Care Home: Jaden House

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Heather House Nursing Home
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,

What the care home does well The way that the service assesses people`s needs before they are admitted to the home is thorough. The staff support people to be as independent as possible, to make decisions about their lives and to take part in the running of the home. People who use the service have opportunities to take part in a range of activities both in the home and the community. They participate in planning meals and are encouraged to eat healthily. The home makes sure that people have access to health care services when they need them and provides emotional and practical support. There is a consistent and trained team of staff and an experienced and supportive manager, who listen to what the people who live in the home say they want. The home is run in a way that looks after people`s welfare and safety. We asked people what does the home do well. A person who lives in the home said "help us with food and budget, Sunday roast dinner, laundry, care for me." Another person who uses the service answered "Listens, looks out for me, money, washing. It is a lovely place to live in." A health and social care professional told us "This new home has had an excellent start. Suzi Welsh and her team are clearly dedicated to meeting the needs of the residents and developing their skills, so that they can achieve more independence in the future." What has improved since the last inspection? This was the first key inspection of the service, which was registered on 23rd July 2009. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. We asked what could the home do better and a person living there said "Nothing". One staff member suggested "Get more involved with things in the local area", while another said "do more out of house activities". A health and social care professional told us "My only query is the sign on the front of the house, which clearly labels it as a residential home in the community." In the AQAA, the home has identified further developments that they plan to make happen, for example implementing quality assurance surveys and collating feedback to see how they might improve the service. Key inspection report Care homes for adults (18-65 years) Name: Address: Jaden House 33 Hammonds Lane Totton Southampton Hants SO40 3LF     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: Laurie Stride     Date: 0 8 1 2 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 30 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 30 Information about the care home Name of care home: Address: Jaden House 33 Hammonds Lane Totton Southampton Hants SO40 3LF 07799405266 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Suzanne Belinda Welsh The registered provider is responsible for running the service care home 5 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia sensory impairment Additional conditions: Date of last inspection Brief description of the care home Jaden House is located in central Totton and is a short walking distance from shops, medical centres and sports facilities. The service is intended to provide short term transition accommodation for up to 5 people with learning difficulties who may also have mental health problems and diagnosis of Autism and Aspergers Syndrome. The home provides a family type environment with the aim of developing peoples skills to enable them to move on to more independent living arrangements. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 0 5 5 0 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: We (the commission), visited Jaden House on 08/12/09. This visit was part of the homes first key inspection, which takes into account all the information we have received about the service since it was registered. The information included the homes Annual Quality Assurance Assessment (AQAA), which the owner/manager sent to us prior to the visit. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Before our visit, we had sent survey questionnaires to the manager to distribute to people who use the service, staff members and health and social care professionals. At the time of writing this report we had received completed questionnaires from the three people who live in the home, four staff members and three health and social care professionals. During this key inspection visit we spoke with the people who live in the home, a staff member, deputy manager and the registered owner/manager. We also looked at Care Homes for Adults (18-65 years) Page 5 of 30 samples of the records held in the home. Care Homes for Adults (18-65 years) Page 6 of 30 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 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 30 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 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are interested in using the service have their individual aspirations and needs assessed prior to a place being offered, so that they and the service can be assured that the persons needs can be met. Evidence: The homes annual quality assurance assessment (AQAA) told us As a family type nurturing environment we provide a warm and comfortable environment that people can feel relaxed in. We ensure that when we receive an initial referral that the service user is suitable for the service and we can meet their needs to move them forward to more independence. It is very important in this small home that all service users are compatible and can work together as a team. We currently have three girls who are working extremely effectively together. We involve families and all external agencies and healthcare professionals who are involved with the service user. Service users are provided with their service user guide and terms and conditions of residency and this is discussed with them to ensure they understand the contents. The home had sent us a copy of their Statement of Purpose prior to the service being Care Homes for Adults (18-65 years) Page 9 of 30 Evidence: registered. The manager told us that this document and the Service User Guide had since been updated