staff is not recorded. The Provider is strongly recommended to review the risk management strategy for all residents to ensure that all risks and the action needed to reduce these are recorded and up to date. Residents are encouraged to make their own decisions and choices. They receive continuity of care by having individual key workers. There is evidence that considerable attention is given to helping residents to make decisions about how to spend their time. Residents are involved as far as possible in decisions regarding the running of the home. They are involved in cleaning, cooking and menu planning. Regular residents meetings are undertaken. Care Homes for Adults (18-65 years) Page 13 of 33 Care Homes for Adults (18-65 years) Page 14 of 33 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. Residents enjoy individual lifestyles and are able to choose from a range of opportunities for leisure and personal development. They are able to maintain relationships with their family and friends if they wish. Residents enjoy a choice of good quality food. Evidence: Residents are treated as individuals who have different interests and aspirations. Activities and learning opportunities are provided accordingly. Residents enjoy a full lifestyle with a variety of options to choose from. Routines of the home are flexible to accommodate this. Residents are part of the local community. They enjoy attending various day centres and groups, participating in social events and activities that personally interest them or to further develop their life skills. Activities that residents enjoy include dancing, computer skills, disco, karaoke, going to church, meeting Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: relatives and friends, playing sports, going to college, music, nightclubs, swimming, crochet, puzzles, reading, calligraphy, keep fit, going to the pub, and sewing. One resident spoken with described how they enjoyed their visit to the town today, where they had a haircut and drink out. On the day of this visit most residents were out and returned to the home in the late afternoon. Residents are able to relax in the home watching television or DVDs, cooking or playing games. There is a patio area where residents are able to sit and grow plants in pots. Residents are able to see their family and friends as often as they wish. All residents have the opportunity to go on holiday if they wish. At the time of this visit, one resident was looking forward to a holiday abroad with their relative. Residents are supported towards independent living skills. They are encouraged and supported with domestic tasks wherever possible such as shopping, cooking, cleaning and laundry. Laundry and kitchen facilities are domestic in nature. There is good understanding of individuals food choices and preferences. Residents are supported in cooking and menu planning. They choose their meals at residents meetings. On the day of this visit, one resident was making a quiche. Planned meals and what people eat is written down, records indicate good quality meals. The home supports residents with special diets. Care Homes for Adults (18-65 years) Page 16 of 33 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. Residents benefit from support which meets their individual preferences. Their physical and emotional needs are met. Evidence: Residents are given the personal support they need to maximise their independence, while respecting their dignity and privacy. Staff have an understanding of the preferred routines of each resident and how to meet their needs. Residents have access to social and health care professionals, such as GP, chiropody and dentist. They are supported with any appointments. The home monitors any more specialist health care needs, such as epilepsy, blood pressure or special diets. Potential future health care needs are anticipated and planned for. Residents weight is monitored and the Acting Manager said that no one had any nutritional problems at the moment. Arrangements are in place for the storage and administration of medication by staff. An easily monitored dosage system is used and storage is secure. Medication records Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: are completed appropriately, with the exception of one handwritten administration entry, which does not state the reasons for completion of the course. The Acting Manager explained that this was usually recorded, was an oversight and would not happen in future. All staff who administer medication are trained to do so; a record of their signatures is kept. The Acting Manager assured the inspector that the process of updating this record would be completed shortly. Subsequent to this visit, the Acting Manager confirmed that written guidelines for the administration of medication prescribed on a when required basis, are complete and available for staff. Care Homes for Adults (18-65 years) Page 18 of 33 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. Residents views and concerns are listened to and acted upon, although this could be better reflected in written records. Systems are in place which aim to protect residents from potential abuse. Evidence: Residents are at ease and confident talking with the manager and staff who listen to their views and concerns. The home provides a written complaints procedure. Residents have access to this in a format that they can easily understand. The Acting Manager said that this would be updated when the new manager for the home is appointed. The home has received two complaints since the last key inspection. The Acting Manager explained that although one was currently being investigated by the organisation, residents are not put at any risk. A record of all complaints is kept, although one did not contain any specific details. The Provider is strongly recommended to ensure that the record of complaints includes details of the issues raised, the investigation made, any action taken and the outcome. Written policies regarding the protection of vulnerable adults are available for staff. These include the procedures for the local authority. Staff receive training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: The home has a system in place, which aims to protect the financial interests of residents. Small amounts of cash are held on the behalf of some residents. This is kept securely. All money is stored individually and transaction records are maintained. Cash checked tallied with accounts seen. Receipts are kept for purchases made. Staff make regular checks and the organisation audits the system. Subsequent to this visit, the Acting manager assured the inspector that a log book has been developed, which records all valuables kept by the home on behalf of residents. Residents have the opportunity to go on holiday