Care Home: Homeleigh Farm

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What the care home does well There is a relaxed and homely atmosphere. People say that the support workers give them the assistance they need in ways that are right for them. There are interesting occupational and social things that people can do. People are helped to stay in good health. This includes keeping an eye on how everyone is and then calling doctors as soon as they are needed. People`s medicines are handled safely so that they take them in the right way at the right time People are helped to lead normal lives through responsible risk taking. People are served with good quality meals. There are reliable health and safety arrangements in place. What has improved since the last inspection? When we last completed a Key Inspection visit to the Service we found that things were going well. Therefore, there was no need for us to require that any improvements be made. The Assessment says that the Registered Provider is committed to reviewing the Service in a critical way so that improvements can be made on an ongoing basis. The Assessment says that a number of improvements have been made in this way. These include the following things. The individual plans of support have been made more user friendly. This has been done so that people who live in the Service will find it easier to be actively involved in making their own decisions. The range of meals provided has been extended so that people can have more choice and variety. People have been supported to promote their good health. They have been given information about things such as giving up smoking and managing their weight. Radiator covers have been fitted to help reduce the chance of someone being burnt. The entrance hall and the lounge have been redecorated. More support workers have completed a relevant National Vocational Qualification. The people who live in the Service have become more actively involved in the appointment of new support workers.All of these things contribute to the Service being better able to support people in ways that are right for them. What the care home could do better: The records of how a formal complaint was investigated by the Registered Provider have not been kept in the Service. Without them the Manager cannot evidence to us that the matter was dealt with promptly and thoroughly. The quality assurance system does not fully involve all of the people who live in the Service. They are not directly told about what has been said about their home and about what improvements the Registered Provider intends to make as a result of the comments that have been made. Key inspection report Care homes for adults (18-65 years) Name: Address: Homeleigh Farm Dungeness Road Lydd-on-sea Kent TN29 9PS     The quality rating for this care home is:   three star excellent 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: Mark Hemmings     Date: 1 5 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: Homeleigh Farm Dungeness Road Lydd-on-sea Kent TN29 9PS 01797321506 01797322134 homeleigh.farm@craegmoor.co.uk Craegmore.co.uk Parkcare Homes Ltd care home 6 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: 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). The maximum number of service users to be accommodated is 6. Date of last inspection Brief description of the care home Up to six people who have a learning disability can make their home in Homeleigh Farm (the Service). The property is a detached bungalow that has been extended and adapted for its present use. Each person has their own bedroom. None of the bedrooms have a private wash hand basin. There is a bathroom and a shower room. There is also a main lounge, a second lounge, the conservatory and a dining room. The Service is in a rural location and is about one mile from Lydd. This is a small village that has a general store. The nearest big town is Ashford and that is about 10 miles away. At the back of the building there is quite a large garden that is also a small holding. There is a soft fruit orchard and a vegetable patch. At the bottom of the garden, there is quite a large chicken house. The Service has two people carrier vehicles. The Registered Provider is a private limited company. The weekly fee for Care Homes for Adults (18-65 years) Page 4 of 29 6 Over 65 0 Brief description of the care home living in Homeleigh Farm runs from £1997.00 to £2300.00. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 3 Star. This means that the people who use this Service experience excellent quality outcomes. The previous Key Inspection was completed on 18 May 2006. The previous Annual Service Review was completed on 30 April 2008. For the present Key Inspection, we arrived unannounced at the Service at about nine oclock in the morning and we were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We received the Assessment on time and it is well completed. Further, we considered any information that we have received about the Service since the last inspection. During the inspection, we spoke with all of the six people who live in the Service. We also spoke with the Registered Manager, the Deputy Care Homes for Adults (18-65 years) Page 6 of 29 Manager, one of the Team leaders, three support workers and the cook. We walked around parts of the accommodation and the grounds. Also, we looked at a selection of key records and documents. These included the staffing roster, staff training records, records relating to complaints, various policies and procedures and health and safety certificates. Before we visited the Service, we asked all of the people who live there and 10 members of staff to fill out a questionnaire for us. We wanted them to tell us what they think of Homeleigh Farm. Four people who live there and four members of staff kindly completed them for us. Later on in our report, we will tell you the main things that people are saying in these questionnaires. The Registered Provider has also recently asked the people who live in the Service and their relatives what they think about the Service. As we go through our report we will tell you some of the things that people who live in the Service are saying in their replies. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? When we last completed a Key Inspection visit to the Service we found that things were going well. Therefore, there was no need for us to require that any improvements be made. The Assessment says that the Registered Provider is committed to reviewing the Service in a critical way so that improvements can be made on an ongoing basis. The Assessment says that a number of improvements have been made in this way. These include the following things. The individual plans of support have been made more user friendly. This has been done so that people who live in the Service will find it easier to be actively involved in making their own decisions. The range of meals provided has been extended so that people can have more choice and variety. People have been supported to promote their good health. They have been given information about things such as giving up smoking and managing their weight. Radiator covers have been fitted to help reduce the chance of someone being burnt. The entrance hall and the lounge have been redecorated. More support workers have completed a relevant National Vocational Qualification. The people who live in the Service have become more actively involved in the appointment of new support workers. Care Homes for Adults (18-65 years) Page 8 of 29 All of these things contribute to the Service being better able to support people in ways that are right for them. 