to include further details about the physical environment. There are currently three people living in the home. The manager was able to show us that a full assessment of each individuals needs and aspirations had been carried out before, during and following admission. This involved the manager and each individual, their families and also their care managers, who made the initial referrals. The records included personal histories, risk assessment and management plans. A new referral had been received and the person who was interested in using the service had written a list of his reasons for wanting to move in. A transition meeting had taken place and the individual had been visiting the home twice a week and talking with the other people who live there and staff. The manager said she is waiting for an updated care management assessment before finalising plans for the person to move in. One of the people who lives in the home talked to us about the reasons she was referred to Jaden House and told us about the positive feelings she has about the way her life has progressed since moving in. Each of the people who live in the home had taken part in our survey questionnaire prior to our visit (one person was assisted by support workers in completing the survey). All said they received enough information about the service before they started using it so they could decide if it was the right place for them. We also received positive comments from three health and social care professionals surveys who have contact with the service. All said that the homes assessment arrangements always ensured that accurate information is gathered and that the right service is planned for people. Care Homes for Adults (18-65 years) Page 10 of 30 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. People who use the service know their assessed and changing needs and personal goals are reflected in their individual plan. They are encouraged and supported to make decisions about their lives and to take planned risks as part of an independent lifestyle. Evidence: The AQAA told us We keep our service users files as live documents and continue to review and implement new care plans and risk assessments as changes occur for individuals. Care plans include covering aspects of personal, social, health, emotional and psychological care and make referrals to the health team when needed. We support individuals to make their own decisions and provide advice and guidance to improve personal safety awareness and encourage advocacy. We identify where areas of support are needed and document how we will support these in agreement with the service user. During our visit we saw that detailed and comprehensive care and support plans are in Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: place for each person who uses the service. These are reviewed every four weeks, or more frequently if needed, with the participation of the individual concerned and progress reports are sent to the placing authority care managers. One of the people who lives at Jaden House showed us her support plan file and talked to us about the contents of the different sections. It was clear that the individual was very involved in all aspects of the service that is planned for her and had a say in the way that information about her was recorded. The person told us what the risk assessments meant to her and about how she had developed a greater awareness of factors affecting her personal safety and has been able to independently manage situations better. We talked with a member of the staff team who is a key worker for the person who showed us her support plans. The staff member told us about the weekly key worker meetings they have with the manager or deputy and the monthly progress reports they write with the participation of each person who uses the service. The staff member also said that support plans are live documents that are constantly reviewed and amended to reflect individuals changing needs and goals. We had received a completed survey questionnaire from each person who lives in the home. Two indicated that they usually make decisions about what they do each day, while the other person said they always do. The responses we received from the three health and social care professionals were all positive. All indicated that peoples social and health care needs were always properly monitored, reviewed and met by the service and that the service always responded to the diverse needs of individuals. Asked what does the service do well, one health and social care professional told us the home are working well with a person who can present challenging behaviours. With regard to this the service have asked for a review and have as a consequence of that review, re-written care plans to advise staff. The home are working in collaboration with the medical team and the clients parents on a management plan, the result of which is that the clients behaviours are improving. Another health and social care professional said The service is very person centred, whilst also providing the structure and support that the residents need. The staff input is appropriate to the developmental level of the residents and the staff are showing their skill at working with young people with a learning disability who have a history of complex and chaotic lifestyles. This person added This new home has had an excellent start. Suzi Welsh and her team are clearly dedicated to meeting the needs of the residents and developing their skills, so that they can achieve more independence Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: in the future. The health and social care professional added that the home has a good atmosphere and there is a commitment to the people who live there. Three members of staff completed our survey questionnaire. All indicated that they are given up to date information about the needs of the people they support or care for. All of the staff members indicated that they feel they have enough support, experience and knowledge to meet the different needs of people who live at the home. This was further confirmed by the comments about staff and managers from the three health