Care Home: Kalmia & Mallow

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What the care home does well Prospective service users are provided with good quality information about the home, in different formats and people have the opportunity to visit the home and have detailed needs assessments carried out before they move in. Care plans are reviewed and updated regularly and the contents are very clear and descriptive. The people living at Kalmia and Mallow are supported very well to make decisions about their lives and take risks as part of an independent lifestyle. The people living at Kalmia and Mallow are able to take part in a wide range of activities that suit them and be part of the local community. People are very positively supported to have and maintain good relationships with their family and friends and their rights and responsibilities are respected and recognised in their daily lives. The menus are flexible and varied and the people living at Kalmia and Mallow are offered a healthy diet and enjoy their food. Personal support is provided in the way people choose and the care provided is very `person centred`. People`s physical and emotional health needs are met and they are protected by the home`s medication policies and procedures. Complaints are recorded and dealt with appropriately, in accordance with the service`s complaints procedure and staff are well trained in areas such as adult protection and medication. Kalmia and Mallow are homely, comfortable and safe environments for people to live in. Service users are supported by a competent, well trained and effective staff team and the service follows robust recruitment procedures. Kalmia and Mallow are well run homes and the people living there benefit from good quality leadership and day-to-day management, People are genuinely living in their own homes, with their best interests, health and happiness being absolute priority to the staff and management. What has improved since the last inspection? The provision of a specialist bath has been completed, in accordance with a previous requirement. The sensors fitted to external doors have been repaired, as required.The garden area has been tidied considerably and a small memorial garden for service users to remember their loved ones has been created. Communication dictionaries have been compiled to help support people better, who don`t use words to talk. The staff team and management structure is far more stable. What the care home could do better: Kalmia and Mallow continue to meet the national minimum standards and, in some cases, have exceeded them. The two previous requirements have been addressed and there are currently no improvements or suggestions to put in this section. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kalmia & Mallow Dereham Road Watton Thetford Norfolk IP25 6HA     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: Debra Allen     Date: 3 0 0 6 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 31 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 31 Information about the care home Name of care home: Address: Kalmia & Mallow Dereham Road Watton Thetford Norfolk IP25 6HA 01953884597 01953883458 kalmia.mallow@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Conquest Care Homes (Norfolk) Limited Name of registered manager (if applicable) Mrs Nanette Jane Phillips Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Kalmia and Mallow are two interlinked, six bedded bungalows on the outskirts of Watton. Care is provided for up to twelve young adults with a learning disability. The focus of one of the bungalows is on supporting service users with specific behavioural needs. In the other house, staff assist people with quite profound needs, including physical disabilities. The accommodation is purpose built and all on the ground floor. The houses are set in a hollow with quite high banks on three sides so the outlook is restricted. One of the bungalows has a large garden. The other bungalow has a very small area at the back. The service users each have a single bedroom and in both bungalows there are shared bathrooms, lounges and dining rooms. There is parking to the front of the bungalows. The home is owned by the Craegmoor Healthcare organisation and is being managed on a day-to-day basis by Mrs Nanette Phillips, who has successfully completed her registration as manager with the Commission. The fees Care Homes for Adults (18-65 years) Page 4 of 31 12 Over 65 0 care home 12 Brief description of the care home are variable and calculated according to each persons individual needs and care/support requirements. Care Homes for Adults (18-65 years) Page 5 of 31 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: Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. The fieldwork of this inspection was carried out over a period of seven hours, during which time a number of people living at Kalmia and Mallow were observed and spoken with and a tour of the premises was undertaken, which included seeing some peoples personal rooms. Discussions were also held with some of the staff, the manager and Care Homes for Adults (18-65 years) Page 6 of 31 deputy manager. Various records were looked at in detail, which included Person Centred Care Plans (PCCP), staff files and other records relating to health and safety. Meanwhile, a well completed and detailed Annual Quality Assurance Assessment (AQAA) was returned to The Commission, as requested, prior to this inspection. Three service user surveys were also completed and returned, all of which contained positive responses. No requirements or recommendations have been made as a result of this inspection. What the care home does well: What has improved since the last inspection? The provision of a specialist bath has been completed, in accordance with a previous requirement. The sensors fitted to external doors have been repaired, as required. Care Homes for Adults (18-65 years) Page 8 of 31 The garden area has been tidied considerably and a small memorial garden for service users to remember their loved ones has been created. Communication dictionaries have been compiled to help support people better, who dont use words to talk. The staff team and management structure is far more stable. 