Care Home: Jubilee Mews

What the care home does well The home is very well managed, the manager and the staff team have a positive approach to providing good support to the residents. They are particularly successful at treating people as individuals and using each person`s unique strengths, abilities and past experiences as a means to moving them toward recovery and a better life experience. The staff are interested in developing better ways of working with people by keeping their nursing practice up to date and informed by current developments in mental health research. Staff commitment and moral is high and the organisation works at developing the good working practices and team work. The staff team has work hard at developing relationships with other professionals involved in the lives of people living at the home. Staff are given good training and receive regular supervision to make sure that they are knowledgeable, skilled and confident in the roles they undertake. There is a very low level of staff sickness and staff turnaround. The records are very good including good pre admission assessments, and good standards of care plans which set out how the home intends to meet the needs of people using the service. There are good arrangements in place to review and monitor peoples placements to ensure that the services being provided were effective. There are good social networks both in the service and outside. The gardening project works well at enabling people to engage in work in a safe and well supported setting. It allows people to earn a wage, exercise, obtain positive work experiences and to see the results of their work. Staff work flexibly so that people could enjoy everyday social events without feeling constrained by staff needing to get back to the office because their shift was over. Staff support people to take sensible risks and to make choices and decisions that had a positive effect upon their lives. They are supported to take part in activities available in their local community, work to obtain financial reward and increase and develop positive relationships with the people they live with and to engage in social events arranged at the home. People living in the home said that they were "happy" with the support they get from the staff and that they had the opportunities to "say what they feel about things". They also said that staff were kind, and that they enjoyed living at Jubilee Mews. What has improved since the last inspection? Since the last inspection there has been an improvement in the way that staff make sure that they are fully aware of, and implement, all, medication care plans correctly, making sure that people receive the support they need to administer their own medication safely. The vulnerable adults policy and procedures now fit with the local authority`s safeguarding duties and responsibilities to make sure that staff are clear about what action they should take to protect the vulnerable adults in their care. What the care home could do better: No requirements or recommendations were made as a result of this inspection. The Manager continually works toward developing the quality assurance process so that they can make ongoing improvements to the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jubilee Mews 15-21 Jubilee Road Gosforth Newcastle Upon Tyne Tyne & Wear NE3 3DX     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: Suzanne McKean     Date: 1 9 0 5 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Jubilee Mews 15-21 Jubilee Road Gosforth Newcastle Upon Tyne Tyne & Wear NE3 3DX 01912130988 01912131115 admin@mentalhealthconcern.org www.mentalhealthconcern.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mental Health Concern care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Mental Health Concern is a `not for profit? organisation which provides mental health care to adults living in community houses and other residential settings. Jubilee Mews is a registered nursing home that provides accommodation and support to 12 adults with enduring mental health care needs. The home is staffed 24 hours a day by registered nurses and support workers. The home comprises three houses, each with four bedrooms, located in the Gosforth area of Newcastle. The home provides the people living there with easy access to local facilities and transport links. Each house has a lounge, kitchen/dining area, four bedrooms, a bathroom, toilets and a shower room. There is also a conservatory and a large garden to the rear of each property. Mental Health Concern nursing services are commissioned via Service Level Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 12 Brief description of the care home Agreement by NHS statutory agencies and form an integral part of the localities health services. Therefore no direct charge is made to any prospective resident who is referred to our registered Nursing Homes. A notional total bed cost can be attributed. 07/08 budgets range from approximately £850 to £950 per bed/per week. The most recent inspection report was available on request to people living at the home, their families and visitors. Staff and people using the service are made aware of inspection outcomes during staff and householder meetings. Information about fees charged is included in each persons contract with the provider. Care Homes for Adults (18-65 years) Page 5 of 30 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Summary: This is an overview of what the inspector found during the inspection. How the inspection we carried out:- Before the visit we looked at, the information we have received since the last visit on 15th May 2007. Care Homes for Adults (18-65 years) Page 6 of 30 How the service dealt with any complaints and concerns or protection of vulnerable adult issues since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. Used surveys to find out the views of residents their relatives or representatives and professionals who visit the home. The visit: An unannounced visit was made on 19th May 2009, this visit was carried out over 7 hours. During the visit we: Talked with people who use the service, the staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at the records which must be kept. Checked the staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building and parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? Since the last inspection there has been an improvement in the way that staff make sure that they are fully aware of, and implement, all, medication care plans correctly, making sure that people receive the support they need to administer their own medication safely. The vulnerable adults policy and procedures now fit with the local authoritys safeguarding duties and responsibilities to make sure that staff are clear about what Care Homes for Adults (18-65 years) Page 8 of 30 action they should take to protect the vulnerable adults in their care. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents needs are cleary identified during a good comprehensive pre admission assessment, and they are given the necessary information to help them make up their mind if it is the appropriate service for them. Evidence: The home has a good service users guide that provides a good level of information to service users in an easily understood format. It contains the necessary information about the staff and manager of the home. The people deciding if they wish to use the service can visit the home and they are all given a copy of the service users guide. The residents said that they had a contracts and examples were seen in service users records. The placing authority carry out their own assessment and the home do their own assessment of needs independent to this. Records contained both assessments and this provided a comprehensive picture of service users needs, including social, spiritual and aspirational needs. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The way that people move into the home can be gradual and can be structured in a way that meets the needs of the individual. The records and discussion with the staff show that there have been examples where extensive work has been carried out with residents prior to their admission to make sure that they will benefit from the placement. This has involved joint assessments with other agencies to look at the persons possible progress through different services. This gives a longer term plan for the individual and supports them to maximise there potential to live more independent lives in line their their choices and abilities. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Very good care planning and review processes make sure that staff are clear about how they should meet the health, personal care and mental health needs of people using the service. This is done in a way that respects their views and supports them to retain control over the way they live their lives. Evidence: All of the people living at the home have a care plan that has either been agreed with them and the records show this through them signing them. The care records looked at were easy to understand and had been written in plain English. The residents spoken to were aware of the contents of their plans and understood the purpose of them. Each of the residents have a key worker and one said that if they have any problems understanding what was written about them, their key worker would spend time trying to help them understanding them. The care cover areas such as information about peoples lives before they came to live Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: at Jubilee Mews, and an assessment of peoples needs in the seven key areas promoted in the home of independence, choice, fulfillment, privacy, dignity, rights and citizenship. All care plans had been reviewed regularly and they clearly identify how the service would meet peoples needs and support them to maximise their independence and develop their skills and abilities. There are good records of how residents are encouraged to express their choices and work in partnership with staff to make decisions in all areas of their lives including medication management, diet, holidays, and how they spend their day to day lives. They are supported to live actives lives in line with their previous lifestyles, interests and aspirations. Appropriate risk assessments are carried out although they are encouraged in positive risk taking by looking at issues such as medication or when residents stay over at friends houses. The care plans are reviewed monthly with the resident and this is the opportunity for them to identify it it continues to be appropriate and if any changes need to be made. Full annual re-assessments are carried out. The homes key worker system makes sure that there is a supportive relationship with people using the service and the staff. It was clear that staff understood the benefits of involving people in the preparation of their assessments and care plans. People had signed the information contained in their care records to confirm their agreement with the contents. Mental Health Concern, has in the past, provided its staff with guidance on how to assess and manage risks. The records in the care plans show that where risks had been identified they plans were put in place. There were also assessments for physical care were also in place around areas such as nutrition and healthy lifestyle choices. There was evidence that the manager and his staff team understood the importance of people being supported and encouraged to take control of their own lives and make their own decisions and choices. Care Homes for Adults (18-65 years) Page 14 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. There are very good arrangements to support people to live active and fulfilled lives in line with their rights, choices, abilities and previous lifestyles. They are supported to maintain contact with their families and friends and are given assistance when necessary to maintain a healthy lifestyle. Evidence: People living at the home had been provided with opportunities to develop and maintain important personal and family relationships. The care plans contain information about peoples families and friends. Staff support the individual residents to assist them to maintain positive contact with their relative. People spoken to did not feel that they were subject to any restrictions in the way they receive their visitors but understood that they lived in shared accommodation and the way this had to be taken into account to maintain other peoples privacy. The home has a visitors policy which was known to the staff and the residents. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: There was very good evidence that service supports people to join in meaningful daytime activities of their own choice. This included a number of opportunities in the local community and the use of facilities available to all residents of the area. Residents also accompany staff to do the weekly shop which is planned by the group. People in the houses are supported to regularly attend various local social clubs and projects and they are encouraged to participate in local community activities and events. These include the Welford Day Centre, Rowan Project, Clubhouse, Key Enterprises, Workfirst and Womens Groups. Staff try to foster residents relationships with their family and friends. Residents use local amenities such as General Practitioners, chemist, supermarkets, pubs, cafes. One resident said I can do the things that I am interested in but dont have to do things just because other people do it. Two residents were on holiday on the week of the visit, they had chosen the destination they wanted to go to. The resident who had not gone with them said that she had decided not to go on this occasion but had agreed to have day trips and spend her time in other ways. Assessments completed by staff contained information about how people using the service viewed their own rights and, what had prevented them from fully exercising those rights in the past. Residents are expected to be responsible for the day-to-day running of their house and to comply with the terms of the Mental Health Concern license agreement. The manager confirmed that qualified staff had made decisions to curtail the freedom of some people living at the home to protect their mental and physical well-being. These decisions had been agreed between the person concerned and their key worker, following which a care plan had been put in place. These are reviewed during six monthly review meetings. There was a discussion with the manager about the way that the home will include the Deprivation of Liberty Act, good practice guidance into the way that the care planning is carried out. There was an expectation that people using the service would be involved in the domestic routines of their house and in the planning and cooking of their meals. Residents said that they were expected to help out with the shopping and carry out their household chores. A sample of menus was examined. The menus covered the main meal times and included details of the range of foods and beverages available at the breakfast and supper time meals. There was evidence that the home promoted healthy eating and one resident had been supported to lose weight by eating healthily. Each of the people interviewed said Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: that they were very happy with the quality and variety of food served at the home. Care Homes for Adults (18-65 years) Page 17 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. There are good systems in place to support people living in the home have their health care needs met in a way that is well planned and supports them to lead healthy lifestyles. Evidence: The homes statement of purpose included information about how the health care needs of people living at the home would be met. The residents health care needs are overseen and managed by qualified nursing staff. The staff are knowledgeably about how people using the service were supported to maintain better physical and mental health, through their day to day lifestyle choices and through good care planning. Information about peoples health care needs had been recorded in their care records. They show that medical advice is sought from a variety of sources including physiotherapists, General Practitioners and dietitians. Residents said that that they had been assisted to attend hospital and GP appointments when they needed to. The residents are supported in very individual ways and the staff are aware of the needs of the residents and how they will be met including the way that the person has Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: their preferences were taken into account. Arrangements were in place to provide support workers with health care training where a need to do so is identified. Members of the qualified nursing team usually provide this training. The manager has told us that the staff have worked alongside residents and other professionals to produce advanced directives of care and the care plans show this. There are examples of where staff have involved Independent Mental Capacity Advocate services to assist a resident to move on to a more appropriate service, and one resident has ongoing advocate support. Mental Health Concern had developed a policy that staff were expected to follow when administering medication. The cupboard used to store medication was clean and hygienic. All medication had been properly secured. Photos to identify each person were available in their care records. Records were in place covering the ordering, receipt, administration and disposal of medicines. Controlled drugs were not being administered at the time of the inspection. Only qualified nursing staff administered medication. Some of the people living in the home are encouraged to take part in managing their medication, by collecting their medication from the pharmacy and/or by holding a weeks supply to take themselves. This follows a risk assessment