Care Home: Kestrel House, St Anne`s Opportunity Centre,

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What the care home does well The service makes sure that it writes things down very carefully so that everybody knows what people need and how staff are going to help them. The home has very good risk assessments so that people can be helped to be as independent, as they are able, as safely as possible. People are encouraged and allowed to make as many decisions about their lives, as they are able. People are involved in planning their daily activities, which include going to work and to college, and are supported to lead a busy and happy life. People are helped to keep in contact with people who are important to them. The people who live in the home go shopping for their food and staff help them to choose and prepare it. The home make sure that people are helped in a way that they prefer by asking them to agree to how they are to be helped and sticking to the ways of helping them that is written down. The home has written down what help people need to make sure that they stay as healthy as they can and support people to go to the Dr or nurse when they need to. The staff give people their medicine in a safe way. The home make sure that people are not badly treated by anyone, they listen to what people say to them and know what to do if they are worried that people are not being treated properly. People feel safe, in the home and are happy to talk to staff if they have any worries or concerns. The staff work in the home for quite a while, so that people do not have to get used to new people all the time. The manager looks at how many staff are needed to help the people in the home and makes sure that there are always the right number of staff on duty. The home is run by a manager who has lots of experience and knows what she is doing. People are very happy to talk to her and ask her to change things if they are not happy with them. The people who live in the home are very involved in making any changes to improve their lives. The home make sure that they regularly check that they are giving people the best possible care. What has improved since the last inspection? The home has made sure that all staff do training that is particularly helpful in the work they are doing. What the care home could do better: The manager must register as soon as possible. Key inspection report Care homes for adults (18-65 years) Name: Address: Kestrel House, St Anne`s Opportunity Centre, 84 Hambridge Road Newbury Berkshire RG14 5TA     The quality rating for this care home is:   three star excellent 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: Kerry Kingston     Date: 1 3 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Kestrel House, St Anne`s Opportunity Centre, 84 Hambridge Road Newbury Berkshire RG14 5TA 0163540862 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): stannesopportunitycentre@btconnect.com St Anne`s Opportunity Centre Ltd Name of registered manager (if applicable) Mrs Jacqueline Louise Thompson Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Kestrel House is a small residential home located close to the local town and all amenities. The home is registered to provide 24 hour care to five adults, who have learning and possibly associated behavioural disabilities. The home offers structured care to enable clients to develop more independent life skills at their own pace and within their own abilities. The home is well equipped throughout and has a large secluded garden which is well utilised. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home Fees charged are approximately £1000 per week, it can be more or less depending on the assessed needs of the individual. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on the 9th May 2007. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 10.30 and and 2.30 pm on the the 13th of April 2010 . The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Care Quality Commission and completed by the manager, surveys returned to us by the five people who use the service, staff of the home helped some people to complete them, and seven surveys returned to us by staff who work in the home. Discussions with four people who live in the home, the manager, the responsible individual and two other staff members took place. Limited observation of people and their interactions with staff took place during the visit to the home. Reviewing records of the people who use the service and other records and procedures Care Homes for Adults (18-65 years) Page 6 of 28 was also used to collect information on the day of the visit. All information received by the Commission since the last inspection, about this service was also taken into account when producing this inspection report. Care Homes for Adults (18-65 years) Page 7 of 28 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. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home would only admit people who have been properly assessed so that it can be sure it is able to meet their needs. Evidence: There have been no admissions since 2008, those admissions were people who already received a service from the provider. People who live in the home have full assessments and plans of care developed from the assessments. The home regularly review placements to ensure that it can continue to meet peoples current and changing needs. The home has an up-to-date referral,assessment and admission procedure which includes, introductory visits and an introductory programme to be developed to meet peoples individual needs. The home has a Service User Guide in easy to read format produced with pictures and symbols and/or simple English, dependent on the needs of the individual. The Statement of Purpose was reviewed and modified on the 24th March 2010, to Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: reflect the changes to the management of the home. Care Homes for Adults (18-65 years) Page 12 of 28 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. People are fully aware of their assessed and changing needs and are fully involved in reviewing and amending plans of care, as necessary. The home encourages and supports people to make as many decisions about their life as they are able. People are supported to have as much freedom and independence, as is appropriate, as safely as possible. Evidence: Care plans for three people who use the service were seen. The home has extensive care planning tools to ensure that they produce a comprehensive person centred plan for each person. Information is extremely detailed and presented in an effective way to ensure it can be used as a working tool. Information includes contacts (social/families), financial which includes all aspects of benefits , how much, which issuing office, saving plans and financial management needs, general health, daily living and relationships. People also have mental capacity assessments, aims and development plans. All plans of care and records are up-to-date, informative and used Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: as effective working tools. Plans of care ensure that equality and diversity needs are met, that is, the person centred plans are very individualised to meet all the needs of the individual, such as autism, emotional immaturity and sexuality. A staff survey noted that Care Plans are very well produced. The AQAA noted that weekly house meetings are held. Three people spoken to said that they have regular house meetings where they discuss things they want to. People said that they make decisions for themselves and are involved in making decisions about the home, in general. People are communicative,articulate and able to advocate for themselves. One person confirmed that even though they dont put forward ideas they are able to say no to suggestions put forward by others, if they disagree. It was clear that all daily and behavioural programmes are agreed with people before being implemented. People change their lifestyle and activity programmes,as they choose, with support and advice from the staff team. One person described their new healthy eating and exercise regime that they believe will make them healthier and feel better. Four people said that the staff always listen to them and try to act on their wishes and choices. Risk assessments are of excellent quality and cover all necessary areas , for individuals. They help staff to support people to be as independent as possible as safely as possible. For instance several people are able to access the community unaccompanied but some have to have total supervision at all times. Risk assessments allow people as much freedom and independence as possible, all are agreed with individuals and all know their programmes,risk assessments and risk minimnisation strategies. Care Homes for Adults (18-65 years) Page 14 of 28 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. People are given opportunities to take part in interesting and rewarding activities, are assisted to take part in the community and make choices and decisions about their lifestyle. They are helped to choose and prepare balanced and nutritional meals and encouraged to lead healthy lifestyles. Evidence: Three activity plans were seen, these are agreed with individuals and comprise of activities that they like doing and those that assist people to meet the aims noted at reviews. several people have work placements, they attend college and go to a variety of other external activities. There are many community activities that they access from home, the house is very well situated close to all the local facilities and transport links. Several people have work experience and staff are supporting others to get the appropriate help to find a work placement. A person who uses the service said , I am Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: always busy, I love to be busy.They said that they are very happy with their lifestyle and love the home. One person described new activities that include a college course on healthy eating/lifestyle and other activities, such as walking and swimming to support a more healthy lifestyle. Some people are able to access the community unaccompanied and do so. One person described their visits to the local rugby club and to football they said that they have a season ticket for football but may choose not to have one next season. The manager described how the home help people with any anxieties they may have about being in the community, where unexpected things happen and can change quickly. Two people said that they had been on holiday last year, they choose where they go and if they want to go. One person chooses not to go on holiday. The home also organise day trips and outings. The daily notes, written for each individual, showed that they participate in many activities and that they make choices throughout the day and at all times about their lifestyle. All five people have contact with families, at varying but appropriate levels, dependent on assessed needs and other circumstances. The home encourages, supports and facilitates contact, as appropriate. Plans of care include peoples social relationships and sexuality. People are fully involved in choosing food, shopping for it and preparing it. People get their own breakfast and lunch and have an allocated budget to purchase their own food, they also take turns to buy some joint food that they will all eat. The four people spoken to are very happy with the system and two surveys said that they liked the food. People are able to choose to eat where they wish although there are rules about the timings of mealtimes, to fit in with other daily routines. People are involved in healthy food and hygienic food preparation training at college. One person particularly is embarking on a healthy lifestyle programme that she described to me to help her to feel better, staff are encouraging and supporting her with this and are able to help her to monitor her weight. The AQAA notes that staff do a healthy eating check with people when designing/choosing the menus. Care Homes for Adults (18-65 years) Page 16 of 28 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 home have detailed and effective plans of care to ensure they meet the personal and emotional care needs of the people who live there very well. They make sure that they help people to keep as healthy as possible and are properly trained to administer medication as safely, as possible. Evidence: All five people have detailed care plans which include person centred plans. They are fully involved in the development of the plans. Peoples preferences are recorded in detail,entitled my nightmares that is, what people dont like and what causes them anxiety, for instance one person who reacts badly to unexpected changes. They also have my dreams and aims which are agreed at reviews,included in daily and activity plans and monitored to identify any progress and/or their continuing relevance. Plans of Care reviewed are annually as a minimum and more often if peoples behaviours or needs change. Peoples personal needs are detailed in their plans of care, although most people are able to deal with their own personal care, any specific area that they may need help with is identified, For example, someone who needs to be reminded, on occasion to wash their hair. All programmes are agreed with individuals who are aware of how the