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are thinking of moving in are asked about what support they need and how they want this to be done. They are encouraged to visit the Service to get a first hand feeling of what it is like. Evidence: The Manager asks people who are thinking of moving in about what support they need and want. She also invites the person to visit the Service, usually on more than one occasion. This is done so that they can be confident that moving in to Homeleigh Farm is the right thing for them. She also talks with family members and with people like care managers (social workers). All of this helps the Manager to build up a really good picture of how the person can best be supported. In our questionnaire we ask people who live in the Service, did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Everyone says that yes they did. One person adds, I came to have a look here and to meet everyone. I went out with them. I had a good look and I think its okay here like home. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: We looked at the information that was collected for one person. There is information about practical things such as the help they need to do everyday tasks. There is information about their physical health and how this can be promoted. Other information is about quality of life things, such as the sorts of occupational and social activities the person likes to do. The Manager says that when she gets the information she shares it with the support workers so that they know what support they will need to provide. We asked two support workers about how all of this works out in practice. They say that they are indeed told about people who are about to move in. They say that as a team they discuss how best to help the person in the first few days, while they get to know them better. One support worker says, moving in is a really important time for us all. The person needs to feel reassured that things will be okay and for this to happen we need to know as much as possible about how to support them. We get lots of information from (the Manager and Deputy Manager) and we discuss it between ourselves so that everyone is up to date The Service does not offer short term care. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are actively involved in deciding what support they need and they receive it in ways that are right for them. People are helped to manage their financial affairs. There is a sensible approach to risk taking. Evidence: The people who live in the Service say that the support workers offer them all the assistance they need. Each person has contributed to preparing a written summary of how they want to be supported to do things. These individual plans of support are important because they help people say what they want. Also, the plans give information to support workers so that they know best to help each person. We looked at three these plans in some detail. They give a clear account of who needs to do what and why. For example, there is useful information about things such as helping someone when they become anxious about things. In another instance there is information about the sorts of activities the person likes to be supported to do. In our questionnaire for people who live in the Service we ask, do you receive the care and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: support you need? Everyone says that they always do. One person says, I talk about my plan and say the things that I want. Then I see my social worker and tell her things too about what I want. I have my own copy and can put down things I want. The Registered Providers questionnaire asks, have you been asked to help with your person centred plan? Most people say that they have. Three support workers told us about the individual ways that people who live in the Service like to be helped. They have a good knowledge of each persons individual requirements. They understand the ways in which each person is different. They know how important it is for everyone to be respected as an individual. The support plans are kept up to date so that they are accurate. This involves people who live in the Service taking part in monthly and annual reviews of how things are going. Sensible steps are taken to support people to lead everyday lives of their own choosing. This includes support workers helping people to take sensible risks and to avoid situations that might be harmful. People are supported to run their own bank accounts. The Registered Provider helps them to make sure that they have enough money in their accounts. This sometimes involves receiving funds on someones behalf and then forwarding them to the persons bank account. On other occasions it involves helping people to sort out what payments they are entitled to have. 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. There are interesting occupational and social things for people to do. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. Evidence: There is a range of occupational things that people can do if they want to. These include helping out around the house, working in the small holding, attending a local day service and helping out with the shopping. There are also social things to do such as taking part in games and going out to places of interest. In our questionnaire for people who live in the Service we ask, can you do what you want to during the day? Everyone says that yes they can. The Registered Providers questionnaire asks, are you happy with your activity plan? Most people reply that they are. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We asked people about the activities they do and we got positive replies. One person says, I do lots of different things like doing stuff on the farm, weve got chickens you know and they have to be cared for. I go out to the shops and I like doing pictures at the Centre. I do stuff everyday and I like to be at home in between because Im always busy with things. Another person says, I like to go out in the bus and to help around the farm. I also do things in the kitchen and like that. A third person says, I like to stay at home and do things. I go to my room and I like to be around here and seeing things. Im never bored apart from when its bad weather I suppose. People are helped to keep in touch with members of their families, if this is necessary and if this is what they want. Family members and friends are welcome to call to the Service at any reasonable time. The Manager keeps in touch with family members so that they know how things are going. People are encouraged to make their bedrooms their own private space. They are helped to arrange them as they want them to be. People can lock their bedrooms if they want to. People can use their bedrooms whenever they want. They can choose to have private time on their own or to be in company. If it is necessary, support workers help people to deal with any mail they get. There is a varied menu and good quality meals are served. People who live in the Service consider meal times to be a relaxed and pleasant affair. The Registered Providers questionnaire asks, do you like the food at your home? Most people say that they do. We asked people about this when we were in the Service. One person summarises the overall response when they say, the meals are very good and we have always have plenty to eat. I eat too much sometimes because I like food and then I put on weight. The foods very good really and Ive no complaints at all. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: The support workers are relaxed and informal in how they are. They help people to organise themselves without being bossy. People are helped to wear neat and clean clothes so that they can look how they want. In our questionnaire for people who live in the Service we ask, do the carers listen and act on what you say? Everyone says that they always do. We asked people about this when we were in the Service. One person says, the staff are good here even though they nag me I need it sometimes because otherwise I wouldnt do things that I should do. I get on with them okay. Another says, I like the staff and they do things with me like stuff in the farm and going out. The Registered Providers questionnaire asks, are you happy living in your home? Most people say that yes they are. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, people have seen their doctors as and when necessary. In our questionnaire for people who live in the Service we ask, do Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: you receive the medical support you need? Everyone says that they always do. People can manage their own medication if they want to and if it is safe for them to do it. At the moment, everyone who lives in the Service prefers to have members of staff sorting out their medication for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, medicines are stored securely. The Assessment says that all members of staff who give out medication have been trained so that they know what they are doing. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. These are being completed correctly. People are also helped to take care of themselves in a positive way. For example, one person has been helped to give up smoking. Some one else is being supported to reduce their cholesterol. Another person is being helped to manage their weight. 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. There is a complaints procedure. There are arrangements to make sure that complaints are dealt with properly. However, the way complaints are recorded needs to be strengthened. People are kept safe. Evidence: People say that they can make a complaint or raise a concern if they want to. They are confident that they what they say will be investigated. One person sums up the overall mood when they observe that, I can talk to (the Manager) and anyone if I want to about anything thats not making me happy. Theyll sort it out for me and Ill be happy again. Im okay at the moment. In our questionnaire for people who live in the Service we ask, do you know how to make a complaint? Everyone says that yes they do. There is a user-friendly written complaints procedure. This explains how to go about making a complaint or raising a concern about something. Since our last Key Inspection, the Manager has received a small number of informal complaints. These have all been promptly resolved. The Registered Provider has received one formal complaint. The Manager says that it was investigated by the Area Manager who concluded that the complaint was not justified. However, the records relating to the investigation were not available for us to see. The Manager has agreed that in future the necessary records will be kept in the Service. This is so that she can show us what Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: has been done. People who live in the Service are confident that they are safe and that their wellbeing will be promoted. Our questionnaire for people who live in the Service asks, do the staff treat you well? Everyone says that yes they do. The support workers are confident that people are being kept safe. One member of staff summarises the general mood when they say, the (people who use the Service) all get a good deal here and the staff genuinely want whats best for them. If there was anything not right Im sure that wed all speak up and the company would get it sorted out straight away. All of the people who use the Service have arranged for support workers to help them to manage their personal spending allowance. They are supported to withdraw money from the bank and then they are helped to buy the things they want. One person says, I go to the bank and get money out to spend on things. I get things I want and I know what money I have and I get help to make sure that Ive got enough and dont run out like I would if it was all down to me I suppose. The records show that people who use the Service are adequately protected from financial abuse. The Registered Provider completes a six monthly audit of the financial procedures used in the Service. The records of the most recent audit show that the system is well organised and reliable. Two minor improvements were suggested and both of these have since been done. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is comfortable. Some areas need redecoration. There is a modern fire safety system. The kitchen is well equipped. There is a suitable laundry. Evidence: The building provides a suitable range of facilities for the people who live there. These are in line with what the Registered Provider has committed itself to deliver in its Statement of Purpose. The building is generally well maintained on the outside. However, some of the wooden fascia boards have begun to rot away and they look unsightly. There is no front door bell and so people have to wait by the gate until they can attract someones attention. The gate itself is secured with a padlock and chain. This is not a normal domestic security arrangement. On the inside, the accommodation in general is well decorated and furnished. The flooring in the bathroom is worn and stained. The Manager says that all of these points will be considered for action. This will be done in line with the Registered Providers commitment in the Statement of Purpose to provide people with a homely setting. There is a modern automatic fire detection system that is checked regularly. The Registered Provider has identified the need for some minor improvements to be made Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: to the system. Some of these have been done and others are in the process of being done. The local Department of Environmental Health says that the kitchen is well equipped and well run. We looked in the kitchen too. It is clean and well organised. The cook checks to make sure that the fridges and the freezer keep foods cold enough. There is also a system to make sure that foods are used promptly once they are opened. The cook knows about good food hygiene practices. For example, about the need to keep uncooked meats separate from other foods when they are being prepared. People say that the accommodation is kept comfortably warm. The radiators are fitted with guards. This has been done to reduce the chance that someone will be burnt if they fall against them. The hot water taps that are used by the people who live in the Service are temperature controlled. This means that they will not get hot enough to scald someone. We tested a two of the taps and the temperature was satisfactory. The laundry has a washing machine and a dryer. The laundry is well organised and clean. 