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 31 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 31 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. Prospective service users are provided with good quality information about the home, in different formats, so they are able to make an informed choice about living there. People have the opportunity to visit the home and detailed needs assessments are completed before they move in. Evidence: The care plans looked at during the inspection contained copies of needs assessments, which also included detailed risk assessments and very descriptive personal profiles, all of which were noted to have been completed prior to people moving into Kalmia and Mallow. Three service user surveys were completed returned to the Commission prior to this inspection and some of the additional comments confirmed that people were able to visit the service before moving in permanently. Discussions with the manager and deputy, observations and comments provided in the Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: Annual Quality Assurance Assessment (AQAA) confirmed that each the service users care plan is built around the completed needs assessment form, which then forms the Person Centred Plan, which helps to promote each persons dignity and ensure their choices are met. It was also confirmed that two of the most recent service users used the overnight/day visits to help them with the moving in process. Kalmia and Mallow were seen to provide a brochure and pre-admission pack, which is available in alternative formats and each person was noted to have been given a copy of the Service User Guide. Care Homes for Adults (18-65 years) Page 12 of 31 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. The people living at Kalmia and Mallow have their changing needs and personal goals reflected in an individual plan of care, they are able to make decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: A number of care plans were looked at in detail and individual observations and discussions were held with several people, which helped to confirm that the contents of the plans were accurate. The Person Centred Care Plans (PCCP) were seen to be put together in a well organised manner, which helps to make it easy for staff and service users to access relevant information and review and/or update it and help to ensure consistency of care. The sections in the care plans were seen as follows:Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: (1) Consent to share confidential information with others - these were seen to have been signed by the individual service user wherever possible, or by a relative on their behalf, if unable to. (2) Personal Details - which included name, address, date of birth, brief physical description, medication and individual support needs such as; mobile/non-mobile, has understanding but no speech etc. Also, religious support needed, such as I wish/do not wish to go to church and support needed in respect of ethnic origin, such as I love Christmas and would like the staff help me buy gifts for my family and for their birthdays. (3) On Admission - this section contained details about the person when they first moved in, such as skin condition, weight and medication. This information was seen to have been reviewed regularly and any changes noted. (4) Important People in my life - all the care plans seen were very descriptive and included photographs of relevant people, together with a short but detailed and informative life story. (5) Evaluation Dates - this confirmed the dates that sections (6) to (16) had been reviewed and all the care plans looked at showed that this was done regularly and consistently. (6) Relatives and Social Contacts - all information was seen to be clearly recorded. (7) Dates that are important to me - many of these included birthdays of current family and friends but some were also seen to contain dates for people who had died, if it was important to the service to be able to remember. It was noted for one particular person with high support needs that staff should assist the person to buy a birthday card for their relative, by offering them a choice so they can eye-point, then assist with writing it and take the person to post it. (8) What I Do - this section included information in respect of daily routines and activities, as well as hopes and wishes for the future. Some of the individual records seen showed how people have been and continue to be positively supported to achieve their goals. (9) Social Interaction - clear records were kept in this section, together with dates, all of which were seen to be consistently maintained and updated. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: (10) Health, Keeping Safe and Medication - all five care plans that were looked at in detail contained good quality, indepth information and descriptions of each persons individual needs and also included areas such as PEG feed, epilepsy and diabetes. (11) Finances - for people with higher support needs, clearly written guidance was seen to be available for staff to follow, together with detailed risk assessments. Money management assessments were also seen to have been regularly carried out and clearly indicated when someone was either becoming more or less independent in respect of their finances. (12) Personal Care - all care plans contained well compiled information of peoples individual needs including what/how/with who/where and when they wanted assistance with their personal care. (13) Mental Health and Behaviour - good information and descriptions were seen in this section, including evidence of regular reviews and updates as necessary. (14) Communication - excellent work was seen to have been carried out with the people living at Kalmia and Mallow in respect of communication, including peoples individual communication methods, their levels of understanding and what staff need to do. A lot of time and effort was also seen to have been put in to compiling Communication dictionaries, which included expressions, noises and mannerisms etc plus their meanings. It was stated that communication dictionaries have been designed to help support people who dont use words to talk. The dictionaries are not exhaustive and should be updated and added to as necessary. (15) Independence - gave good descriptions of peoples past and current abilities and methods of positively supporting people in order to further enhance their independence. (16) When I become sick - clear guidance for personal care, religious/cultural requirements, contact details and protocols. (17) Daily Entries - all seen to be respectfully written and gave good insight to individuals daily lifestyles. (18) Professional Visits - well recorded and descriptive in respect of person, purpose, outcome and any follow up required. (19) Contacts/Visit Sheets - consistently documented. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: (20) Charts - including seizures, bowel movements, weights etc. (21) Property Sheets etc. - seen to be added to appropriately. All of the above sections were seen to contain numerous supplemental pages (additional care plans), which showed how any changes were addressed and monitored and requirements met. Numerous risk assessments were also seen within most of the above sections, each of which was completely individual, regularly reviewed and updated and provided clear guidance for staff to be able to genuinely help support people to live their lives as they choose, whilst being protected from harm as much as possible but without restricting their lifestyles. Overall, from the evidence seen during this inspection, it was confirmed that the people living at Kalmia and Mallow are genuinely supported and encouraged to make decisions for themselves, take risks appropriately and live their lives as independently as possible. Good evidence was also available to confirm that residents meetings take place on a regular basis and that the people living at Kalmia and Mallow have their views included and listened to. Meanwhile, all the records and personal information relating to the people living at Kalmia and Mallow were seen to be stored securely in the staff offices, thus ensuring confidentiality. Care Homes for Adults (18-65 years) Page 16 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Kalmia and Mallow are able to take part in activities that suit them, be part of the local community, enjoy leisure activities as they wish and have good relationships with their family and friends. Peoples rights and responsibilities are respected and recognised in their daily lives. People living at Kalmia and Mallow are offered a healthy diet and enjoy their food. Evidence: It was evident from the records maintained, photographs, observations and discussions, that everybody living at Kalmia and Mallow is encouraged and supported to develop themselves as much as they want to, with empowering risk assessments in place to further help support this fact. Some of the educational, day-to-day living and leisure activities that were noted Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: included: Attending work placements, day/education centres, cooking, bowling, boat trips, swimming, bingo, shopping, beauty sessions, reflexology, paperwork, social gatherings, music, painting, fancy dress, playing darts, biking, hoovering other household tasks. It was noted that one person has designed and created name plaques for each of the Kalmia and Mallow bungalows and another has created a vegetable plot in part of the garden, which they are currently growing items such as runner beans, potatoes and peas. Peoples rights were seen to be particularly respected with regard to personal mail and it was noted that all personal mail is delivered to the individual person concerned and a statement was noted in the care plans which read: Every service user has the right to open up their own mail it was also stated that if a service user is unable to do this, staff are to deliver and open the mail with the relevant service user and read the content to them, a second staff member is to sign to confirm that this has been done. Each person was noted to be very genuinely supported to make and maintain friendships, and positive support of individuals sexuality was also noted. Although a mealtime was not actually observed during this inspection, evidence was seen in both of the bungalows, which confirmed that people have plenty of choices around what they want to eat, whilst being supported to maintain a healthy and balanced diet. Good records were also seen for people with special dietary requirements such as diabetes or PEG feeds. Some of the main options seen on the menus included cottage pie and seasonal vegetables, chicken casserole and jacket potatoes, Sunday roast with trimmings, fishermans pie and peas, liver and bacon casserole, sweet and sour chicken and rice, home-made burgers and chips. It was stated that each person is encouraged to give their input when designing the weekly menus. Also, that all menus are flexible and alternative meals are provided for on request. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Kalmia and Mallow receive personal support in the way they prefer, their physical and emotional health needs are met and they are protected by the homes medication policies and procedures. Evidence: The care plans looked at, observations and discussions provided good evidence that peoples individual wishes are acknowledged in respect of the way they are supported, which, in many cases, was mostly by listening to, encouraging or prompting people with daily or personal healthcare tasks. However, for people with higher or more complex needs, excellent records and descriptions were seen that had been put together in such a way as to ensure consistency of care by staff. The communication diaries were also seen to be referred to in respect of ensuring peoples physical and emotional health needs are met. A small memorial garden was seen to have been created, which provides people with some quiet reflective time if they wish to remember someone. One person had stated Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: that I like to use the memorial garden to remember [name] when Im missing them. Other very clear supplementary/additional care plans were also seen with regard to individuals moods or behaviour and show how their emotional needs were being met. Other records looked at confirmed that people are supported to have regular and ongoing involvement with various care professionals such as doctor, community/district nurse, phlebotomist, dentist, oral health adviser, optician, chiropodist, reflexologist, dietician and physiotherapist. At the time of this inspection, no service users maintained or administered their own medication but records were seen to show that appropriate risk assessments have been undertaken and regular reviews are carried out, in order to give people ongoing