staff are going to support them to meet their needs. People are Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: articulate, communicative and generally able to fully advocate for themselves, they were observed discussing issues with the manager and other staff. Some comments from surveys received from staff included, we make sure people have equal opportunities, we empower service users as much as possible, we meet all the needs of service users,we are good at person centred care,the home support people with daily needs whilst allowing them to develop as individuals. Everyone who uses the service has a detailed health care plan, it includes all the relevant and necessary information to assist staff to help people stay healthy. Annual health checks now include blood tests, one person has been diagnosed,as a result of this, with a chronic illness which can now be managed effectively. Peoples capacity to consent to medical treatment/ interventions is also noted in the Health Care plans. People have an about me booklet, which gives medical staff information to enhance the care people are given in hospital, should an admission be necessary. There are detailed records of any visits to health care professionals and all health care checks are recorded and up-to-date. There are excellent records of all health care activity and how staff help people with any health care issues, any health care programmes are developed with the individual to ensure their agreement and understanding. People have well developed and detailed behaviour contracts, as necessary. People are involved in and sign to say that they agree with the way staff will help them to adhere to the contracts (behaviour programmes). Staff are all trained in the use of breakaway techniques and non violent crisis interventions, they do not currently, use any physical restraints. The home uses a monitored dosage system, which was instigated on the 1st march 2010, in response to one error made by a staff member. Records seen were accurate, all medication is stored securely and the home has no controlled drugs. The home does not use medication prescribed to be taken, as necessary, to help people with behaviour control. All staff have recently up-dated their medicine administration training and completed a course accredited by Keele university, it is an excellent detailed training pack. The Pharmacist can be asked for advice at any time, the Primary care trust pharmacist visited the home in 2009 to look at medication and did not note any issues or concerns. Care Homes for Adults (18-65 years) Page 18 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has comprehensive complaints and safeguarding policies and procedures that staff and people who live in the home understand. People are listened to, feel safe and are protected from all forms of abuse. Evidence: The home has a comprehensive complaints policy, produced in a user friendly format and included in the Service User Guide. Three people spoken to were very clear about how they would make a complaint if they needed to. There have been no complaints recorded about the home for several years. Peoples views are recorded in several ways, such as, in the house meeting book and in the reviews of the plans of care. Four people spoken to said or indicated that they are always listened to and staff take action, whenever possible to make sure that they are as happy as possible. The manager confirmed (as noted on the AQAA) that there has been one safeguarding referral since the last inspection. One of the people involved said that they thought staff handled the situation well and they feel very safe in the home. The AQAA noted that the abuse policy is produced in a simple format, for the people who use the service. Training records showed, and staff confirmed, that all staff have been trained in the safeguarding of vulnerable adults (POVA) and training is up-dated, as necessary. There have been no safeguarding concerns or referrals in the past 12 months. The four people spoken to said that they felt very safe in the home and said that they could talk to any of the staff and the manager if they had any concerns or worries. Staff spoken to had a good understanding of safeguarding, knew their moral Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: and legal responsibilities to those in their care and were aware of where to take any concerns outside of the organisation, should it ever be necessary. They said that they are very confident that any issue raised that concerns peoples safety or well being would be addressed, immediately. The Commission has received no information with regard to complaints or safeguarding issues about this home, since the last inspection (except as notified by the home). Peoples behaviour plans are produced in the form of contracts, agreed by the people they relate to so that everyone knows how behaviours will be dealt with and how people will be supported with them. The home does not use physical restraint although all staff are trained in the use of non violent crisis intervention, with the focus on the de-escalation of aggressive or distressing behaviours. Detailed incident reports are completed, as necessary. Individuals have a financial passport that details all income and expenditure and how people are to be supported with their finances. All deal with their own money with varying degrees of support as detialed in their financial passport (which forms part of the plans of care), receipts are kept, when appropriate, to monitor the amount of money being spent and what on. Care Homes for Adults (18-65 years) Page 20 of 28 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 house is kept to a good standard of hygiene, is comfortable and is a pleasant environment to live in. The environment meets the individual and group needs of the current residents. Evidence: The house is homely and well kept. Three bedrooms were seen, they are spacious,very personalised,contain entertainment systems, of individuals choice and good quality furniture and fixtures. Rooms are allocated according to the needs of the people who live there. There are no en-suite facilities but there are two bathrooms, one which contains a walk in shower, in the house. The home has a maintenance plan, included in the annual development plan, a maintenance man and a good relationship with the landlord who effects repairs when necessary. The provider is responsible for the internal decor and residents said that they choose their own colour schemes. People make good use of large attractive garden, people being encouraged to grow things in raised beds and participate in a gardening project. Care Homes for Adults (18-65 years) Page 21 