and social care professionals who completed our survey. Care Homes for Adults (18-65 years) Page 13 of 30 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 service is run in a way that ensures daily life is flexible and focused on the needs and wishes of the people staying there, who are supported to make choices and to develop their life skills. The home ensures that a range of social activities, community access and support with maintaining relationships are available to people who use the service. Evidence: During our visit we saw that support planning put an emphasis on the development of individuals skills for daily living and more independent lifestyles. This is in keeping with the homes Statement of Purpose. A member of staff we spoke with was very clear about keeping the aims of the service in mind, for example when supporting people out in the community this time would be used for working with individuals to develop budgeting skills. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Since the home opened the manager and staff have been building up a resource folder and knowledge of community facilities and services. People who use the service are supported to follow their interests, for example going to dance classes, the theatre and taking up horse riding again. We were shown photographs of a night out that the three people who live in the home had obviously enjoyed. We were told of a planned restaurant night in the home, which was being held in order both to have fun and practice social skills. We saw detailed key worker reports evaluating the outcomes of supported activities, which again confirmed that staff are clear about the aims of the service being provided. The manager told us that staff are talking to people who live in the home to see if they are interested in doing any college courses at the next intake. During the time of our visit we saw two people independently using the communal computer in the conservatory. The importance of specific family and personal relationships are documented in the support plans for each individual and support is given to maintain these links in appropriate ways. One person who uses the service told us about how she is able to do this and how the home supports her in this respect. At the time of our visit, the deputy manager attended a meeting with external agencies in order to improve opportunities for contact for this individual, which resulted in a positive outcome. We observed that peoples dignity and rights are respected in their daily life in the home. An atmosphere of mutual respect and inclusiveness between service users and service users and staff was very apparent throughout our visit. One individual talked to us about taking responsibility for doing things around the house and was aware of health and safety in the home. A list of daily tasks was on the wall in the kitchen and each person wrote their initials next to each task they chose to do, to make sure that tasks are rotated fairly. Another person showed us where the staff keep records of fridge temperatures and was aware of the need to test the temperature of cooked food and how this was done. This again demonstrated a focus on people learning skills through everyday activities. One of the people who live in the home told us she goes to bed when she likes. A staff member told us that each person who lives at Jaden House receives their own mail and can ask staff for support in dealing with any issues. We saw a poster on the kitchen wall advertising a Christmas meal event and this had been signed by both staff and people who use the service to say they were going. The people who use the service are supported to help plan and prepare meals and mealtimes are flexible to suit their activities and schedules. During our visit we saw individuals making their own lunches at times that suited them. The manager told us how people who live in the home are encouraged to eat healthily and to budget and Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: plan meals. We saw further evidence of this when one individual who was taking part in meal planning checked in the fridge and freezer for the dates when various food items needed to be used. The three health and social care professionals who took part in our survey indicated that the service always support people to live the life they choose wherever possible. People who use the service all said they can do what they want to do during the day, in the evening and at the weekend. In our survey we asked staff what could the home do better. One staff member suggested Get more involved with things in the local area, while another said doing more out of house activities. A third staff member told us with more activity funding, staff could be more creative with the activities and resources we could get get service users involved in. At Jaden House we do endeavour to give the service users a well rounded experience even though we have a limited budget. Care Homes for Adults (18-65 years) Page 16 of 30 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. People who use the service receive personal and health care support in the way they prefer and require. They are supported to retain, administer and control their own medication where appropriate, and are protected by the homes policies and procedures for dealing with medicines. Evidence: Support plans gave details of how each person prefers to be supported and we observed a good rapport between people who use the service and staff. Staff members interacted with the people who live in the home in a sensitive and respectful manner and communicated well, promoting a friendly and inclusive atmosphere. One of the people who use the service talked to us about having key workers and how they are known as buddies, who are there to provide support. We saw that each person had an initial health action plan and the manager told us that she is looking for different formats for these, as not everyone who lives in the home liked the current format. However, each individuals health related needs were well documented in their support plans, including records of appointments and the outcomes of these. The manager had notified