Care Home: Hooton Chase

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What the care home does well The needs of people are met by the way the service obtains assessments relating to the needs they have in their daily lives. The people who use the service have their needs met by the way the service has devised care plans. They are enabled to make decisions about their lives and have any risks they face through this acknowledged by the service. The people who use the service are able to pursue the leisure opportunities open to them with staff support, are able to maintain links with their families and have their rights respected. The service meets the nutritional needs of individuals and encourages them to be involved with the planning and preparation of food. The people who use the service are supported as they wish and have their health needs met. Their health needs are promoted through the management of medication. The people who use the service and their families are provided with the information they need if they wish to make a complaint and feel confident that the service would listen and act on any concerns. The people who use the service are protected from abuse. The people who use the service are provided with a well maintained environment which is clean and hygienic. The people who use the service are supported by people who are trained to meet their needs and have received a thorough induction into how to best support the people who live at Hooton Chase. The recruitment of new staff protects people from abuse. The people who use the service receive support that is managed in a way that serves their interests. Their interests are further served by the way the service assesses the quality of care it provides. The health and safety of individuals is promoted. Comments received during the visit included: `It is always clean and tidy-they could take me abroad on holiday` `I get supported to live independently eg do my own room and dust` `It supports me to live independently and do things for myself` `Staff do a wonderful job` `Staff are lovely and caring` `I get fantastic support working here` What has improved since the last inspection? The service has now improved the storage of those medications which have to be stored in a refrigerator so that the health and welfare of people is promoted. Aspects of the environment including the introduction of pictures and ornaments have made the building more home like in appearance. Activities in the local community have improved to ensure that individuals are more included in opportunities in the wider community. What the care home could do better: No requirements are raised as a result of this visit. Some good practice recommendations have been raised. Key inspection report Care homes for adults (18-65 years) Name: Address: Hooton Chase 1 Hooton Road Ellesmere Port Cheshire CH66 1RU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Paul Kenyon     Date: 0 4 0 5 2 0 1 0 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Hooton Chase 1 Hooton Road Ellesmere Port Cheshire CH66 1QU 01513274781 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Mohamad Jeelany Meeajun Name of registered manager (if applicable) Lorraine Edwards (Acting Manager) Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following categories of service only: Care home only- Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability- Code LD The maximum number of people who can be accommodated is: 12 Date of last inspection Brief description of the care home Hooton Chase is situated in semi rural area on the border between Cheshire and Wirral near to Ellesmere Port. It comprises of a detached two storey property which is located within its own grounds. The service is registered for 12 adults who have a learning disability. The service was registered in December 2008 and is owned by Mr Mohamad Jeelany Meeajun. The Manager Lorraine Edwards is currently in an Acting position yet has applied to the Care Quality Commission for registration to become Registered Manager. The fees are varied and according to the identified needs of the resident. 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection of Hooton Chase. The visit took place during the morning and afternoon period and included an examination of records, interviews with the people who use the service, interviews with staff and a tour of the building. In addition to this we looked at information that was sent to us by the service in their Annual Quality Assurance Assessment (AQAA) prior to our visit. We also looked at three surveys that were completed by three people who use the service which was again sent to us prior to our visit. Comments made by individuals and staff are included within this report. Care Homes for Adults (18-65 years) Page 5 of 27 What the care home does well: What has improved since the last inspection? The service has now improved the storage of those medications which have to be stored in a refrigerator so that the health and welfare of people is promoted. Aspects of the environment including the introduction of pictures and ornaments have made the building more home like in appearance. Activities in the local community have improved to ensure that individuals are more Care Homes for Adults (18-65 years) Page 6 of 27 included in opportunities in the wider community. 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 7 of 27 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 8 of 27 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 needs of people are met by the way the service obtains assessments relating to the needs they have in their daily lives. Evidence: We looked at how the service assesses the needs of people before they come to live or use the respite services at Hooton Chase. One had come to use the service for respite since our last visit. The service had obtained an assessment of the persons needs before they had come to use the service and will contained a summary of all considerations that needed to be made to be supported in their daily lives. Care Homes for Adults (18-65 years) Page 9 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have their needs met by the way the service has devised care plans. They are enabled to make decisions about their lives and have any risks they face through this acknowledged by the service. Evidence: We looked at five care plans relating to the people who use the service. All care plans had been reviewed in January 2010 and there was evidence that the individual, families and health professionals involved in their support had been present while the care plan had been reviewed. There was no ongoing evidence that individuals or their families had been involved after this review. We asked individuals about care plans and they were not aware of this document. In order to ensure that people are aware and agree with their plan of care, it is