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well qualified staff team who are able to effectively meet the diverse needs of the resident group. Staffing levels are continually reviewed to ensure there are appropriate numbers of staff in the home. Evidence: Five people live in the home, most are independent with regard to personal care and staffing reflects peoples needs at different times of the day. Staff work until 11pm and then sleep in overnight. There is a minimum of one staff on duty on a quiet evening but more usually two, sometimes three to cover activities and/or social occasions.The manager reviews staffing every week to ensure there are the correct amount of staff to meet peoples individual and group needs. The home has not had any staff leave in the past year and tend to retain staff for many years.The newest staff records were from 2008. They do not use agency staff, any shortfalls are covered by permanent staff doing extra hours or using bank staff who the people who live in the home know. Comments from surveys completed by people who use the service included,the home does everything well, staff give good help and support when we need it,I always prefer there to be one staff on duty. Comments from staff surveys included the home does everything well, a good home to work in,staff are experienced. The negative comments from staff were, there is some lack of Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: consistency, routines change quite often and there is some conflict between staff. The manager is aware of some of the issues, she felt they had mainly been resolved and any continuing issues are being discussed with the relevant staff. Staff records are kept in the head office, which is situated in the grounds of the home, four were seen. They all included a CRB check, two references, identification and all the other necessary paperwork to ensure, as far as possible that they are safe to work with vulnerable people. Notes are kept of interviews and people who live in the home are involved, if they choose to be, in certain aspects of the recruitment procedure, mainly the informal showing people round their home and expressing their opinion of the candidates to the interviewers. Staff are well trained, the AQAA noted that eight of the eleven permanent care workers have an NVQ 2 or above qualification. The home ensures people have relevant training, (to the needs of individuals) such as mental health and autism training. Staff training records are excellent and all staff have a development plan for the following year. A staff member said that they get very good opportunities to complete appropriate training courses and described several that they had completed recently. The manager and records confirmed that people complete Learning disability framework training, which includes a detailed induction and lets people achieve up to a level 3 qualification. Training records showed that people complete and up-date all training, as appropriate. Staff were seen interacting with people sensitively and positively and people who use the service appeared too be very confident and comfortable in their interactions with staff. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is not, as yet , registered to manage this home but is registered to manage another run by the same provider. The home is being managed very effectively, in the best interests of the people who live there. The people who live in the home are involved in looking at the quality of care they are offered and in any developmental changes made. The home adhere to Health and Safety policies and procedures to ensure people are kept as safe as possible. Evidence: The registered manager left in November 2009, the home has appointed a manager who is already registered to manage another home run by the same provider, she will manage both homes, as she has been doing since November. She is awaiting her CRB clearance that she applied for on March 2nd 2010, to enable her to apply for registration. The manager has been in post for 16 years, and has managed Kestrels in the past. She has all the necessary management and care qualifications and additional teaching qualifications so that she is able to contribute to staff training. Staff described the management as very supportive and a staff survey said that the home Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: is well run with supportive management. People who use the service spent alot of time in the managers company, on the day of the visit, they appeared to be very comfortable in her presence and gained self confidence with her encouragement. Two people said that she listens to them and they would tell her if they had any problems. The home has robust quality assurance processes which include regular regulation 26 visits, these are recorded, necessary actions are noted and checked at the next visit. The home sends out annual questionnaires to interested parties such as care managers, involved health professionals, peoples families and the people themselves. The provider collates the responses and they are included on the annual development plan along with information taken from people who use the service (that is from weekly house meetings, and care reviews). All is discussed in a development meeting that all residents participate in. Some completed questionnaires were seen, they are generally very positive about the home, the staff and the management. Two people spoken to said that they loved the home and felt that they are doing well there. The AQAA noted that all health and safety checks are up-to-date and policies and procedures are reviewed as necessary. The home has a comprehensive Health and Safety folder which contains all health and safety records including maintenance certificates. All necessary health and safety checks are completed under contract at the prescribed time. Fire information is kept separately. The fire officer visited in 2009 and required the home to improve its fire risk assessment, this has been done. A revisit to check the requirement on 1/12/09 resulted in him being satisfied that it had had been met and congratulating the home on the quality of their new comprehensive risk assessment. This has now been adapted to be used for other heath and safety risk assessments. The radiators in the home are not covered but the manager has begun assessing their safety and is deciding which ones may need covering. The home keeps detailed accident and incident records, as necessary. There have been no accidents reported during the past year. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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. 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