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. There are enough support workers on duty. Support workers have the necessary skills to support people in ways that are right for them. Security checks are completed on new members of staff. Evidence: The records show that there is a minimum of three support workers and one team leader on duty from early in the morning until later in the evening when the night support workers come on duty. At night there is a waking staff presence. Each week day there is the Manager, the Deputy Manager and the cook on duty. In our questionnaire we ask members of staff we ask, are there enough staff to meet the individual needs of all the people who use the Service? No one says that there always are, two people say that usually there are and two people say sometimes. When we were in the Service we kept a look out for things that might give us a clue about how well the place is being staffed in practice. We noticed that one person who wanted to go out to work on the farm was given one to one help to do so. Another person who was having trouble setting up their DVD player was quickly helped to sort out all of the wires. When two people got annoyed with each other, two support Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: workers tactfully suggested ways that they might settle their disagreement so that it did not drag on. The records show that the Registered Provider completes a number of security checks on new support workers. These include things such as confirming their identity, taking up references and doing a police check. This is done to make sure that they are trustworthy people to work in the Service. The records show that support workers are doing quite a lot of training. This includes introductory training for new members of staff. In our questionnaire for members of staff we ask, did your introductory training cover everything you needed to know to do the job when you started? Everyone says that it met their needs very well. After their introduction, there is ongoing training in key subjects such as first aid, health and safety and responding to difficult situations. The records show that most of this training is up to date. In our questionnaire we ask members of staff, are you being given training that is relevant to your role and that keeps you up to date with new ways of working? Everyone says that yes they are. More than three quarters of the support workers have completed a relevant National Vocational Qualification (NVQ). The Manager says that all new support workers will be encouraged to study for the award. Our observations show that support workers are well supported by the training they receive so that they can appropriately support the people who live in the Service. 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. The Service is well managed. There is a quality assurance system, but this should more directly involve the people who live in the Service. There is a suitable health and safety system. Evidence: The Registered Manager has a good knowledge of how things are going. She also holds a particular management qualification. The support workers say that there is good team work between them. There are handover meetings at the beginning and end of each shift. These are held so that support workers can be kept up to date with developments. In our questionnaire for members of staff we ask, do you feel that you have enough support, experience and knowledge to meet the different needs of the people who live in the Service? One person says that they always do, two people say usually and one person says sometimes. People who live in the Service are regularly asked what they think about their home as Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: part of everyday life. About once a month there are Your Voice Meetings. These are where the people who live in the Service get together with a member of staff to review how things are going and to suggest any improvements. The minutes of a recent meeting show that one person wanted to go for a plane ride. This has since been done. Each year the Registered Provider also asks the people who live in the Service to fill in the questionnaires from which we have already quoted. The records show that the results of the questionnaires are then used to plan improvements to the Service. For example, people who live in the Service said that they wanted to be more involved in the appointment of new support workers. This has now been done. They meet a candidate before an appointment is made. However, there is no organised system to feed back to people what has been said in the questionnaires and what is going to be done to introduce any suggested improvements. The Manager says that the Registered Provider intends to address this in the near future. The Registered Provider arranges for someone senior to call to the Service once a month to check how things are going. The records of these visits show that the visitor in question speaks with people who live in the Service and with members of staff. They also look at various records and documents. In addition to this, the Manager completes a number of self audits. This involves her checking things to do with subjects such as food safety, health and safety and medication. The records show that the audits are finding a high level of compliance with the Registered Providers policies and procedures. The records show that there are fire drills and all members of staff have regular fire training. They also show that all items of equipment used in the Service remain in good working order. The records show that there have not been many accidents in the Service since the Key Inspection. Most of them have been minor bumps and bruises. One of them involved someone attending hospital to have a minor cut treated. The building is regularly checked to help make sure that there are no hazards that might result in someone having an accident. The records show that things are being dealt with promptly. 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 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!