Care Home: Littleover Manor

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What the care home does well People are referred and assessed before they use this service so they know the staff can support their needs. The people in charge listen to the individuals that use this service, and they will change things if required. People are supported to attend all health-care appointments. Staff at the service work hard to make sure people receive support the way they want. Their preferences are recorded in a care plan so staff know what support people need. The staff receive training to ensure they have the skills to support people in a respectful and dignified way. The staff are employed to work here after many checks are completed to ensure they are suitable. The managers at the service do a good job and people can go and see them at any time. What has improved since the last inspection? This is a new service and their first inspection What the care home could do better: We did not find any shortfalls during our visit. We found that people received the service they wanted and which met their needs. We have made some recommendations. If the manager agrees to put these into place, they would enhance the service people receive. Key inspection report Care homes for adults (18-65 years) Name: Address: Littleover Manor Littleover Manor 453 Burton Road Littleover Derby DE23 6FL 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: Claire Williams Date: 1 2 0 1 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 32 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 © (2010) 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 32 Information about the care home Name of care home: Address: Littleover Manor Littleover Manor 453 Burton Road Littleover Derby DE23 6FL Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tracy Jackson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 0 0 care home 6 Livlife (UK) Ltd learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 6 The registered person may provide the following category of service Care Home only PC To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Learning Disability Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home This is a new service which was registered in July 2009, to provide personal care and accommodation for up to 6 people, of either gender who have a learning disability. Littleover Manor is a detached house in a residential area of Littleover, four miles from Derby city centre. The service is close to local facilities and public transport. The property is currently owned by Mr Singh. People have an en-suite single bedroom. Four bedrooms are available on the ground floor and two bedrooms are available on the first floor. Access to the first floor is by stairs and a stair lift has recently been installed. Information about the service is provided through the Statement of Purpose and Service User Guide. These documents are avilable in a written and pictorial format to enable people to access them. People will have access to the inspection report which will be displayed in the service. The current fees for the service are dependent on the outcome of a financial assesment. The minimum fee are £750 per week and the maximum fee is £880 per week. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We came to the home without telling the manager before we came and spent a day there. We had received a lot of information about the home from the manager, the staff and people living at the home before we came. The information we received helped us plan what we would do when we arrived. At the service we spoke to the Manager, staff and spoke to people that were using the service. We also observed the way staff supported people in the service. We looked at a lot of records and documents that told us about the service, and the way it is managed. We spoke to three staff who were working during the time we were at the service We spoke to 2 people about their experiences of using this service. We looked at three peoples bedrooms. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well What has got better from the last inspection This is a new service and their first inspection Care Homes for Adults (18-65 years) Page 8 of 32 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Claire Williams CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 Care Homes for Adults (18-65 years) Page 9 of 32 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 10 of 32 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 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the service 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. Evidence: People are provided with information about the service and their rights. These documents are available in written and pictorial format to enable individuals to access them. The feedback we received from peoples representatives confirmed this. They also told us they had enough information to enable them to assist people to make a decision, about using this service. In the information provided about the service, the manager told us; they ensure all individuals have a full pre-admission assessment, which is undertaken by the Manager, and their prospective Health Care Professional. They told us people and their advocates, are also consulted. The records we looked at confirmed this. We looked at the files for two people, and the records demonstrated that a detailed assessment of their support needs had been undertaken before they had moved into this Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: service. There was evidence to support that based on this information a judgement was made on whether the placement would be successful, and if the service was able to meet peoples needs. This ensures people move into a service that is right for them. Feedback confirmed that people are encouraged to visit the service as part of the transition process. This ensures individuals can familiarise themselves with the staff and the building before they move in on a permanent basis. It also enables the staff team to have an opportunity to interact with people, and gain an insight into how they communicate. Care Homes for Adults (18-65 years) Page 13 of 32 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. Peoples care needs have been assessed, risk factors identified and care planned in ways that reflect their individual preferences and abilities. Evidence: We looked at 2 peoples care more closely and looked at their files. As stated in the self assessment we received, we found that each person had written information in place, to help staff know how to support peoples care needs and to minimise risks. This information was detailed and up to date and was written respectfully and positively and considered peoples individual preferences and needs. The plans had been completed with both written and pictorial information, which enables