Care Home: Lenore, The

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What the care home does well People are provided with a brochure which tells them about what they can expect once they move into the Lenore. Prospective service users are provided with opportunities to visit the home before reaching a decision about whether to accept a placement. People`s needs are assessed over a 12 week period following their admission into the home. This helps to make sure that the Lenore is able to meet people`s needs. Service users are encouraged to take part in organised in-house activities and access community based recreational, educational and work place opportunities. This helps to make sure that people are able to lead fulfilling and stimulating lives. Service users are supported to maintain links with families and friends. They are encouraged to contribute to the assessment and care planning process. This helps people to feel valued and in control of their own lives. A range of support plans and risk assessments have been completed for each person. This means that service users can be confident that staff will know how to meet their needs. The arrangements for meeting people`s healthcare needs are good helping them to lead a healthy lifestyle. The ratio of qualified staff has increased exceeding the 50 per cent minimum standard. Arrangements are now in place to provide new staff with induction training that complies with the `Skills for Care` Common Induction Standards. This helps to make sure that staff have the skills and knowledge they need to meet people`s needs. The home is well managed and there are good arrangements for keeping staff and people using the service safe. What has improved since the last inspection? Service users` care plans and risk assessments have been computerised. This has helped to make them more accessible and easier to use. The format used to record information about how people`s needs are met, has been reviewed and updated to make it more comprehensive. The home has introduced social activity and cookery clubs. This is helping to provide service users with more opportunities to develop skills in these areas. The home`s menu format has been improved making it easier for service users to make informed choices about what they want to eat each day. Staff`s medication training has been updated. Healthcare information and educational leaflets are now available within the home and can be accessed by both service users and staff. Access to hearing tests at the home is now provided. Staff have completed training in visual and hearing impairments. This is helping to promote people`s health and well being.Good arrangements are in place for responding to complaints and keeping people safe from harm and abuse. The premises and its facilities are satisfactorily maintained providing people with good accommdation which is well looked after. What the care home could do better: No requirements have been set following this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Lenore, The 1 Charles Avenue Whitley Bay Tyne & Wear NE26 1AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elizabeth Gaffney     Date: 2 7 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Lenore, The 1 Charles Avenue Whitley Bay Tyne & Wear NE26 1AG 01912513728 F/P01912513728 lauramurray.lenore@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Paul Royston Duchett,Mrs Teresa Duchett care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 22 The registered person may provide the following category of service only: Care Home only - Code 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, Code LD, maximum number of places 22 Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places, 22 Date of last inspection Brief description of the care home The Lenore is a large older style home situated in a residential street within Whitley Bay. Local facilities such as shops, restaurant, and pubs are all within easy walking distance. The home caters for 22 people with mental health care needs. Some people also have a learning disability. Single room accommodation is provided over the first and second floors of the home. One bedroom has an en-suite facility. Communal facilities consist of a dining room, four lounges, eight toilets, two showers, and three Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 22 22 Brief description of the care home bathrooms. There are pleasant outdoor areas to the front and side of the home. Street parking is available. Information about fees is included in the homes service user guide and statement of purpose. Fees range from 383 to 445 pounds. Copies of the Commissions inspection reports are available in the homes reception area and office. Extra charges are made for private chiropody, newspapers, hairdressing, and transport where benefits received cover this expense. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. 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. How the inspection was carried out. Before the visit, we looked at: * Information we have received since the last visit on 19 March 2008; * How the service dealt with any complaints and concerns since the last visit; Care Homes for Adults (18-65 years) Page 6 of 29 * Any changes to how the home is run; * The managers view of how well they care for people; * The views of relatives, staff and other professionals. An unannounced visit was made on the 27 October 2009. During the visit we: * Talked with some of the staff and the manager; * Looked at information about the people who use the service and how well their needs are met; * Looked at other records which must be kept; * Checked that staff had the knowledge, skills and training to meet the needs of the people they care for; * Looked around the building to make sure it was clean, safe & comfortable; * Checked what improvements had been made since the last visit. An Expert by Experience also attended the inspection. The role of the Expert by Experience is to find out what people using the service think about the quality of the care and support they receive. Their comments have been included throughout this report. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? Service users care plans and risk assessments have been computerised. This has helped to make them more accessible and easier to use. The format used to record information about how peoples needs are met, has been reviewed and updated to make it more comprehensive. The home has introduced social activity and cookery clubs. This is helping to provide service users with more opportunities to develop skills in these areas. The homes menu format has been improved making it easier for service users to make informed choices about what they want to eat each day. Staffs medication training has been updated. Healthcare information and educational leaflets are now available within the home and can be accessed by both service users and staff. Access to hearing tests at the home is now provided. Staff have completed training in visual and hearing impairments. This is helping to promote peoples health and well being. Care Homes for Adults (18-65 years) Page 8 of 29 Good arrangements are in place for responding to complaints and keeping people safe from harm and abuse. The premises and its facilities are satisfactorily maintained providing people with good accommdation which is well looked after. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 29 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. There are suitable arrangements for making sure that peoples needs are assessed before they move into the home. These help make sure that staff know how to meet peoples needs when they move into the Lenore. Evidence: People are only admitted into the home following a full needs assessment. These assessments are carried out by trained and experienced mental health professionals. The home has obtained copies of these assessments and uses them to inform their own in-house care plans and risk assessments. Before people move into the home they are provided with written confirmation that the Lenore will be able to meet their needs. Following a persons admission, a member of staff is identified to help them adjust to their new living arrangements. This member of staff provides the new person with information about the home and how it is run and organised. A 12 week assessment is carried out to ensure that the Lenore is able to offer a suitable placement. Of the seven service users who returned surveys, the majority said that they received Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: enough information about the home before they moved in. Staff who returned surveys said that they always receive up to date information about the needs of the people they support. The Expert by Experience reported that service users told them that their needs had been assessed by a community psychiatric nurse and other professionals before they moved into the home. Service users also said that they were satisfied with their assessment. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for meeting peoples individual care needs and goals are satisfactory. Because of this, people using the service can be confident that their assessed needs will be satisfactorily met. Evidence: Peoples care records include information about: their assessed needs; what staff hope to achieve by their involvement and what each person needs to contribute to achieve the goals set out in their care plans. A range of care plans have been devised for each person covering such areas as mental and physical health, and domestic, leisure and employment skills. Care plans are written in plain English and easy to understand. People have signed their care plans to confirm their agreement with the contents. Each person has had their needs reviewed during the last three months. Care records are kept secure at all times. The Expert by Experience reported that: All service users knew that they had a care Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: plan and all had knowledge of the periodic reviews held to update this. No problems were voiced. One service user was satisfied that their needs were met to the best of the homes ability. Another service user awarded the home ten out of ten for meeting their needs. People said that they felt in control of their lives and received the support they needed to make day-to-day decisions. Of the seven people who returned surveys, the majority said that they are able to make their own decisions about what they do each day. Where relevant, assessments completed by specialist mental health professionals are used to help the home make a decision about whether a suitable placement can be provided. The home also carries out its own assessments where staff have identified that people are at risk of harm. For example, there was evidence in one persons care records, that risk assessments covering the mis-use of alcohol, smoking, challenging behaviour and the possibility of re-offending, had been completed. Care Homes for Adults (18-65 years) Page 14 of 29 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. Staff actively encourage, and provide varied opportunities for people to develop and maintain independent and work based living skills. This means that people are provided with opportunities to enjoy a full and stimulating lifestyle that may help improve their mental health. Evidence: People are encouraged to join in meaningful daytime activities of their own choice. They are supported to make use of community facilities such as local shops, transport and health care services. The Expert by Experience reported that: One service user said that every afternoon they go out on shopping trip into Whitley Bay. They said that they enjoy this contact with people outside of the home and believe that their life is enriched by their hobbies and interests. The Expert by Experience also said that service users reported that the homes rules on drugs, alcohol and violence provide people with good boundaries and because of this, there are no problems. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People are supported to develop and maintain important personal and family relationships. For example, family members and friends are welcomed at the Lenore where this reflects the wishes of the person and, as long as it does not negatively affect the lives of other people living at the home. Service users said that staff respect their privacy and provide support when they need it. People felt that staff respected their rights, and of the seven people who returned surveys, all said that staff treat them well, and listen and act on what they have to say. Details of each days menus are displayed in the dining room. The menus include details of the choices available at main meal times. The menus provide opportunities for healthy eating and offer five a day portions of fruit and vegetables. People are offered three meals a day and a hot meal choice is available at each main mealtime. Meal times are flexible and people can take their meal in the dining room, or in their bedroom if they prefer. People have access to a drinks trolley in the dining room and are able to prepare hot beverages as and when they like. Some people also have fridges and kettles in their bedrooms. People told the Expert by Experience that they are satisfied with the quality of food served at the home. None of the people accommodated at the Lenore require assistance with eating or drinking. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples physical and mental health care needs are satisfactorily met helping them to lead healthy lives. People feel valued and able to retain control over the way they want to live their lives. Evidence: Service users care records show that they receive healthcare as and when needed. For example, all service users have seen an optician during the last 12 months. Support plans have been devised which promote peoples health and well being. These cover such areas as support required when attending medical and healthcare appointments, taking medication and monitoring peoples mental health. However, it was identified that the care records of a person with learning disabilities did not contain a Health Action Plan. Also, the MUST nutritional risk assessment has not been completed for all people aged over 65 years. Where required, support plans setting out how staff should meet peoples personal care needs have been devised. For example, in one persons care records, there are support plans covering the support they require with self care and personal hygiene. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Of the seven staff that returned surveys, all said that they are given up to date information about the needs of the people they care for. They also said that the way information is shared within the home works well. There good records covering the administration and disposal of medication. All medicines are kept safely locked away. The medication cabinet is kept clean and tidy. Staff were observed administering medication in a safe and professional manner. Staff have received accredited medication training and their competency to administer medication has been assessed. An experienced pharmacist recently checked the suitability of the homes day to day medication practices and identified no significant concerns. (NEED TO CHECK THIS WITH YOU.) Peoples bedrooms contain lockable facilities. This means that people who are able to administer their own medication can keep their medicines safe. Care Homes for Adults (18-65 years) Page 18 of 29 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 for addressing complaints and protecting people from harm or abuse are good. This means that people can feel safe and protected in their own home and know that any concerns they raise will be treated seriously. Evidence: Each service user has been supplied with a copy of the homes service user guide which contains details of the providers complaints procedure. Neither the home nor the Commission have received any complaints since the last inspection of the service. Of the seven staff that returned surveys, all said that they would know what to do if someone expressed concerns about the home. The majority of service users said that they have been told how to make a complaint. The Expert by Experience reported that: all service users ware confident that they simply have to knock on the managers door to make a complaint. None of the service users expressed concerns about their personal safety. The home has a safeguarding policy which they follow. However, the policy has not been updated to reflect recent legislative changes in adult protection. The home takes immediate action to protect the people in their care and works well with other professionals. Three safeguarding referrals have been made to relevant professional bodies, including the Care Quality Commission. No staff have been referred to the Independent Safeguarding Authority because they are unsuitable to work with Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: vulnerable adults. All staff have received safeguarding training. Care Homes for Adults (18-65 years) Page 20 of 29 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 arrangements for ensuring that the premises are well maintained are good. This means that people are able to benefit from living in a home that has good facilities and is generally well maintained. Evidence: The home is safe, comfortable, free from offensive odours and clean. It offers easy access to local amenities and transport links, and community health services. The appearance of the Lenore is in keeping with the local community and has no visible signs that might identify it as a care home. A CCTV system is used to monitor visitors to the home. There is no evidence that this has a negative effect on peoples daily lives or their right to privacy. A number of bedrooms were visited, as were all communal areas, toilets, and bathrooms. Furniture and fittings were satisfactory and people said that they are satisfied with their bedroom accommodation. Specialist aids and adaptations are not required. The home has some rooms occupied by people over 65 where the radiators are unguarded. These individuals have chosen not to have the radiators in their rooms guarded even though the potential risks associated with this have been explained to them. Each of these individuals has been assessed as having the capacity to make this decision. Risk assessments have been completed. All windows on the first and second Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: floors have been fitted with restrictors. However, some people have chosen to remove the restrictors fitted in their bedrooms. Of the seven people who returned surveys, the majority of people said that the home is kept clean and fresh. The Department of Health infection control checklist had been completed and a member of staff had been designated as the link between the home and the infection control nurse. The arrangements for monitoring infection control arrangements remain unchanged from the last inspection. No infection control concerns were identified. The Expert by Experience reported that: everyone I spoke to was very satisfied that, in Lenore, they had found a good place to live with a good standard of accommodation. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by suitable qualified and well supervised staff who are available in sufficient numbers to meet their needs. Because of this, people are able to fully benefit from being cared for by staff who are properly supervised, trained and employed. Evidence: The home has a core rota that all staff work to. Changes to the rota are agreed verbally with either the manager or provider and a record is made in the homes diary. Levels of staff turnover are low. The home has no vacancies and agency staff are not used. An examination of the rotas showed that there is always a minimum of two staff on duty throughout the working day. Extra staff are rostered on duty at busier times of the day. Of the ten staff who returned surveys, all said that sufficient staff are rostered on duty to meet peoples needs. The Expert by Experience reported that: one service user said that they are able to get hold of a member of staff whenever they need to. The Expert by Experience also reported that this was confirmed by other people using the service. Seven of the ten staff employed at the home have completed a nationally recognised Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: qualification in care. Staff have received the required statutory training. For example, in the sample of personnel records checked, there is evidence that all staff have completed training in first aid, health and safety, fire prevention, infection control and food hygiene awareness. Staff have also completed learning disability awareness training. Each staff members personnel file includes details of what training has been completed and when training updates will be required. Before staff commence working at the home, they are required to complete an application form, attend an interview and provide a full employment history. A Criminal Records Disclosure Certificate and two written references have been obtained for each member of staff. The identity of staff is checked and verified. New staff are provided with in-house induction training. A written record of the training provided is kept. Following a recommendation made during the last inspection, arrangements are now in place to ensure that new staff have received training in the Skills for Care Common Induction Standards (CIS). CIS completion certificates have been completed for recently appointed staff. Staff who have completed a National Vocational Qualification in Care will have received basic equality and diversity awareness training. This area is also covered in the in-house inductiontraining programme. Arrangements are in place to ensure that staff receive regular supervision. Of the ten staff who returned surveys, all said that: their induction covered what they needed to know to do their job; the training they receive is relevant to their job, helps them to understand peoples needs and keeps them up to date with new ways of working; they met regularly with their manager; they have the skills and experience to meet peoples needs. Care Homes for Adults (18-65 years) Page 24 of 29 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 arrangements for protecting and promoting peoples health and safety are satisfactory. This means that people are able to benefit from living in a well run home where their health, safety and welfare is treated seriously. Evidence: The manager has completed the Registered Managers Award and a National Vocational Qualification in Care at Level 4. The manager has more than four years experience as a senior staff member and manager at the Lenore. Since commencing work at the home, Ms Murray ensures that her mandatory training is kept up to date. The home uses a quality assurance framework devised by the former local authority registration body. The system covers such areas as the management of the environment and service users care records. A quality assurance review has been carried out during the previous 12 months. The provider is not carrying out monthly monitoring visits to assess the quality of Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: services provided at the home, as required by Regulation 26 of the Care Homes Regulations. However, the provider works at the home for approximately six hours each weekday. They also employ an independent consultant to visit the Lenore every eight to ten weeks in order to monitor the performance of the home and produce a report of the outcome. These arrangements are considered to be satisfactory. A previous requirement set regarding this matter has now been deleted. Since the last inspection, the manager has issued quality questionnaires to a sample of people using the service. Peoples responses have been analysed and the outcome shared with the Commission. The opinions of professionals visiting the home have not been sought on a formal basis. Many of the homes policies and procedures have not been reviewed during the last 12 months. Peoples financial records are satisfactorily maintained. The records checked were accurate and up to date. The balance of money held for each person matched that indicated on their financial record. Peoples money is not pooled and it is kept secure at all times. Satisfactory arrangements are in place to protect peoples health and safety. For example: the home has a health and safety policy which is available for staff to refer to; the premises are safe and no health and safety concerns were identified during the inspection; information about hazardous materials has been obtained; all electrical equipment has been tested within the last 12 months; workplace risk assessments have been recently reviewed. Steps have been taken to make sure that good fire prevention measures are in place. For example, the homes fire risk assessment has been revised during the last 12 months; there are current safety certificates for the alarm system, emergency lighting and fire extinguishers. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 Complete a MUST nutritrional risk assessment for service users who have poor nutritional health or who are aged over 65 years of age. Where service users have a learning disability, obtain a copy of their Health Action Plan. Review and update the homes safeguarding policy to ensure that it covers changes in recent legislation. Ensure that the views of visiting professionals, and other people with an interest in the home, are obtained and used to feed into the Lenores quality assurance process. Ensure that the homes policies and procedures are reviewed and updated yearly. 2 3 4 19 23 39 5 40 Care Homes for Adults (18-65 years) Page 28 of 29 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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