if they wish. Currently the organisation does not pay for the cost of this. Residents agree to pay for the cost of their holiday together with the costs of the necessary staff to support them. Subsequent to this visit the Acting Manager confirmed that this agreement will be recorded in future; a new authorization form has been developed to include the costs with dated signatures of the resident concerned, their next of kin, care manager and representative from the organisation. Care Homes for Adults (18-65 years) Page 20 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a comfortable and homely environment, although their quality of life would be improved by the repair, refurbishment and redecoration of the home. The premises are best suited for people with few mobility difficulties. Residents protection may be enhanced by the provision of a comprehensive emergency staff call system and a review of the method of monitoring epilepsy. Evidence: The building fits in with the local community and has a style and atmosphere suitable for people who live there. Residents benefit from living in comfortable accommodation. The premises are generally suitable for their current needs. Residents have unrestricted access in the house and to the small patio area. The patio area has improved since the last key inspection; it is tidy and contains pot plants. This area is especially important because, as the home has no garden, it is the only outside area available to residents. The Acting Manager described further plans for improvement as including new garden furniture and additional plants. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: The house is maintained and decorated by a Housing Association, which owns the property. Since the last key inspection work has been undertaken, including redecorating one room for a resident who changed bedrooms and a flat roof repair. Some new carpet is being fitted the day after this visit. However it was observed that residents would benefit from the general redecoration of the whole home. Some areas of the home are in need of more significant refurbishment, such as the damp in the staff bathroom and kitchen, stains on the dining room ceiling, the tiling in an upstairs bathroom and the walls and carpet in the downstairs hallway. The Acting Manager explained that the Housing Association are in the process of addressing the areas of damp; the home is due for refurbishment although it is currently unclear whether this will take place this year or next year. A statutory requirement has been made; the Provider must also send us an action plan, which includes planned timescales for completion of the necessary work. Adequate recreational, dining, toilet, bathing and individual accommodation are available to residents. The home provides a lounge, dining area and a quiet room. All residents have their own rooms, arranged over three floors. Residents clearly like their rooms, which are all individual and highly personalised. They are able to choose the colours of their rooms and how their furniture should be arranged. Bedrooms meet service users needs and are well furnished. There are no lifts, specific environmental adaptations or disability equipment within the home. Current residents have few mobility problems. Discussion took place regarding the mobility needs of one resident. The Acting Manager assured the inspector that there are presently no problems but that any potential future needs are anticipated and planned for. Discussion took place regarding the staff call system; currently call points are in bathrooms and toilets only. Previous inspections have identified that the system should be extended to residents rooms. The Acting Manager indicated that currently residents continue to make their way to the locked door of the staff sleep in room if they need assistance at night; there are few problems at night; a baby monitor is used to monitor epilepsy; the organisation supports an extension to the existing system; this is being considered by the Housing Association who owns the building. The Provider is strongly recommended to consult with an Occupational Therapist or other suitably qualified specialist with regard to extending the staff call system and appropriate methods of monitoring epilepsy. The premises are clean and hygienic. Staff spoken with stated that carpets were cleaned regularly. Residents use both the laundry and the kitchen with support from Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: staff. Care Homes for Adults (18-65 years) Page 23 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a sufficient number of qualified, trained and supervised staff who have a good understanding of their needs. Improvement to some record keeping may enhance their protection. Evidence: A good rapport was observed between residents and staff. Residents spoken with indicated that staff are very good and look after them well. There were enough staff on duty at the time of this visit to meet residents needs. There are a minimum of two staff on duty in the mornings, three in the afternoons with one sleeping in at night, although more are available depending on residents needs. There are no auxiliary staff employed in the home, as staff support residents with all domestic tasks. There is an on call system for emergencies. Staff shifts are rostered and written down, although the record seen does not contain the full names of staff. The Provider is recommended to ensure that the staffing rota contains the full names of staff. The home has a procedure in place which aims to recruit suitable staff who can meet the needs of residents. Records seen showed that residents are protected by Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: appropriate pre employment checks. Proof of identity is checked as part of the recruitment process by the organisation, although there was no evidence of this within the staff files in the home. The Provider is strongly recommended to ensure that evidence for recruitment checks on proof of identification is available for inspection in the home. Induction training is undertaken for all new staff. This is written down, although records do not show detailed information. The Acting Manager assured the inspector that this would be included in the new training for learning disabilities shortly to commence for all staff. The home provides an ongoing programme of training for staff, which is designed to further develop and update their skills. Records show that appropriate courses and qualifications have been undertaken, including first aid, food hygiene, moving and handling, fire, medication, the protection of vulnerable adults, health and safety, challenging behaviour, infection control, diabetes, risk assessment, learning disabilities and National Vocational Qualifications. The