opportunities to be able to self-administer as and when possible. Good, clear guidelines were also seen in respect of people self-medicating. Meanwhile, Kalmia and Mallow was seen to have good and safe practices with regard to the handling, administration and recording of medication and no errors or omissions were noted in the records during the inspection. Each person was also noted to have an individual care in respect of sickness and death, which included religious/cultural wishes. Care Homes for Adults (18-65 years) Page 20 of 31 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. Kalmia and Mallow has a clear complaints procedure, which helps ensure that people feel their views are listened to and acted upon. Staff are well trained in areas such as adult protection and medication, to help ensure people are protected from abuse, neglect and self-harm as much as is possible. Evidence: Kalmia and Mallow has received a few complaints during the last year and all of these were seen to have been recorded, investigated and dealt with appropriately and in accordance with the services complaints procedure. The recruitment practices and procedures at Kalmia and Mallow were seen to be robust, with all staff required to have a clear enhanced disclosure from the Criminal Records Bureau (CRB) before starting work and all staff are reported to have received up to date training in adult protection. Clear and detailed individual risk assessments were seen to be in place for each person, to further ensure their health, safety and personal welfare is protected, including personal relationships and finances. All three surveys returned stated that people knew who to speak to if they were Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: unhappy and that they know how to make a complaint. Care Homes for Adults (18-65 years) Page 22 of 31 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. Kalmia and Mallow provide a homely, comfortable and safe environment for people to live in, which is clean and hygienic. Evidence: General observations were made whilst undertaking this inspection, which confirmed that people were very much at home and the whole environment was noted to be friendly, comfortable, clean and hygienic, with no obvious safety hazards. A tour of the premises showed peoples own rooms to be very individual and personal and people were noted to have chosen the colours and furnishing etc. for their rooms. The communal areas were seen to also be very accessible, comfortable, clean and homely. A number of improvements/additions were noted since the last inspection including a small memorial garden that has been created for service users to go and light a candle when missing their loved ones, helping with the bereavement process. The rear garden has also been tidied greatly, and service users are able to enjoy using the swing-seat, sensory area and spend more time relaxing outside. One person also Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: now has their own vegetable plot. However, it was acknowledged that, given the size of the garden and the amount of mature trees and shrubs, consistent garden maintenance is a difficult job for staff to keep on top of during the course of their regular care shift. Meanwhile, numerous specialist equipment was observed to be available throughout Kalmia and Mallow and the installation of a specialist bath has been completed, in line with a previous requirement. Care Homes for Adults (18-65 years) Page 24 of 31 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. Service users are supported by a competent, well trained and effective staff team and the service follows robust recruitment procedures. Evidence: Two personnel files were looked at in detail during the inspection and each of these was found to be well organised and contain comprehensive information, which confirmed that Kalmia and Mallow follow the robust recruitment procedures that are in place. Some of the documents seen in the staff files included: photograph, identification, references, employment contract, training records/certificates, evidence of receipt of a clear, enhanced Criminal Records Bureau (CRB) disclosure. It was commented on during the inspection that there have been a few difficulties in the last year, followed by some changes in the staff team but, from those people spoken to, it was stated that the team is working together much more effectively and has become a lot stronger. This statement was supported by observations during the inspection and the numerous records seen. Care Homes for Adults (18-65 years) Page 25 of 31 Care Homes for Adults (18-65 years) Page 26 of 31 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. Kalmia and Mallow are well run homes and the people living there benefit from good quality leadership and day-to-day management. A good Quality Assurance process is in place and the people living at Kalmia and Mallow know their health, safety and welfare is promoted and protected. Evidence: The current manager, previously the deputy, has recently successfully completed her registration with the Commission and a new deputy has also been appointed. The responses from the people spoken to during this inspection confirmed that the ethos, leadership and management of the Home benefit all who live and work there. It was also stated that people have felt very supported by the management team and eveyone has worked well together during recent difficulties. The policies, procedures and record keeping in respect of health and safety aspects were observed to be of a high standard, covering numerous areas in great, but clear, detail such as infection control, water temperatures, fire safety and all related checks, Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: drills and evacuations, safe use and storage of hazardous substances and chemicals (COSHH), etc. Clear and detailed risk assessments were also seen, which have been reviewed and updated, as necessary, on a regular basis. Overall, the atmosphere during the inspection was cheerful and relaxed and observations confirmed that people were genuinely in their own homes, with their best interests, health and happiness being absolute priority. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 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 30 of 31 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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