recommended that those people who are able to, sign their daily diaries periodically to confirm this. Advocates or families should be involved for other people. Care plans also tended to be in a format for staff but not in a format to meet the communication needs of the people who use the service such as pictorial form. It is recommended that pictorial forms of care plans are produced to Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: meet the communication needs of individuals.Care plans include an outline of all the needs of individuals in relation to their communication, health, medication and the support required in their daily lives. We looked at how people make decisions about their lives. The service has provided some information to people in pictorial form in relation to complaints and satisfaction surveys as well as information on advocacy services. This should be extended to care plans. Information is available in relation to advocacy services and this relates to a local advocacy service. The advocate has been involved with individuals and supported individuals to complete three surveys received by ourselves prior to this visit. Individuals have access to their monies and this is done by the use of an accountable finance system which ensures that finances are provided to individuals as they wish. Three people rely on an external and independent agency to manage their finances. We looked at how the service takes the risks faced by individuals i their daily lives into account. Risk assessments have been incorporated into the care planning process and these were reviewed in January 2010 with the individuals, their family/advocate and health professional involved in their support included in this. Each risk assessment outlines the areas of risk faced by each person and how these can be minimised. Risk assessments are also extended to fire risk assessments for each person. It is recommended that the format of risk assessments are made accessible to individuals in pictorial form. Care Homes for Adults (18-65 years) Page 11 of 27 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. The people who use the service are able to pursue the leisure opportunities open to them with staff support, are able to maintain links with their families and have their rights respected. The service meets the nutritional needs of individuals and encourages them to be involved with the planning and preparation of food. Evidence: Only one individual pursues formal education although it is anticipated that this will be completed later this year. There was evidence that people have pursued occupation prior to them coming to live at Hooton Chase. Records indicated that the emphasis at present in the home is to maintain community contact through leisure activities and household routines rather than maintaining education or occupation. Records indicated that people are supported to access the community. This includes a mix of leisure activities as well as household related activities such as shopping. Each Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: person has an activities programme which includes access to local leisure facilities and the level of staff support required. At present risk assessments suggest that people need staff support at all times. Records provide an ongoing commentary on the community links that people have and we noted that the activities enjoyed by people had been extended in line with our recommendations from previous visits. The situation of the service is such that there are transport links to all parts of the local community. We looked at how individuals are able to maintain links with family and friends. Records suggested that people are able to continue to maintain links with others either through visits from family and friends or through individuals spending some time at their familys homes. This was confirmed through discussions we had with two people. A lounge ares on the upper landing of the building has been created to enable any visits to take place in private. There was evidence that families had been involved in the initial setting up of care plans. The service has now developed links to a local advocacy service and this service has been involved with some people who do not have any immediate family. We looked at the rights of individuals. Our tour of the building involved viewing bedrooms of individuals who were present during our visit. These individuals had been asked if we could view these rooms with their permission and they were agreeable with this. During the visit, we noted that staff talk to individuals and offer an informal and friendly approach during these interactions. Throughout our visit, we noted that individuals were given the choice to go out on an activity and if individuals did not want to go, this was respected. All individuals were able to access any part of the building they wished. Each person has an activity plan. Included in this is reference to the extent to which people are involved in household tasks, either in maintaining their own tasks or for the good of the household as a whole. This was confirmed through records as well as interviews with individuals. Daily diaries provided evidence that routines such as laying tables, washing dishes, assisting with laundry and assisting with meals were commonplace in the daily lives of individuals. We looked at how meals are provided within the service. Care plans noted that there are no individuals with specialist dietary needs living at Hooton Chase at present although records do indicate that there is an emphasis on healthy eating. Menus are available but tend to act as a general guide. An emphasis is placed on meals being in line with the preferences for individuals on that day and a record of food provided suggested that there is an ad hoc approach to providing meals although this is in line Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: with preferences and healthy eating. We witnessed staff asking people what they wanted for lunch on the day of our visit. Daily diaries suggested that individuals are involved in shopping as well as some preparation of meals and other activities such as baking. During our visit, all individuals had lunch in the dining room. This was noted to be an informal event with staff siting eating with individuals. This provided an opportunity for individuals and staff to discuss activities and for staff to gain the views of individuals on a variety of topics. The dining room has become more welcoming since our last visit with the inclusion of ornaments and pictures. At present one person needs assistance with eating and people have their weights monitored on a regular basis. The kitchen is domestic in scale and presented as a well organised and clean facility. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are supported as they wish and have their health needs met. Their health needs are promoted through the management of medication. Evidence: We looked at how individuals at Hooton Chase are supported by the staff team. Details of how people are to be supported are included within each care plan. The care plans were initially devised in January 2010 and included the individual, members of their families and other health professionals involved in their lives. Individuals we spoke to were not always clear about the details of their care plan and it was clear that agreement to support was done verbally with no recorded evidence that this had been agreed by the individual. It is recommended that each person has the opportunity to sign their daily records periodically so that their agreement to the support they are provided with is determined. For those who are unable to do this, it is recommended that their families or advocates do this on their behalf. The service has devised personal preference records which include details of how individuals wish to be supported and their preference in relation to their personal appearance.These are being developed an it is recommended that these are completed as fully as possible. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Activity plans have been devised and these provide a flexible structure on when individuals are involved in personal hygiene, household routines and leisure activities. These are made available to each person. There is no keyworker system in place. An advocate has been introduced into the service. Information on this advocacy service is available to people and it was reported that three individuals who responded to our surveys had been supported by advocates to complete this. We asked people about the support they were provided with. In all cases, people were happy with the staff team and felt that they responded to the wishes of each person. We looked at how the service maintains the health of people. Health Action Plans have been devised for each person indicating the health needs of people and how these can best to met. Training for staff has been devised for health action plans as evidenced through training records. Each person has been registered with a general practitioner and there were records indicating that people had continued access to health professionals such as doctors, chiropodists, dentists, opticians, general health checks and specialist nurses. Care plans revealed that individuals need support to maintain their health in all cases and that staff made appointments on their behalf. Interviews with individuals who live at Hooton Chase noted that they considered themselves to be healthy at present but if they needed health appointments, these were arranged by the staff team without delay.Records are available providing a summary of any visits to health professionals with an indication of progress made with each appointment. The weight of people is monitored on a regular basis. Care plans give an indication in relation to the physical and mental health of individuals. We looked at how medication is managed. No one self administers medication at present and this is included within individuals risk assessments. All medication is securely locked away in a purpose built cabinet with any medication that requires storing in a refrigerator in place .All records in relation to receipt, administration and disposal of medication were noted be in place and appropriately recorded. The pharmacy supplier audits the systems used at Hooton Chase on a regular basis. Agreements have been sort by doctors into the use of homely medications. Staff training records and interviews with staff confirmed that all staff had received medication training. Care Homes for Adults (18-65 years) Page 16 of 27 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. The people who use the service and their families are provided with the information they need if they wish to make a complaint and feel confident that the service would listen and act on any concerns. The people who use the service are protected from abuse. Evidence: We looked at how the service deals with any complaints or concerns about the quality of support provided by the service. The service has a complaints procedure on display which outlines timescales and the response of the service to any concerns that people may have. This is mainly for professionals or family members. A complaints procedure is in place for the people who use the service and this is presented in a format which is designed to be appropriate to their communication needs given that it is in pictorial form. We spoke to two people. Both were asked about the action they would take if they were not happy with the support they received. Both said that they would speak to the manager and were confident that any concerns they had would be dealt with. Information received from the service prior to our visit indicated that the service had not received any complaints and we have not received any concerns either. We looked at how the service protects people from abuse. The service has referred an allegation of abuse in relation to finances since our last visit. The service took all the Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: steps it required to ensure that the allegations had been referred to the Local Authority and that we had been made aware of the issues. Steps have been taken to ensure that the financial interests of individuals have been safeguarded as a result. Training records and interviews with staff confirmed that they had had training in abuse awareness and were aware of the whistleblowing procedure. Staff had also received training in actions to deal with any physical or verbal aggression and this was included within risk assessments placing emphasis on dealing with any aggression through positive staff interactions. One person who uses the service told us that they felt safe living at Hooton Chase. Care Homes for Adults (18-65 years) Page 18 of 27 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 people who use the service are provided with a well maintained environment which is clean and hygienic. Evidence: We toured the premises. There have been some improvements to the premises since our last visit. The exterior patio areas have either been re-laid with new paving stones or are in the process of being completed. The interior of the service has had ornaments and pictures included in some areas such as the dining room and this has created a more home like feel to the building. New fire doors have been fitted and there is now more information for people provided in pictorial form. We toured bedrooms and other areas. Some rooms are more personalised than others yet this reflects the preferences of individuals. Three lounge areas are available. One has been created on the upper landing of the premises as a quiet area. A computer is available here but there is no access to the