Acting Manager explained that staff supervision consisted of a combination of informal and formal recorded one to one sessions. Care Homes for Adults (18-65 years) Page 25 of 33 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 enjoy living in a well run home with a relaxed atmosphere. They benefit from a qualified and experienced Acting Manager. The home aims to run in the best interests of residents, although this would be enhanced by more frequent visits by representatives from the organisation. Residents are protected because staff have written policies and procedures to follow, although this could be improved by the completion of updating information. Residents would be better protected by improvements to the testing and recording of the systems and procedures in place for the prevention of fire. Evidence: In November 2008, the Registered Manager was seconded to another part of the organisation, with the original intention to return in six months. The Acting Manager has been managing the home since this time. They are experienced in caring for Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: people with learning disabilities, have been working in the home for six years and have obtained a National Vocational Qualification at level 4. During this visit the Acting Manager explained that the Registered Manager would now not be returning to Highfield Road and that the organisation was in the process of recruitment for a new manager. It was said that the organisation will formally notify the Care Quality Commission of the outcome of the recruitment process. There is an open and inclusive atmosphere in the home. At the time of this visit residents were confident and relaxed chatting and spending time with staff. Both staff and the Acting manager responded promptly and appropriately in a friendly and polite manner. The organisation uses a recognised quality assurance system and regular meetings are held throughout the year. Feedback is received from a Service Users Forum. Residents have meetings in the home and issues discussed are recorded. Visits from a representative of the organisation as the Provider were discussed. These take place, although not on a regular monthly basis. The last two most recent visits were undertaken in October 2008 and January 2009. A statutory requirement has been made; the Provider must also send us copies of their Regulation 26 visit reports for six months from 31st July 2009. The home has a range of recorded policies and procedures that are available for staff. These include complaints, safeguarding vulnerable adults and medication. The Acting Manager explained that the organisation is currently in the process of reviewing and updating all policies and procedures and are aware that additional guidelines needed. The Provider is recommended to complete their stated intention to supply a range of comprehensive and updated policies and procedures, which provide written guidelines for staff about the duties they perform. A number of records have been looked at as part of this inspection. These have been mentioned within this report where appropriate. Records and certificates seen generally indicated the regular testing and maintenance of systems and equipment within the home. This includes a fire alarm certificate issued by an external contractor in April 2009. However, the fire log book shows that although staff tested the fire alarm system until January 2009, this has only taken place once since then; there are no records of false alarms, fire drills or emergency lights tests by staff. A statutory requirement has been made. Accidents and incidents are recorded appropriately. The Acting Manager monitors the premises and the accommodation. This is done so that potential hazards to health and Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: safety can be identified and addressed. There are comprehensive environmental risk assessments, although documents show a date of 2007. The Acting Manager explained that these continue to be relevant and assured the inspector that the date of review would be recorded in future. The home has procedures in place for the maintenance of food hygiene; hot food temperatures are tested appropriately, although not all are recorded. The Acting Manager assured the inspector that this would be done in future. The management of the refurbishment of the home was discussed. The Acting Manager explained that the Housing Association are in the process of addressing this, although it is currently unclear whether refurbishment will take place this year or next year. A statutory requirement has been made under The Environment section of this report; the Provider must also send us an action plan, which includes planned timescales for completion of the necessary work. Care Homes for Adults (18-65 years) Page 28 of 33 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 29 of 33 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 24 23 The registered person shall 31/07/2009 ensure that the premises are of sound construction and kept in a good state of repair externally and internally; all parts of the home are kept clean and reasonably decorated. In order to maintain residents quality of life, the Provider must ensure that all areas of the home are kept in a good state of repair and decoration. The Provider must send the CQC an action plan, which includes planned timescales for the completion of the necessary work. This action plan must be sent to the CQC by 31st July 2009. 2 39 26 Where the registered provider is an organisation, the home shall receive an unannounced visit from an appropriate representative 31/07/2009 Care Homes for Adults (18-65 years) Page 30 of 33 of the organisation at least once a month. In order to fully ensure that the home is run in the best interests of residents, the Provider must visit the home at least once a month. The Provider must send the CQC copies of their Regulation 26 visit reports for six months from 31st July 2009. 3 42 23 The registered person shall, after consultation with the fire and rescue authority, make adequate arrangements for reviewing fire precautions and testing fire equipment at suitable intervals; ensuring by means of fire drills at suitable intervals that staff and service users are aware of the procedure to follow in case of fire. In order to protect residents, the Provider must follow good practice and guidance from the local Fire and Rescue Authority regarding fire precautions; this must include the frequency of fire alarm and emergency lights tests and fire drills and the recording of false alarms. 30/06/2009 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Adults (18-65 years) Page 31 of 33 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 32 of 33 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!