and the development of a plan. Peoples competence to administer their own medication had been reviewed and their care plans reviewed and modified. The manager confirmed that there is a procedure for fully investigating any medication errors and that staff are provided with support to ensure that any incidents do not reoccur. Care Homes for Adults (18-65 years) Page 19 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 arrangements in place for handling complaints were satisfactory and people were confident that their complaints would be listened to, taken seriously and acted upon. Satisfactory arrangements were in place to protect people from harm or abuse. This meant that people could feel safe and protected in their own home. Evidence: There are good complaints policies and procedures, that was easy to read and understand as they are written in plain English. All people who move into the home are given the information about how to complain and staff are expected to go through the homes complaints procedure with each person on a six monthly basis. There are no people accommodated who require the homes complaints procedure to be made available in a different format. The complaints procedure provided staff with guidance about how to handle complaints. People living at the home said that they would be happy to raise any concerns they might have with the manager or a member of the staff team. One resident expressed some concerns during the visit about the way that the funding for food is organised. He had raised this using the homes procedures and he was satisfied that the issues were being looked at. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The providers safeguarding policy provided staff with guidance about how to handle adult protection concerns. There has been one incident when a issue was considered under the protection of vulnerable adults procedures however this was not pursued under the process as it was judged to be a mental health issue rather than a protection issue. All staff had received training in the protection of vulnerable adults. The qualified staff have received more in-depth training in the protection of vulnerable adults. People living at the home said that they felt safe and secure. Staff spoken to were able to satisfactorily describe the action they would take to protect people from potential harm or abuse. Care Homes for Adults (18-65 years) Page 21 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. The houses provide good quality housing, furnishings and fittings meaning that people can live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: The home consists of three detached houses on a street in a predominantly residential area of Gosforth in Newcastle. Each house has a garden and parking area to the front of and very large gardens to the rear. They are all designed in similar ways with four bedrooms in each house a shared lounge and kitchen. There are shared bathroom and toilets. The houses had been adapted to meet the needs of the people living there. For example, there was a ramped access to each of the houses. There are currently no residents who require any specific aids or adaptations although the individual way that care is planned would make sure that these would be provided if necessary. An adapted shower room was available in each house but no other bathing aids are required at present. There are no shared bedrooms and those visited were well maintained and had been decorated to the taste of the resident. The people living in the home are given a key Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: to their bedroom door so that they can keep their rooms private. One person said that their bedroom was lovely and that they chose the color of the walls and had bought the soft furnishings themselves. People use the communal space in their leisure time where they could mix with others and watch television. Each house had a conservatory and lounge area. People choose to see family and friends in the privacy of their own bedroom or in the communal areas. Although the furnishings and fittings provided in each house were of a good standard, some places would benefit from re-decoration and some furniture needs replacing, these have been identified by the manager as part of the quality assurance process and there is an action plan in place to address them. The houses were clean and well organised and there were no hazards evident. The manager and the staff are vigilant about health and safety and take advice from outside agents as necessary. The home had an infection control policy. Staff had completed an infection control checklist to ensure that problems in this area were minimised. Each house had its own laundry facilities and all staff have received infection control training. Care Homes for Adults (18-65 years) Page 23 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. The home employs knowledgeable, skilled, well trained and supervised staff. They have been recruited using good procedures, in sufficient numbers to make sure that the people living in the home can be supported and cared for safely. Evidence: The service has a stable staff team and a number of the staff have worked in the home for a number of years. There are adequate numbers of staff employed and the rota show that the staffing levels are consistently maintained. Generally staffing for the three houses are, seven am to nine am, one member of staff - nine to five between four and five staff depending upon what is happening in the day, five to eight thirty pm, one member of staff, and eight thirty to seven thirty, two staff, one of which provides waking night cover. This varies at the weekends depending upon the activities of the residents. At the time of the visit staff were also on holiday with residents. Housekeeping cover was available Monday to Friday. The rotas showed that extra staff were available during busy times of the day to cover such things as staff training, meetings and medical appointments. A member of staff felt that