people to have some understanding about what area of support is being addressed. In the files we found that well being records were in place and completed regularly to ensure good communication is maintained between the staff regarding each person. Staff that we spoke to demonstrated their knowledge of peoples needs. They had a good understanding of peoples preferences and their communication style. Information was recorded in peoples care plans about their preferred communication methods, and any Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: aids they may use, to assist them such as symbols and photographs. This ensures the staff have access to the required information to enable them to assist people to make choices and promote their independence. The manager told us in the self assessment that the staff team aim to promote peoples choice, control and independence. Our observations of the way the staff members interacted with people supported this. We observed the staff members offering choices throughout our visit, and they encouraged people to be independent when undertaking daily living tasks. Feedback provided in the surveys told us that people and their representatives felt their needs were being met to a good standard. Care Homes for Adults (18-65 years) Page 15 of 32 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. People living at the service enjoy opportunities to develop life skills and wider social contacts; links with families and friends are promoted and supported Evidence: The manager told us in the self assessment how they ensure all people have the opportunity for personal development, by allowing individuals to continue to develop the skills they have, such as a particular hobby. They said they encourage people to undertake domestic skills where possible such as maintaining their bedroom area and to prepare food. They told us they ensure people have the continuing opportunities to fulfill their spiritual beliefs. Discussions with staff members confirmed this. The records seen indicated that individuals recreational, social, educational and leisure interests and hobbies were generally well met. The records identified individual choices, and preferences in relation to the activities they liked to participant in. This enables the staff to support and promote individuals independence within their chosen activity or interest. We looked at many photos to support the activities people had participated in Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: since they had moved into this service. Some of these included: a trip to Skegness, discos, Karaoke, lunch at different pubs and various parties over the festive period. During the time of our visit, three people were at the service and two people were out attending college. On their return they spoke about the Chinese lanterns they were being supported to make, and they seemed to have enjoyed this activity. During the afternoon one person was supported to visit a friend, and one person played their electric guitar, which they told us was one of their favourite activities. These observations supported that the routines were flexible and lead by people using this service. Discussions with the staff team confirmed that the staffing levels were adapted when possible to ensure sufficient staff were on duty to support people in community based activities and events. However we did receive some feedback to support that this is area that could be improved upon. Staff told us they would like to go out more often, but this was not possible when only two staff were on duty. This is because two people require a wheelchair for their mobility. The staff rotas in place demonstrated that 2 staff were on duty as a minimum at all times. There was limited information in peoples files concerning their preferred routines. This would enable the staff to work in a consistent way when supporting peoples needs. Feedback in the surveys, completed by peoples representatives, confirmed that peoples needs were met in a dignified and respectful way, and observations supported this. We observed the arrangements made for people to have their evening meal. Staff members were observed asking each individual, their choice of food using their preferred method of communication. The meal time was relaxed, and people were provided with their preferred choice. The menus devised are currently available in written format only. Discussions took place regarding how a large pictorial menu could be used to assist some people in making choices regarding meal preferences.Staff discussed how people living at the service were supported to go out for meals and try different types of food. In the files of the two people case tracked there was limited information in place regarding their likes and dislikes with regard to food and drink. Staff spoken with told us they are beginning to build up a good knowledge of peoples preferences and needs. Feedback provided in the surveys from peoples representatives demonstrated their satisfaction in respect of the activities, life experiences and the food provided. The following comments were made: The service is good at supporting people with social activities, and they are good at listening to what people want and need. Staff are polite and helpful to people and their visitors. The person I visit seems very happy living at this service and has told me they want to stay here. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: The person i visit is offered many choices throughout the day. I am satisfied with the care and support they receive. The staff are working very hard to ensure they understand peoples needs and behaviours. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support from staff in the way they prefer and want. They receive their medication as prescribed, which promotes peoples health and welfare. Evidence: The records we looked at, and the feedback from the surveys demonstrated that, people receive support with their personal care in the way they liked. In the information provided about the service the manager told us they support people with their personal care to the highest standard and promote privacy, dignity and independence at all times, and our observations supported this. The service works in partnership with a range of health care professionals in order to support peoples health care needs. People are supported to access health care services, such as G.P appointments, dentists, opticians and hospital visits. Information was provided in the files we looked at concerning their medical history both past, present and including their current prescribed medication. Each person has a health action file in place that is used to support them in understanding their health care needs. This enables them to take ownership of their own health care. This file is used to record all appointments. It is taken to all health care visits to enable individuals with staff support, to record any advice or treatment given. The records in place included pictorial formats to assist individuals understanding. This information is also recorded in peoples support plans. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: We found that the receipt, administration and disposal of medicines for the people whose care we case tracked was being recorded accurately and showed that people are taking their medicines as their doctor has prescribed. One person had been prescribed antibiotics, and although this had been listed in their support file, this information had not been updated and reflected in their care plan. This plan had been reviewed regularly, and after these antibiotics had been prescribed, but no information was recorded to reflect this change in need. The manager told is in the information provided by the service, that all staff have received accredited medication training. The records seen, and discussions with staff members confirmed that all of the team leaders who are responsible for administering medication had undertaken this training. We was told that two staff, have had an observation of their practice undertaken to ensure they are competent at administering peoples medication. All other staff members were due to have this observation undertaken in the future. Care Homes for Adults (18-65 years) Page 20 of 32 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. People are protected by having their rights to complain upheld and through staff understanding their responsibilities to report concerns. Evidence: The manager told us in the information provided by the service, they have an accessible complaints procedure in place, and that all individuals are aware of who they can complain to. They told us people have regular advocacy meetings where they can discuss the service, and any issues they may have. These are then taken to the manager to action if necessary. The manager told us procedures are in place in relation to safeguarding people from abuse, and that the staff are aware of and follow these. She told us the finances are checked daily by the management team. Discussions with staff members and the training records seen confirmed this. The staff members spoken to demonstrated their knowledge and their responsibilities in relation to responding to any complaints or safeguarding issues. As stated in the information we received from the service; an accessible complaint procedure is in place. This enables people to be aware of the processes in place. The service intend to obtain accessible information about safeguarding, to enable people to understand what constitutes as abuse. The service told us they have not received any complaints or had any safeguarding incidents since they became operational, and we have not referred any issues to the Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: service. All of the people currently using this service have requested for their finances to be managed by the staff team. We looked at the systems in place and found these to be satisfactory. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely environment which promotes their Independence. Evidence: This is a new service and therefore the building is fit for its stated purpose, and meets all of the legal requirements. The manager told us in their self assessment how they provide a homely and safe environment for people to feel comfortable in. They told us the service offers a jet spa bath, and that all rooms have walk in showers and wet rooms. They said the rooms are quite spacey and there is a ramp for wheelchair access to the service. They provide aids such as handrails for people who need them, and they said the building is furnished to a good quality and is fit for purpose. We had a brief tour of the building and can confirm that the physical environment provides for the individual requirements of the people who use the service. All rooms are single, with en-suite facilities and a separate bathroom is available as stated in the self assessment. There are two floors in this service with a stair case for access. A chair lift has recently been fitted to enable people with physical disabilities to access the first floor. There are two bedrooms on the first floor and the statement of purpose told us they these are for people who are fully ambulant. People have access to a communal lounge and dining area. In order to promote peoples Independence sensory aids have been fitted to all rooms. There is a large garden at the rear of the property, but this is not yet accessible as the ramp has not yet been completed. The service hopes to complete this soon and provide a sensory area for Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: people to enjoy. All rooms visited have been designed and furnished to reflect a homely style. They have been personalised in accordance with peoples preferences. People who want to have lockable storage have been provided with this facility. Observations supported that people were able to move around freely. One person told us: I like my bedroom it is very nice and has all my personal things in. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has established systems for recruiting, training and supporting its staff, so that the interests of people in their care are protected and their overall welfare is promoted. Evidence: In the information provided about the service the manager told us; they had a good staff team, and all of them had a National Vocational Qualification (NVQ) to level 2 and level 3. They said some staff are working towards a health and social care qualification, and some are working towards the Leadership and management in care Level 4 qualification. This demonstrates the motivation to training by the staff and the provider, and ensures a skilled and competent staff team support people in this service. Information provided in the self assessment told us, the staff had a good knowledge of peoples needs and disabilities, and they attend regular staff meeting and have regular supervisions. They said staff work in a person centred way. The records we looked at and our observations confirmed this. We were told that the staffing levels are based on the dependency needs of the people accommodated in the service. The staffing levels at the time of our visit was two staff supporting 5 people as a minimum on all shifts, and the manager is present during the day. Discussions with staff members and the feedback provided in the surveys told us that generally the staffing levels were satisfactory. Seven out of the ten staff who completed a survey told us They always had enough staff, and three said They usually did. We did receive some comments in the surveys telling us that More staff could be Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: provided especially for activities. Observations during our visit