us when one of the people living in the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: home had become unwell and told us about the actions the service had taken. The person concerned said she was feeling better now. We saw how people who use the service are supported to manage their own medications, when these are required, in ways that suit each individual. This is based on an assessment of any risks involved. Each person has a safe in their room where they can store their medication when needed. One individual tells staff when they have taken medication and staff then record this. Another person writes on their activity records when they take medication. We saw the home keeps records of medications coming into the home and those returned to the pharmacist. There is a suitable medication cabinet in the office including a facility for storing controlled drugs if these are prescribed. The four staff members who took part in our survey indicated that they receive training that gives them enough knowledge about health care and medication. A member of staff we spoke with told us they had received basic theoretical and practical training in managing medications through a pharmacy and that refresher training is booked. The manager is scheduled to attend more in-depth training. Prior to our visit we received responses to our survey questionnaire from three health and social care professionals. All said that the service always seek advice and act on it to meet peoples social and health care needs and improve their well-being. All said that the service always support people to administer their own medication, or manage it correctly where this is not possible. All told us that the service always respect peoples privacy and dignity. Care Homes for Adults (18-65 years) Page 18 of 30 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 views of people who use the service are listened to and acted on and they are protected from abuse, neglect and self harm. Evidence: The AQAA told us that the home has not received any complaints and there have been no safeguarding referrals or investigations. During our visit we saw that there is a clear and accessible complaints procedure and the home has a copy of the local authority safeguarding procedures. A staff member we spoke with knew about these policies and procedures and was clear about her responsibilities in relation to reporting and recording any issues or concerns. We observed that there is an open and friendly atmosphere in the home and that people who use the service felt free to express their views. Two of the three people who use the service and completed our questionnaire indicated they know who to speak to if they are not happy. All said they know how to make a complaint. The four staff members who responded indicated that they know what to do if someone has concerns about the home. The three health and social care professionals told us that the service always respond appropriately if they or another person have raised any concerns. Support plans gave details about how each person manages their finances and the different levels of support the home provides for this. Clear records are kept of any Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: transactions involving peoples money. The home have kept us notified about any incidents that may affect the safety and welfare of people who use the service. These notifications show that the service have responded appropriately to situations and managed them well. The sample of support plans we saw contained guidance for staff on working with individuals occasionally challenging behaviour. A staff member we spoke with told us about training they had received in dealing with such challenges and said they would not expect to use any physical interventions. This is in line with the homes policies. Care Homes for Adults (18-65 years) Page 20 of 30 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. People who use the service benefit from living in a homely, clean and comfortable environment. Evidence: Jaden House is a domestic property located in central Totton and is a short walking distance from shops and local services. The environment is homely and comfortable and we saw that the three people who currently live there have settled in well together. Through talking with two of them it was evident that they have a sense of ownership, for example in the way they take part in the daily running of the home. Private accommodation is made up of five single bedrooms, all with lockable doors and hand washbasins. One bedroom measures slightly less than the national minimum standards and this is highlighted in the Service User Guide. This also states that the home does not offer en suite bedrooms because it is intended as a short stay transition service. As well as their personal mobile phones, people who use the service have access to a cordless phone and so phone sockets have not been routinely fitted in the bedrooms. The home has one communal lounge, a large kitchen/diner and a conservatory/diner. Upstairs there is a bathroom and toilet and a separate shower room and toilet. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Downstairs there is another toilet with hand washbasin. The premises were well maintained and furniture and fittings were of a good quality. There is a well-kept rear garden. Radiators covers have been fitted throughout the house and the AQAA confirmed there are individual risk assessments in place with regard to the use of window restrictors. The home has a utility room equipped with a washing machine, dryer and separate sink and hand washing facility. We observed a good standard of cleanliness throughout the building. People who use the service indicated in our survey questionnaire that the home is always fresh and clean. Care Homes for Adults (18-65 years) Page 22 of 30 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. People who use the service are supported by appropriately trained and supervised staff and are protected by the homes recruitment policy and practices. Evidence: The AQAA told us that staffing levels are regularly reviewed to meet the needs of the service users and to