sufficient staff were rostered on duty until 5pm and this allowed staff to support people to be independent Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: both within the home and in the local community. On-call cover is available outside of office working hours and was provided by qualified staff. The turnover of staff was low and there were no vacancies. Mental Health Concern relief staff had occasionally been used to cover shortfalls in the homes rota. People living at the home felt well supported by staff. No concerns were expressed about the conduct of staff. Staff had access to a comprehensive training programme that used both in-house and external training providers. There is a very good on line system for the manager to look at the regular notifications of available training courses. The programme covered the mandatory and specialist training needs of both qualified and non-qualified staff. The manager had access to a database that enabled him to track when staff needed to update their training. A sample of two staff training records were examined and it was noted that all staff had up to date training in the following areas, moving and handling, first aid, basic food hygiene and fire safety. They had completed health and safety training and one person needed to complete this training. An analysis of staff training needs had been done as part of their annual appraisal. Mental Health Concern have strategies to encourage good team work and have had a Time Out Day to give staff the opportunity to discuss issues relevant to the future of Jubilee Mews and bond as a team. Mental Health Concern had a robust recruitment and selection procedure and information required to confirm that newly appointed staff had been subject to rigorous pre-employment checks was not available within the home. However these were made available very quickly. In the sample of staff files examined, there was evidence that all of the information needed to make the decision to employ were available including, an application form, Criminal Records Bureau disclosure checks and verification of identity, a contract of employment, and a disclosure statement of any convictions or cautions as well as two written references for each applicant. Staff meetings had taken place approximately every six to eight weeks and detailed minutes had been kept. There was evidence that staff had received regular structured supervision. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides a clear sense of leadership and very good management resulting in a safe well run home, which takes into account the views of residents and staff and is run in the best interest of the people living there. Evidence: The manager is a qualified registered mental health nurse and had obtained the Registered Managers Award. Mr Jones has extensive experience of working with adults with mental health care needs in a variety of settings. There is also a deputy manager in post who has extensive experience and has also achieved the Registered Managers award. The staff of Jubilee Mews work very well together to improve the quality of life experienced by people using the service. Staff felt that the manager ran the home in an open and transparent manner. The home offered care that was focused on the needs of the people living there and staff had established good working relationships with families and other professionals. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The manager was aware of current developments in his own field and showed a good insight into changes in legislation that would impact on the service they are providing. Mental Health Concern provides it staff with access to an in house journal club. A member of staff scans professional literature to identify articles that might be of interest to staff working at the home. Unannounced visits to monitor the quality of care and support provided at Jubilee Mews are carried out by the Mental Health Concern Chief Executive every two months. The providers Practice Standards Manager also visits the home on a monthly basis to carry out a quality audit. All staff receive regular supervision. The home has student nurses for their clinical placements and exit interviews are held with them as part of the strategy to monitor the quality of the clinical support given during their placement. People living at the home work in partnership with staff during the nursing process from assessment through to evaluations of care plans. Mental Health Concern has a Service User and Carer Board and two of the people at Jubilee Mews are active members. The providers Visitors Policy was changed following comments made by people attending Board meetings. The home has good records of accidents and these are well completed. There is a range of health and safety records kept although they were not examined at this inspection. The provider had a detailed and comprehensive health and safety policy and supportive documentation. A tour of the premises identified no health and safety concerns. A range of health and safety monitoring tools had been used to check that the building was safe for people to live and work in. These covered areas such as the safety of electrical appliances through to the use of computer equipment. An audit of the homes fire records was undertaken and it was confirmed that the required fire prevention checks had been completed. The home has a fire risk assessment and staff received fire instruction, and participated in fire drills, at the frequency recommended by the fire service. A range of workplace risk assessments are in place. External contractors are used to check that the thermostatic valves controlling the temperature of hot water supplied to the homes bathing facilities are working satisfactorily. The finance records of the people using the service were well maintained and are audited regularly. 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 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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