supported that the staffing levels were sufficient to meet peoples support needs in the service. However as mentioned previously when two staff are on duty, people would not be able to access the community. People we talked to spoke positively about the staff team and the following comments were made: The staff are good and nice The staff are helpful and friendly. In our discussions with staff members they told us they was well supported and enjoyed their role. These comments were confirmed in the feedback we received in the surveys. Observations supported that the staff members had a good knowledge of peoples support needs, and provided assistance in accordance with peoples preferences. We received the following comment from a persons representative: The staff are working very hard to ensure they understand peoples needs and behaviours. We also received comments from the staff team about what they thought about their role and working in this service. Some of these included; I enjoy my job, we provide good care to people and are always there for them. I think we provide quality care to people. We always meet their needs at all times. We take people out when we can and do activities they enjoy. We provide good care and have good training opportunities. We work well as a team, and meet peoples needs. All staff act very professionally and are very friendly and are a pleasure to work with. Information provided in the self assessment told us that all staff are interviewed and if successful have CRB and references obtained and checked. We looked at the files for the most recently recruited staff members. The records demonstrated that all of the required checks, and information had been obtained to ensure people are safeguarded, and the staff members are suitable to work with vulnerable people. Care Homes for Adults (18-65 years) Page 26 of 32 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 home is a well-managed and safe place in which to live and work. People living there are consulted and able to enjoy lifestyles that complement their individuality. Evidence: The service is managed by an registered manager who has worked in many care settings predominately with people with learning disabilities. She is currently undertaking the NVQ Leadership and management in care Level 4 qualification. She is supported by an experienced manager and provider who assist with the daily running of the service. A delegate of the provider visits the service on a monthly basis to monitor the standards in place. We looked at the reports from this visits and they demonstrated that the service was meeting peoples needs to a good standard. The manager told us in the self assessment how they aim to maintain a high standard in the running of the home. She said they do this by making sure that all staff or aware of the policies and through providing regular supervisions. Observations of staff practices demonstrated that their focus is aimed at promoting independence and indivdualised care and support.The staff spoken with confirmed that the manager provided them with the leadership, direction, support and guidance they Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: required. This enables them to work effectively in supporting the needs of the people using the service. The feedback in the staff surveys told us that staff felt supported by the management team and the following comments were made: We are well supported, so we can provide a good service and focus on encouraging independence. We give the best support to people, and I am well supported. The service is managed well. We have access to all of the information that we need to do our job to the best of our ability. I find my job very rewarding and work with a good professional team. I really enjoy working in this service. Some staff members did make the following comments about how the service can be improved and these included: Communication within the service could be improved. It would be beneficial for the people who live here if they had access to a sensory room. The service has implemented a range of quality assurance activities in order to obtain feedback from people. These include regular meetings with people and their advocates, annual quality assurance questionnaires and staff meetings. The service have already sent out surveys to people and various stakeholders and some of these have been returned. One comment received from a stakeholder included; I think the home is very well run, and is very good. The manager is very helpful, and I am always made to feel welcome and people are well looked after. We was told a report from the findings would be completed when all of the surveys have been received or when the timescale for their return has expired. As this service is a new build and has recently been registered, all of the equipment is under warranty and therefore in good working order. Information within the self -assessment stated that all of the required health and safety risk assessments were in place. The self assessment was completed in sufficient detail to tell us how the service has been operating since it became operational. Some of the areas within the self-assessment were brief and there was limited information in some of the outcome areas, to support how the service wants to improve in the next 12 months. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 32 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 Description 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 Description 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 6 People should have information recorded in their files about their Life history. This will enable the staff to be aware of their past before they moved into this service. Information should be recorded in peoples files about their ability to make decisions in their daily lives. Information about peoples preferred routines should be recorded in their files. This will assist the staff to meet individual needs in accordance with their perferences. Information about peoples likes and dislikes in respect of food and drink should be recorded in their files. This is to ensure the staff team are aware of their preferences. A pictorial menu should be devised to assist people to make a choice at meal times. All staff that administer medication should have an assessment of their practice undertaken. This is to ensure 2 3 7 16 4 17 5 6 17 20 Care Homes for Adults (18-65 years) Page 30 of 32 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 they are competent in undertaking these tasks. 7 20 When people are prescribed antibiotics these should be included in their plan of care. This is to ensure all staff are aware of this change in need. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 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 © (2010) Care Quality Commission (CQC). 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