provide the 1:1 support that is included in the core hours. Two of the staff completing our survey indicated that there is always enough staff to meet the individual needs of all the people who use the service. Another said there usually is and another did not complete this part of the survey. We observed that the three people who currently use the service were well supported by staff throughout the day. The AQAA also said that staff have clearly defined job descriptions that link with the aims and objectives of the service. This was further confirmed through our discussion with a member of staff and reading some of the key workers evaluations in the support plans. Comments received from staff through our survey questionnaire also demonstrated a commitment to the aims and values of the home. The AQAA stated that all potential staff members have the required checks completed before working in the home and are subject to a three month probationary period. During our visit we looked at the personnel files of two staff members. These showed that Protection of Vulnerable Adults (POVA First) and Criminal Records Bureau (CRB) Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: checks had been carried out by the service in relation to each individual before they started working in the home. Identity photographs, completed application forms and two written references were seen in relation to each staff member. The service also ensures that staff members are checked in relation to working with children, as it is possible that people under the age of eighteen could be referred to the service. Records of probationary period reviews and formal supervision meetings, along with terms and conditions of employment and guidance on the role of key worker, showed the management sets clear expectations of what the service wants to achieve. The member of staff we spoke with told us that people who use the service are involved in the staff recruitment process. The manager reported that two of the six care and support staff currently have a National Vocational Qualification (NVQ) in health and social care at level two or above. The manager has plans to put more staff members forward for NVQ training following the completion of their probationary reviews. We saw certificates of induction training linked to the Common Induction Standards and records of further mandatory and service specific training. This included health and safety, first aid, moving and handling, food safety, fire safety, medication, understanding abuse, equality and diversity and primary prevention (understanding and dealing with challenging behaviour). Conflict resolution training was scheduled for January 2010. The AQAA told us that the Behaviour Resource Manager provides ongoing training to staff to enable them to understand learned behaviours and to be able to link this with behaviours that could have occurred through past experiences. Training to prevent physical and verbal aggression by acknowledging ones own body language and tone of voice and effective communication that reduces the risk of this behaviour. All the staff taking part in our survey confirmed that their employer carried out checks and references before they started work in the home. Asked if their induction covered everything they needed to know to do the job when they started, three told us it did very well and one said it mostly did. Staff completing our survey indicated that they are being given training which is relevant to their role, helps them understand and meet the needs of people who use the service, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. All told us that their manager gives them enough support and meets with them regularly to discuss how they are working. The three health and social care professionals indicated in our survey that the homes managers and staff always have the right skills and experience to support peoples Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: social and health care needs. Two of the people using the service indicated that the staff always listen to them and act on what they say and the other said they usually do. Care Homes for Adults (18-65 years) Page 25 of 30 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. People who use the service benefit from a well run home and their views underpin the self-monitoring, review and development of the service. The health, safety and welfare of people who live in the home and staff are promoted and protected. Evidence: The registered manager is also the owner of the home and has the NVQ level 4 in Health and Social Care and the registered manager award (RMA). Mrs Suzanne Welsh also has previous experience of managing residential services for younger adults. During our visit we observed that the manager communicates a clear sense of direction and leadership, which staff and people who live in the home understand and are able to relate to the purpose of the service. The management approach of the home creates an open, positive and inclusive atmosphere. The AQAA told us that the home is currently implementing quality assurance surveys for staff, service users and their families to gain feedback and enable them to improve the service. During our visit we saw records relating to house meetings held in October and November and the manager said that the next meeting will be chaired by Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: a person who lives in the home. We received positive feedback about the service from the people who live there, members of staff and health and social care professionals who took part in our own survey. We saw records indicating that safe working practices are promoted and maintained in the home. For example, the fire log book was up to date and there is an emergency evacuation plan and detailed fire risk assessment. Records are also kept of servicing carried out on equipment, systems and appliances. People who use the service demonstrated their knowledge of the health and safety procedures in the home. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 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 30 of 30 - 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!