Care Home: Holly Lodge

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What the care home does well The home is well managed and run in the best interests of the people that are supported by the service. The home values equality and diversity and puts the people they support at the centre of everything it does. All the people that use this service have cultural needs assessments on file. There is an enthusiastic and competent staff team who bring a diverse range of skills and experience to the service. There are excellent learning and development opportunities for staff and managers. Training is well organised and monitored. There is a homely, clean and accessible environment where the people who use this service can be as independent as possible. The people who use this service are able to access a range of community activities including pub meals, holidays and clubs. The home positively promotes the health and well-being of the people it supports. All attend local General Practitioner surgeries for well man checks and medication reviews. What has improved since the last inspection? The people who use this service have become more confident and widened the choices they make about the activities they take part in. The home has further developed "Opportunity Sessions", that help to improve communication with the people that use the service and enable them to express themselves better. The lounge and dining room have been redecorated and there are plans to decorate the bedrooms in the near future. Pictorial menu guides have been introduced to give the people who use this service a better choice of what they would like to eat. The organisation has strengthened the procedures for reporting and monitoring safeguarding concerns. What the care home could do better: There are no recommendations or requirements as a result of this visit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Holly Lodge Alexandra Drive Vines Lane Hildenborough Kent TN11 9LT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Mills     Date: 0 7 0 7 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 31 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 31 Information about the care home Name of care home: Address: Holly Lodge Alexandra Drive Vines Lane Hildenborough Kent TN11 9LT 01732834225 01732834225 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) : Avenues Support Services care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. 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 Holly Lodge is a small residential care home providing care and support to four people with learning disabilities. The Avenues Trust is the registered provider. The Trust has a number of care homes and a community care agency in the local area. The bungalow is situated in a rural area near to the village of Hildenborough and local shops and bus stops are approximately a mile away. The home has plenty of living space, including a lounge and separate dining room, a kitchen and laundry room. There are gardens to the front and rear of the property. There is off road parking just outside the gardens of the home. Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home The weekly fees for this home were given as £1,685 at the time of this visit and are based on the assessed needs of the individual service user. Further information about the home can be obtained from the registered manager, Mr Wayne Lloyd. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This visit formed part of the annual regulatory process of the newly formed Care Quality Commission (CQC) under the Care Standards Act. The process takes into consideration information that we have gathered during this visit and information that we have received prior to the visit. This includes the homes Annual Quality Assurance Assessment (AQAA) and notifications required by the Act, as well as information that other people have given us, including the results of surveys and the views of visiting health and social care professionals. During this visit we spoke to the four people who use are supported by this service, two members of staff, the registered manager and the area manager. We made a tour of the home and made direct and indirect observations throughout the visit. Important Care Homes for Adults (18-65 years) Page 6 of 31 documentation such as care plans, staff files and training records and medication records were examined. This evidence is then used to make a judgement about the star quality rating for the service. The people who use this service indicated that they enjoy their lives in the home and can choose how they spend their time. Staff advocate on behalf of the people they support and said that they believe care in the home is of a very high standard and that they receive plenty of excellent training to help them do their jobs. Feedback from supporters of the people who use this service was equally positive and comments such as, Im very happy with the care the home gives my relative, were received. The people that live in this home, their supporters, the staff, the registered manager and the area manager are all thanked.for the welcome they gave and their help during throughout the regulatory process. The quality rating for this service is three stars. This means that the people who use this service experience excellent outcomes in all aspects of their care and support whilst living in the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 31 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 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users and their supporters are given good information about the home so they can make an informed decision about moving into the home. Thorough pre-admission assessments are made before a place is offered at the home. This ensures that only those people whose needs can be met and who are suitable to live there are offered a place in the home. Evidence: The home has a comprehensive Statement of Purpose and Service User Guide that are made available to relatives and supporters of the people who live in this home. The registered manager and staff of the home help the people who live there to understand their rights and responsibilities by using simple verbal and non verbal prompts. From observation during this visit it was clear that they were comfortable in the home and saw their own rooms as their personal space. There are clear and thorough pre-admission policies and procedures. Examination of Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: the care plans showed that all the people living in the home had received comprehensive pre-admission assessments that identified their support and care needs, cultural and religious needs, likes and dislikes and other relevant information. The home had then uses this information to formulate their support plans. We found good evidence that the plans are reviewed on a regular basis and altered as needs change or the aspirations of the people who live in the home become clearer. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports the people who live there to make as many decisions as possible about the way they lead their lives and to take appropriate risks. Where a service user cannot make an informed decision then their best interests are put to the fore in the spirit of the Mental Capacity Act. Evidence: Two care plans were examined. The home calls these Person Centred Plans (PCPs). These plans are important documents because they are one of the means by which the people who use this service and their supporters know that their care and support will be given in the way they would wish. In addition, they are an important source of reference for staff and can provide a basis for decision making when someone may not have full mental capacity. The care plans are comprehensive and clearly identify the needs and wishes of the service users and the decision making process. There are clear polices in place in Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: respect of decision making and risk taking. Risk assessments are in place for environmental and individual risks. The Avenues Trust, the registered provider, has developed a system for giving the people who use the services the chance to try different activities that may be outside their comfort zones. The organisation refers to these as Opportunity Sessions. A written document and written records support the process. The registered manager talked knowledgeably about the backgrounds of the individual service users. It is recognised that in the care in large institutions in the past has led to some of the people who use this service becoming very set in their routines and somewhat reticent about trying new things. The Opportunity sessions give them this chance and we were told that all are now making good progress in making wider choices and decisions. The registered manager demonstrated a good working knowledge of the new Mental Capacity Act and how it influences the way that care is delivered. Best interest meetings are held in cases where serious decisions need to be made but the person using the service does not have the mental capacity to make an informed choice. The registered manager talked about a recent situation in the home where surgery could have been an option for one person. A meeting was help with relatives, health and social care professionals and staff so that the risks of surgery could be weighed against the the risk of non intervention. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home participate in a range of age appropriate, meaningful and interesting activities that help them gain autonomy, independence and self esteem. Evidence: The homes Annual Quality Assurance Assessment (AQAA) document told us that the Trust has embraced the concept of Person Centred Active Support (PCAS) to ensure that front-line support staff move from being carers to enablers and put the people who use the service at the centre of all activities in the home. This means that activities are tailored to the individual and that they are involved in all activities in the home from keeping their own rooms tidy to doing their own food shopping and preparing meals as much as possible. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The service is very clear about the way it values equality and diversity. There are robust policies for this and all staff have received equality and diversity training. There is a good age, skill and gender mix amongst the staff and each staff member is encouraged to use their skills, cultural backgrounds and experience to enhance the lives of the people who use the service. For example, if a member of staff comes from overseas they are encouraged to talk about their lives there and to reflect this in celebrations and meals; or if another staff member has creative skills these are used to illustrate information to make it easier for service users to understand. On the day of this visit staff were observed to positively encourage the people who live in the home to participate in household chores. Some of the service users have made very good progress and are able to make cups of tea themselves and prepare meals. Two service users helped with the inspection by telling us about what they do and showing us around the home. As part of the active support planning process the home carries out a cultural needs assessment. This takes into account religious practices, dietary requirements of each religion and any other cultural or religious needs. The Trust carries out a service audit each year. This year the audit focused on healthy lifestyles. Within the Trust there is a Sports and Active Lifestyle group that looks at how all service users can be encouraged to access and take part in more sports and other physical activities. Each resident has an activity plan and book where their preferred activities are recorded. There are also written guidelines and individual profiles. As mentioned in the previous outcome area, service users are able to participate in opportunity sessions to help the service users to consider a wider choice of the things they do. Two of the people who use the service spoke of the activities they enjoy. One said that he likes to go to a disco at the Gateway Club and another said that he prefers to go out for a pub meal. Two others are not so keen to participate in activities but do still get out and about in the community with encouragement from the support staff. Two people who live in the home showed us their rooms. They both have been able to arrange them as they wish and photographs and ornaments reflect their families and interests. The home works hard to enable the people who live there to keep in contact with friends and family. Support staff accompany service users on visits home where additional support may be needed and transport is provided for these visits. Where Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: necessary, relatives have been contacted to assist in the decision making process and there is good written evidence of this on file. On the day of this visit there was plenty of fresh and frozen produce in the home so the people who live there can choose what they want to eat. They were observed to be relaxed about using the kitchen and making drinks and snacks. Since the last inspection more work has been done on pictorial menus to help the people who use this service make more informed choices about what they would like to eat. Healthy eating is encouraged and special diets and these are catered for. It was encouraging that those service users who need special diets were aware of their dietary needs. One explained that he takes his special snacks to the club with him so he does not eat the wrong food. All the people who live in the home said that they enjoy their meals and have plenty to eat. Staff confirmed that the home purchases good quality food and that the people who live there are involved in all aspects of food preparation from learning about healthy eating, food shopping and meal preparation. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes the health and well-being of the people who live there and their privacy and dignity is respected. Evidence: The individual service user plans are very well organised into seven separate files for easy access. The health and personal care files of two of the people who live in the home were examined. We found good information that the home works hard to ensure that the service users remain in as good a state of health as possible. All are registered with General Practitioners (GPs)and use the local health services, attending well man clinics and medication reviews with the GP. Other health care specialists are accessed as necessary. Regular dental appointments are made and kept and other health and social care professionals such as chiropodists, ophthalmologists and dietitians are accessed as necessary. There is good written evidence that their advice is sought and followed appropriately. All the service users have moving and handling assessments and these have been Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: recently reviewed to assess the current risks. Staff receive training in empathic support as well as other core skills such as moving and handling and health and safety. Throughout this visit staff were observed to treat the people who they support with respect and kindness. There are comprehensive forms that record the preferred way of taking medicines and sound procedures are in place should someone refuse to take their prescribed medicine. Medicines are stored safely and securely and there are sound policies and procedures for the storage and administration of medicines. All staff have received training in the management and administration of medicines. The service has done a lot of work in dealing with the issues around aging, illness and death. The registered manager has spoken to all the people who live in the home about their wishes about illness, the effects of aging and death. There is a specific, easy to understand document that identifies the wishes of each person when they die. Some have chosen to leave this to their families but others have been able to express their wishes well, including such things as the music that will be played at their funerals. It is acknowledged that this a difficult subject and the home is commended for the sensitive and professional way they have dealt with it. Care Homes for Adults (18-65 years) Page 19 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home listens to the concerns of the people who live there and their supporters so that people can be confident these will be acted upon in an efficient and effective way. Evidence: There are sound policies and procedures for managing concerns, complaints and safeguarding in place. A copy of the complaints procedure is displayed in the home and it is also contained in the service user guide. Relatives are sent a copy of the procedure each year and this procedure is also available in picture and audio format. Staff have all received safeguarding training and those spoken to were clearly aware of their responsibilities in this respect. Team meetings and staff supervisions are used to discuss any potential problems and to learn from any expressed concerns. Since the last inspection the organisation has strengthened the systems for recording and monitoring safeguarding concerns. As part of the monthly quality audit complaints and any safeguarding issues are reviewed. Should there be any safeguarding alerts these would be reviewed by the executive management team. Recruitment procedures are sound so that only carefully vetted staff are offered employment at the home. There have been no formal complaints since the last inspection. Day to day concerns Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: are dealt with as they arise. The handover sheet has a box at the beginning of the first page that prompts staff to record and concerns or complaints and the action taken. There is a key worker system. This means that each person has a named member of staff who takes the lead in ensuing that reviews take place, specialist appointments are kept and lines of communication with friends and relatives are kept open. Opportunity sessions are used to help the service users express any concerns and complaints they may have. Staff advocate on behalf of the people who live in the home when necessary, coming forward with ideas to make their lives more interesting and raising concerns on their behalf when indicated. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe, clean and welcoming. This gives the people who live there a pleasant and homely place in which to live. Evidence: The home is a four bedroomed bungalow with lounge, dining room, toilet and wash basin and bathroom. On the day of this visit the home was clean and tidy. There was a friendly and welcoming atmosphere and the people who live there were seen to be very much at home, moving freely around the bungalow, respecting each others privacy and helping out with household chores. Whilst the bathroom and toilet facilities meet the needs of the people who live there, the bathroom would benefit from some refurbishment in the near future. The bedroom carpets in three of the bedrooms are beginning to look a little tired. One bedroom has recently been fitted with a laminate floor. There are plans to redecorate the bedrooms when some of the people who live there are on holiday. Outside there is a safe and enclosed garden with a patio area. All areas of the home and garden are accessible. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: There are sound infection control policies and procedures. Alcohol disinfectant is available in the laundry and hand wash is placed by all sinks. A tour of the home was made and two of the people that live in the home were pleased to show us their rooms. These rooms have been personalised to reflect the interests and families of the individual whose room it is. No environmental health and safety hazards were noted during the tour of the home and the homes annual quality assurance assessment (AQAA) told us that environmental risk assessments are in place and that fire precautions are adhered to. Care Homes for Adults (18-65 years) Page 23 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a stable, well qualified and enthusiastic staff team who are able to flexibly meet the support needs of the people who live in the home. Robust recruitment policies and procedures ensure that only those people who are suitable to work in the home are offered employment there. Evidence: The staffing levels are flexible to meet the needs of the people who use the service. During the day there are one or two support workers on duty as well as the registered manager. More staff are rostered when needed, for example, to escort someone to a hospital appointment or if everyone is doing different activities on the same evening. There is one sleeping member of staff on duty at night. As the people who use this service have attained a good level of independence this meets their night support needs. The staff team has a good age, gender, ethnic and skill mix so that the lives of the pole who use this service are enhanced by their different experiences and cultures. The Trust has its own training department called, The Avenues Academy. The Academy is proactive in developing training and identifying new areas where further Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: training and development are needed. Individual staff learning and development needs are identified through one-to one staff supervision sessions. There are clear training and development goals that include ensuring staff have the skills and knowledge to enable them to do their jobs effectively; supporting staff to reach their full potential; developing different learning methods such as Computer Based Training (CBT) and open learning workbooks; and developing a culture of continuous learning; coaching and mentoring. Examination of training records showed that there is a good level of well planned and organised training going on. There is an excellent level of both statutory and specialist training available. Specialist areas include subjects such as understanding epilepsy, managing challenging behaviour and understanding communication. All staff receive training in equality and diversity. Staff spoken to said that they get excellent training opportunities and are well supported to continue learning. The home operates a key worker system so that each person who uses the service has a named member of staff who is responsible for important aspects of care and support of the individual such as updating care plans, ensuring that reviews take place and helping people express themselves. Currently four staff hold the National Vocational Qualification at level two (NVQ II) and two more are working toward this qualification. This means that the home will soon have eight-six percent of staff with NVQ II. Communication between the managers and staff is very good. There are monthly team meetings and one-to-one supervisions, daily staff hand overs and good written information for staff. Staff said that they feel able to put forward ideas for improvements and to use their skills to help the people who use this service to continue to gain more independence. The Trust has robust recruitment policies and procedures. Recruitment checks are carried out by the regional office to ensure consistency. Criminal Records Bureau (CRB) and safeguarding (POVA First) checks are made, two written references are obtained and telephone checks if indicated, a full employment history is obtained and any gaps in this are looked into. Once a candidate has successfully completed the recruitment process and has been fully checked, there is an induction period where core skills are taught. No new member of staff is allowed to give personal care to a service user until both the individual service user and the staff member are comfortable with this. New staff attend at least thirteen training days within their first six months of employment. Care Homes for Adults (18-65 years) Page 25 of 31 Care Homes for Adults (18-65 years) Page 26 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. The views of the people who use this service, their supporters and the staff who support them are listened to and acted upon so that the home is run in the best interest of the people who live there. Evidence: The registered manager is well qualified and experienced. He holds a degree (BSc) in Psychology and Health Studies, the Registered Manager Award (RMA) and the National Vocational Qualification (NVQ) in Care at level three. He is currently studying for a Diploma in management which he expects to complete this coming September. He has managed the home for the last three years. His previous post was as a day centre manager and previously he worked in the field of residential care for people with learning disabilities. Staff said that the manager is very easy to talk to and listens to their concerns and ideas and acts upon them when indicated. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: The registered provider for the home is The Avenues Trust. This is a not for profit organisation that has many years experience of service provision for people with learning disabilities and other associated problems such as visual and physical impairment. the Trust has sound organisational goals and excellent quality assurance systems. The quality assurance systems include regular staff and stakeholder questionnaires, monthly quality check visits by a representative of the Trust and four monthly services reviews. Regular meetings are held for managers to exchange ideas and to develop best practice in care in a coordinated and supportive way. The homes Annual Quality Assurance Assessment (AQAA) was completed on time and gave us comprehensive information about the service. It told us that all necessary health and safety checks are carried out on a regular basis and that all certificates needed to ensure the health and safety of service users and staff, such as electricity safety and Legionella checks, are in place. Environmental risk assessments are in place and a tour of the home confirmed that there is good attention to detail in respect of health and safety. Care Homes for Adults (18-65 years) Page 28 of 31 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 31 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 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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