Care Home: Honresfeld Cheshire Home

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What the care home does well Information was collected about residents before they came to live at the home; this would help to decide whether they could be looked after properly. The individual service plans recorded details about what care residents needed and how they would like to be looked after; this helped staff to give them the care they needed and wanted. Residents said they were given choices and were able to what they wished; one said `I can do what I want`. Residents said they enjoyed the meals and were always given different choices. Comments included `the food is great` and `I enjoy the meals very much`. Staff were friendly and respectful and residents said they were happy living at Honresfeld. One resident said `I have met some good friends since coming to live here` and `its like having an extended family`. Residents could choose from male or female staff; this was important as some residents had preferences regarding who would help them with their care. People knew who to talk to if they were unhappy and were sure things would be sorted out. The home was a safe, pleasant, homely and comfortable place for residents to live. Different equipment and aids were available to help keep residents comfortable and safe and to help them to be independent. Staff had been given training that would help them to do their jobs properly and to keep people safe. There were enough staff to make sure residents got the attention they needed. New staff had been checked before they started work; this would make sure they were right for the job. What has improved since the last inspection? There was a person responsible for arranging activities and helping residents to get out of the house more. More volunteers were visiting the home and spending time with residents; they would offer friendship and support to residents. The home had achieved the `Gold Standards Framework` award which ensured residents nearing the end of their lives would get the care and the support they needed. What the care home could do better: Information about the home could be made available in other formats so that everyone knew what was available. The way in which some medicines were handled needs to be improved to make sure there were no mistakes made. The home should always follow the procedures that were there to keep residents safe. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Honresfeld Cheshire Home Halifax Road Littleborough Rochdale Lancashire OL15 0JF     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: Marie Matthews     Date: 1 2 0 2 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 32 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Honresfeld Cheshire Home Halifax Road Littleborough Rochdale Lancashire OL15 0JF 01706378627 01706370678 laura.keita@LCDisability.org 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) : Leonard Cheshire Disability care home 28 Number of places (if applicable): Under 65 Over 65 5 0 old age, not falling within any other category physical disability Additional conditions: 0 28 The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of PD (physical disability under 65 years of age); up to 5 service users in the category of OP (older people). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Honresfeld Cheshire Home is a large period building with extended accommodation, situated in 2 acres of well maintained lawns and gardens. Patio areas are accessible to people in wheelchairs. There are good car parking facilities. The home is approximately half a mile from Littleborough centre where there is a good selection of shops and other community services, including the railway station. Hollingworth Lake Country Park and the Pennine Way are also situated nearby. Whilst the home is on a main bus route, the service is infrequent. The home accommodates male and female residents aged between 18 and 55 years Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home (on admission), in single bedrooms on two floors. Qualified nurses, supported by care assistants, physiotherapists and therapists, provide twenty-four hour nursing care. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. A costing and pricing tool determines fees charged by the home. Individual needs are assessed and then costed accordingly. Items not included in the fee include chiropody, physiotherapy, hairdressing, newspapers, personal toiletries and transport. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 key unannounced inspection, including a visit to the home, took place on 12th February 2009. The last key inspection on this service was on 22nd November 2006 with an annual service review completed on 25th February 2008. The inspection process included looking at records, a tour of the home, discussions with the registered manager, deputy manager, four care staff and two residents who lived at the home. Information was also included from survey forms filled in by four residents. The home sent us their annual quality assurance assessment (AQAA) before the visit; this gave us a good picture of what had improved over the last twelve months and Care Homes for Adults (18-65 years) Page 6 of 32 where further improvements were needed. There were twenty five residents living at the home on the day of the inspection visit. 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. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 32 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information about the home was clear but needed to be available in other formats to ensure everyone had access to the information. Detailed assessments of peoples needs were completed prior to admission to help determine whether their needs could be met. Evidence: The information about the home was clear and available to both prospective and existing residents and their families. Residents surveyed said they had been given enough information about the home that would help them to decide whether Honresfeld was the right place for them to live. However consideration should be given to providing the information in other more suitable formats; this would ensure everyone had access to information they could understand. Two residents individual service plans were looked at in detail. It was clear that people were not admitted to the home until detailed assessments of their needs and preferences had been completed; this would help to determine whether their needs Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: would be met. The prospective resident and significant other people, including health care professionals, were also involved in the assessment process; this would ensure all aspects of peoples needs would be considered. Prospective residents and their families were encouraged to visit the home to meet with staff and other residents; this would help people to decide whether Honresfeld was the right place for them. Residents were not given contracts or statements of terms and conditions with the home; people needed this information to inform them of their rights and obligations whilst living at Honresfeld. Records of training and discussions with staff indicated they had the skills and experience to meet residents needs. Residents said they were looked after and were happy living at the home. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to take control of their lives and given support where needed. Evidence: The individual service plans detailed residents individual needs, preferences, likes and dislikes; this ensured they would receive the care they both needed and wanted. The plans focused on promoting independance and improvements; this showed that the service was committed to improving outcomes for residents and allowed them to take control of their lives. The plans were kept in residents rooms; this ensured it was the residents property and they were aware of the information held about them. The plans recorded how residents communicated and how changes in behaviour could indicate the need for assistance and support; this ensured staff were aware of how residents would make their needs known and help them to respond appropriately. A resident had been involved in a recent training session to help staff develop communication skills. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Any risks had been assessed with strategies in place to keep people safe whilst encouraging independence. It was clear that residents were involved in decisions and choices about their lives; records showed when decisions had been taken by others and the reasons behind this. Residents said they were given choices and were able to what they wished; one said I can do what I want. Some residents had been involved in the recruitment and selection of new staff; this allowed them to choose staff who they thought would be suitable. Some residents were involved in a service user support group; this enabled residents to make key decisions about how the home was run. The plans had been updated regularly to reflect current care needs and preferences; the resident and significant others such as key workers, families, advocates and care managers had been involved. Record showed that peoples money was managed safely and residents were given support to manage their own money if needed. Staff were supported by clear procedures relating to maintaining confidentiality and records were accurate and secure. The reasons for confidentiality had been explained to residents and they (or their relative) had given permission for certain other people to access their records; this would assure them that information held about them would be private. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social, educational and recreational activities met residents individual needs and expectations and they were able to make choices and decisions about their lives. Residents received a healthy nutritious diet that was suited to their dietary needs and expectations. Evidence: Each residents individual service plan included information about their lives before they were admitted to the home and detailed information about their routines, likes, dislikes and preferences; this would ensure they received the care and support they both needed and wanted. They had leisure care plans that detailed specific information about the level of support they required to ensure their social needs were met. Records showed what Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: activities they had participated in both inside and outside the home; these reflected each residents personal abilities and preferences. One resident said he was able to get out on a regular basis and transport was available for this and another resident was looking forward to a girls night out on the evening of the visit; the home had their own transport and staff confirmed that additional staff would ensure residents had the support they needed. During the inspection residents were seen involved in various activities either with each other, family and friends, volunteers and staff; there were aids and equipment to support residents choice of activity. There was an activity co ordinator and a team of volunteers who befriended residents and helped them to meet their social needs; a volunteer co ordinator had recently been employed to develop this service and it was hoped that residents would be given more opportunities to develop friendships. One resident said I have met some good friends since coming to live here and its like having an extended family. Residents survey and discussion with residents indicated they were able to choose how to spend their days. For residents with communcation difficulties they had a set of communication cards; the cards informed people of the persons routines for each day, what they enjoyed doing, information about them and the health and personal support they needed. Records showed that residents were able to continue with their education; one resident had expressed an interest in attending college and appropriate support had been given. Service user committee meetings were held regularly and there were requests for art classes, a game station and a visit to a bird sanctuary as one resident expressed an interest in birds. The manager said holidays were usually arranged by holiday exchange where residents could choose to stay at other homes within the group; this would ensure their specialised needs would continue to be met. Individual plans recorded information about residents likes and dislikes in respect of food and drinks, what cutlery and crockery was needed and how food needed to be presented; this ensured they received a diet that met their dietary needs and preferences. This information was also included on laminated place mats for the dining room and communication cards that the residents kept with them. Menus showed a choice of healthy and nutritious meals and residents confirmed they were offered alternatives to the menu. Comments included the food is great and I enjoy the meals very much. The dining room was bright and tables were well presented. Drinks and snacks were available throughout the day and residents were given tokens to enable them to get drinks from the drinks machine. A recent visit from Environmental Health had recorded that the kitchen was well run. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: Residents confirmed their rights and choices were respected and their routines were flexible; they said they could do as they wished. It was clear that staff and residents were good friends but still respectful of each other. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs were met. Evidence: Records showed that residents received health and personal care based on their needs and preferences; routines were flexible and residents were able to choose how they spent their day. There were technical aids and equipment to help maintain residents comfort and to promote independance wherever possible. Residents health had been monitored and advice and support had been obtained from health care professionals when needed. Staff were trained in health care matters and records showed that key workers were alert to any changes in residents behaviour, mood and general health and had responded appropriately. The service ensured residents received consistent care by providing a designated key worker from admission; residents were able to choose their key worker and friendships had been developed. The staff group was balanced to allow residents to choose from Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: male or female staff; this was important as some residents had preferences regarding who would help them with personal care. Consistent care was also provided by having detailed information about routines and preferences and establishing good links with advocates, family and friends. Records showed that key workers were alert to any changes in service users behaviour, mood and general health and had responded appropriately. Staff had access to clear and detailed medication procedures to help them to manage residents medicines safely. Records were clear and accurate although directions on medication administration charts (MAR) need to be clear and not state as directed to ensure medicines were given as prescribed and disposal records need to be signed by two staff to prevent any risk of mishandling. Medicines were stored securely although temperatures of storage areas need to be monitored to ensure medicines are stored appropriately. Staff had received training to provide them with extra skills and knowledge to help them to manage residents medicines safely. Systems were in place to check whether staff had followed medication procedures and managed residents medicines safely. Residents and relatives wishes concerning death were recorded in the individual service plan and would be respected by staff. The home had achieved the Gold Standards Framework award which is a recognised accredited award its about living well until you die; to achieve this the home had provided staff with specialist training and had developed links with other health care professionals to ensure residents nearing the end of their lives received quality care and the support they needed to die with dignity in their own home rather than in hospital. Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew who to talk to if they were unhappy and were sure their concerns would be responded to. Clear safeguarding procedures and staff awareness would help to keep residents safe from harm although failure to follow procedures could put residents at risk. Evidence: There was evidence to support that residents views and opinions were sought in various ways such as one to one meetings, a suggestion box and review meetings; records showed any concerns had been taken seriously and acted upon. Each resident and their relatives had been given a copy of the complaints procedure as part of the admission pack; survey information and discussion with residents indicated they knew how to make a complaint and were happy with the service they received. One resident said I have never had to complain and I am happy here. Another resident said his complaint had been dealt with. Residents with communication difficulties were able to make their needs known in other ways such as using the communication cards to determine whether they were happy or sad. It was recommended that the complaints information should be available in other more suitable formats; this would ensure the information was available to all residents (see standard 1). The complaints record showed there had been two complaints in the last twelve months and both had been responded to appropriately. Any complaints were Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: monitored to help to improve the service. The safeguarding procedures were clear and all staff had received training; this would ensure staff were able to recognise and respond to any signs or reports of abuse or neglect. There were concerns that one recent incident had been investigated in house and not referred according to the safeguarding procedures. This was discussed with the registered manager on the day of the visit and appropriate referrals were then made. Procedures were in place to support staff with dealing with physical and verbal aggression; this would ensure people were safe from harm. The use of any restraint measures had been risk assessed, recorded, discussed with the resident or relatives and kept under review; this would ensure the measures were appropriate. There were clear procedures to support staff with reporting any bad practice; this ensured residents were protected from harm. Financial procedures and audit systems ensured residents finances were safeguarded. Care Homes for Adults (18-65 years) Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were provided with a pleasant, homely and comfortable environment that met their specialised and individual needs. Evidence: Honresfeld was accessible, safe and well maintained. There was a plan to support further improvements to ensure the home continues to meet residents needs. People were consulted about the improvements that were needed. All areas were safe, comfortable, bright and spacious. CCTV was in place for external areas only. It was observed that residents were comfortable and relaxed and able to access any area of the house and surrounding gardens. A variety of communal areas were available both inside and outside the home; this allowed residents and their visitors a choice of where to sit quietly or with other people. A room was available for residents guests to stay overnight; this enabled residents to maintain contact with friends and family. The garden and patio areas were safe, accessible and well maintained. Bedrooms were spacious and comfortable and had been personalised to reflect Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: residents personalities. Specialised aids and equipment had been provided to ensure residents comfort and to help them to maintain their independence. Residents spoken to said they were happy with their rooms. Bathroom and toilet areas were close to bedrooms and communal areas. Therapy rooms provided residents with a place to relax or to receive specialised treatments. All staff were provided with infection control training; this would ensure staff were aware of the required standards of cleanliness. Survey information indicated the home was fresh and clean and provided a pleasant place for residents to live. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were suitable, competent, supported and provided in sufficient numbers to meet residents needs in a flexible way. Evidence: Records and discussion with staff showed they were provided with appropriate induction, supervision and support and ongoing training to develop their skills and knowledge and to help them to meet residents needs. More than half of care staff had achieved a recognised qualification in care; this would give staff the skills and knowledge to look after people properly. Staff also received a handbook and additional training to help them to understand and respond to residents specialised personal and health needs. One staff said the provision of training was brilliant. Staff said they were aware of their roles and responsibilities and the homes policies and procedures; this ensured residents would be looked after properly. From surveys and discussions with staff and residents it was clear that staff were provided in sufficient number to meet residents needs and additional staff were provided when needed; this ensured the service was flexible and responded to residents needs. Records indicated that staff turnover was low and there were Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: systems in place to monitor sickness and abscence; this ensured that residents would be cared for by staff that were aware of their needs and expectations. The team included staff of various ages and genders; residents were able to choose their key worker providing them with a friend they could trust and rely on. Staff were seen responding to residents and visitors to the home in a friendly, encouraging and respectful manner; residents appeared happy and content. Two staff files were looked at in detail. A safe and fair recruitment process had been followed to ensure residents safety and well being. It was recommended that all staff files should include a recent photograph as a means of identification. Regular audits were done to ensure all staff files met legislation. Records and discussions indicated that staff received regular support from their manager. A system of traffic lights was used to identify the amount of support needed; this would ensure staff received the training and support they needed. The heads of department met regularly to discuss various issues and to help them to keep up to date with any changes; all staff should be given the opportunity to meet as a group. Care Homes for Adults (18-65 years) Page 25 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was safe and well managed. Peoples views and opinions were sought and used to improve the service. Evidence: The registered manager is Laura Keita who has the required qualifications and experience and is competent to run the home; she has updated her skills and knowledge. The registered manager is involved in budgetary decisions and ensures people receive a good standard of service. The atmosphere of the home is open and relaxed and benificial to staff, visitors, residents and their families. Staff said the standards of care were excellent and its just like having an extended family. Staff made positive comments regarding the way in which the home was run. As reported previously staff performance was monitored to identify whether they needed any further training or additional support and regular meetings with the heads of department were held.(See staffing). Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: There were systems in place to obtain peoples views and opinions about the service. Annual surveys were sent to relatives and residents and the results from this were used to develop the service. Resident committee meetings were held to obtain their views and to give them some control over the day to day management of the home. Relatives meetings were not held although the resident and their families were invited to twice yearly review meetings; this gave people the opportunity to meet formally with staff. The company had its own quality assurance assessment that monitored all aspects of the management of the home; the results of this were used to identify areas in need of improvement. The way in which the home was run was monitored each month and records of any action needed to be taken to improve the service were maintained. The registered manager was supported by senior managers and other key people within the organisation. The annual quality assurance assessment (AQAA) was sent to us before the inspection. This was fully completed and contained excellent information about the service; it was clear that the manager was aware of how the service could be further improved. The AQAA was being used as a development plan. The home had achieved the Investors In People award; this was a recognised quality award that monitored the training and development of staff and overall management systems of the home. The home had recently achieved the Gold Standards Framework award which is a recognised accredited award its about living well until you die; to achieve this the home had provided staff with specialist training and had developed links with other health care professionals to ensure residents nearing the end of their lives received quality care and the support they needed to die with dignity in their own home rather than in hospital. Records showed that staff had a good understanding of equality and diversity and this had been put into practice. Policies and procedures were reviewed and kept up to date; this ensured staff had access to clear and safe guidance that would keep them and others safe. Working practices within the home were safe and staff were provided with regular training to ensure they and others were safe. Records showed the home was well maintained and systems were serviced regularly to ensure peoples health, safety and welfare were protected. Care Homes for Adults (18-65 years) Page 27 of 32 Care Homes for Adults (18-65 years) Page 28 of 32 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 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 23 13 Incidents of abuse, neglect or harm must be reported according to the safeguarding procedures. This will ensure appropriate action can be taken to safeguard residents. 16/03/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Consideration should be given to making the information about the home available in formats more suited to people living in the home; this would ensure everyone had access to the information. All residents should be issued with contracts or statements of terms and conditions with the home; this would ensure they are aware of their rights and obligations whilst living at Honresfeld. The temperatures of medication storage areas should be checked regularly; this would ensure medicines are stored correctly and remain effective. Any handwritten directions should be witnessed by a second person; this will reduce the risk of error. 2 5 3 20 4 20 Care Homes for Adults (18-65 years) Page 30 of 32 5 6 20 20 The disposal record should be signed by two staff; this would reduce the risk of mishandling. PRN or as needed directions should be supported by clear protocols to support staff with their decisions to administer or not. The directions on the medication administration records should be clear and precise; this will reduce the risk of error. Consideration should be given to providing all staff with the opportunity to meet as a group. All staff files should include a photograph as a means of identification and this should be included as part of the recruitment process. 7 20 8 9 33 34 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 32 of 32 - 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!