internet. The furniture is comfortable and the premises are bright and airy. Individuals are able to access all areas of the building given that no one has any restrictions with their mobility at present. The building fits in with the local community and is close to transport links to local amenities.The service has received visits from Fire Authorities and Environmental health agencies within the past twelve months. The service has access to maintenance Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: staff and records suggest that there is an ongoing process for the addressing of repairs in the building. Individuals have access to the grounds within the service which are well maintained and there are plans to further develop these areas. The tour of the building noted that the premises were clean and hygienic. No domestic staff are employed given that there is an expectation that the people who use the service are able to maintain the hygiene of their living space with staff support. This was noted in interviews with individuals as well as an examination of daily routines which places an emphasis on people being involved in domestic tasks. No offensive odours were present during our visit. A laundry is available which is situated separately from food preparation and storage areas. The laundry is used by individuals with support and domestic appliances are used at present. Care Homes for Adults (18-65 years) Page 20 of 27 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. The people who use the service are supported by people who are trained to meet their needs and have received a thorough induction into how to best support the people who live at Hooton Chase. The recruitment of new staff protects people from abuse. Evidence: We looked at how the service recruits new members of staff into the service. One person has been recruited of late. We looked at their file and found that it contained information which confirmed their identity as well as police checks to confirm that they are a fit person to work at the service. The file also included evidence about the way the staff member had been provided with an induction into the service. The induction process included training in relation to mandatory training. The file also provided evidence that the staff member had undertaken Common Induction Standards. This is a process whereby the values needed to successfully support people are reinforced to the staff member. In addition to this, new members of staff are provided with information in respect of the expected practice (through the General Care Council Code of Conduct) as well as information about the Mental Capacity Act. We looked at how staff are trained. Interviews with staff members outlined the training they had received. This was reinforced with certificates. There was also evidence that staff had received training in mandatory health and safety subjects as Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: well as training in specifically in relation to the needs of the people who live at Hooton Chase. Such training included managing challenging behaviour, learning disability awareness, safeguarding, principles of care, person centred planning and the role of the care worker. Care Homes for Adults (18-65 years) Page 22 of 27 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 people who use the service receive support that is managed in a way that serves their interests. Their interests are further served by the way the service assesses the quality of care it provides. The health and safety of individuals is promoted. Evidence: We looked at how the service is managed. Since our last visit, a new Acting Manager has been employed by the service with initial support from a senior manager within the organisation. The Acting Manager has experience in supporting people with learning disabilities and has a National Vocational Qualification at Level 3. She is about to apply to us to become the registered manager of the service. We asked staff and the people who use the service about the manager. Comments include she is fantastic and approachable and she listens to us. The Acting Manager confirmed that she has received the support she has needed from the senior manager of the organisation. We looked at how the service examines the quality of the support it provides. The service has developed questionnaires for the people who use the service in a format which contains pictures and symbols. Surveys have also been devised from relatives Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: and health professional involved in the support of the people. These are in place yet have yet to be sent out to individuals. The service provided evidence that the Registered Provider visits the service on a monthly basis to comment on the quality of support provided and produces a report. The service has responded to all the requirements we raised from our last visit and we were able to examine records and interview people in private. The service provided an Annual Quality Assurance Assessment to us prior to our visit. This contained an account of the things the service does well and what could be better. We looked at how the service promotes the health and safety of individuals. There was evidence that staff had receive health and safety training and this was confirmed through staff interviews, certificates and a training plan. There was evidence that the service has checked safety within the building in respect of fire detection and prevention tests, water temperature checks, portable appliance tests and checks to the gas and electrical systems in the building. A fire risk assessment is in place for each person living at the service having been assessed in relation to fire safety. Accidents if they occur are recorded and the service informs us of any events that adversely affect the well being of people. The service maintains certificate in relation to insurance and its certificate of registration. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Care plans should be produced in a format which meets the communication needs of the people who use the service so that they are fully aware of the support they are provided with. The people who use the service or their advocates should sign daily diary sheets on a regular basis to confirm that they are involved with the support they are provided with. Risk assessments should be produced in a format which meet the communication needs of the people who use the service so that they are aware of how their health and welfare will be protected and promoted by the service. The personal preference records should be extended to ensure that the support required by individuals is in line with their wishes. 2 6 3 9 4 18 Care Homes for Adults (18-65 years) Page 26 of 27 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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