Care Home: Longcroft

What the care home does well The manager provides people wishing to use the service with good information about the home and people have a thorough pre admission assessment prior to moving in, to ensure that the home can meet their needs. The care planning process is detailed and informative and daily records are well written and clear about how people have spent their day. The new computerised care planning system allows for risk assessments and management plans to be devised and the manager supplements this with a further plan for any temporary risks that are identified. Longcroft offers people living in the home a range of activities that includes accessing the local community and visiting their family. Health care is good at Longcroft and people using the service are supported to undertake regular health checks for both their physical and mental health. People spoken with told us that they were well supported in this area. The manager has a good system in place for recording and monitoring any complaints he may receive; the system allows for the content of the complaint and the actions taken as a result of any investigations to be recorded. The home has good quality furniture and fittings and is kept clean and tidy. Staff are well trained and supervised and are sufficient in numbers to meet the needs of the people using the service. The manager has good quality assurance systems in place and regularly seeks the views of the people living in the home. What has improved since the last inspection? There has been many improvements made since the last inspection and the manager has shown that he continues to improve the service; one staff member said in their survey "it seems to be improving on a monthly basis". The Service Users Guide is now readily available and is on display in the hallway together with the home`s complaints procedure next to the visitors book. The manager now confirms in writing prior to any admission that the home can meet the individual`s needs. The care plans now clearly describe each individuals needs and they identify the level of support that people need, to enable staff to provide the appropriate level of help. The manager carries out regular audits of the home`s medication system, there is now a risk assessment in place for random drug testing and the medication administration records show the rationale for any prescribed medication that has not been administered. The manager now undertakes regular checks of staffs competency to administer medication.Each member of staff now undertakes a thorough structured induction that meets the common induction standards. The recruitment process has improved and is now more robust and staff have had training in all of the core areas such as first aid, food hygiene, safeguarding adults, medication and health and safety. Staff have also received more service specific training such as understanding mental health, control and restraint and challenging behaviour. What the care home could do better: The staff duty roster should show who is in charge of each shift. The manager should ensure that there is a system for checking that the home`s safety checks have taken place when they are due. Key inspection report Care homes for adults (18-65 years) Name: Address: Longcroft 34 Swan Lane Wickford Essex SS11 7DD     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: Pauline Marshall     Date: 2 8 0 1 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 27 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 27 Information about the care home Name of care home: Address: Longcroft 34 Swan Lane Wickford Essex SS11 7DD 01268572066 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Veneta Ann Samuel Batt,Tony Brian Batt care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Longcroft is a single story building registered to accommodate 5 persons with a mental disorder. There are 5 single bedrooms all with an en-suite facilities. The home has a communal lounge and an open plan kitchen/dining area. There is a good sized garden at the rear of the building and there is space for 4/5 cars on the forecourt. The home is decorated and furnished to a good standard. The home is situated on the main road into Wickford town centre and is therefore in close proximity of local transport and community facilities. The home is in keeping with domestic dwellings within the area. The homes Statement of Purpose is available upon request from the home. The manager said that the fees were £970 to £1200 per week and there are additional charges for items of a personal nature. 2 3 0 3 2 0 0 9 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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: This was an unannounced key inspection that lasted for four and a half hours. All of the key standards were inspected; we checked a random sample of policies and procedures and we looked at some of the records that the home is required to keep. We looked around the building and we spoke to the people living in the home, one staff member and to the manager of the home. We checked the progress of the requirements that were made as a result of the last inspection that took place on 23/03/2009 and we found that these had all been met. The manager completed his annual quality assurance assessment (AQAA) and returned it to us in the required timescale; it was detailed and informative and provided us with good information about the service. The AQAA is a self assessment document that the manager is required by law to complete; we have used the information provided in the AQAA throughout this report. Care Homes for Adults (18-65 years) Page 5 of 27 We sent surveys to the manager to distribute to three people that use the service, four health and social care professionals and to seven of the homes staff to obtain their views on the service the home provides. At the time of writing this report we have received three completed surveys from the people living in the home, one from a health and social care professional and six from the homes staff. All of the surveys that we received were positive about the service and we have included comments from them throughout this report. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? There has been many improvements made since the last inspection and the manager has shown that he continues to improve the service; one staff member said in their survey it seems to be improving on a monthly basis. The Service Users Guide is now readily available and is on display in the hallway together with the homes complaints procedure next to the visitors book. The manager now confirms in writing prior to any admission that the home can meet the individuals needs. The care plans now clearly describe each individuals needs and they identify the level of support that people need, to enable staff to provide the appropriate level of help. The manager carries out regular audits of the homes medication system, there is now a risk assessment in place for random drug testing and the medication administration records show the rationale for any prescribed medication that has not been administered. The manager now undertakes regular checks of staffs competency to administer medication. Care Homes for Adults (18-65 years) Page 7 of 27 Each member of staff now undertakes a thorough structured induction that meets the common induction standards. The recruitment process has improved and is now more robust and staff have had training in all of the core areas such as first aid, food hygiene, safeguarding adults, medication and health and safety. Staff have also received more service specific training such as understanding mental health, control and restraint and challenging behaviour. 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 8 of 27 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 9 of 27 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 get good information about the service and they know that their needs will be met. Evidence: The homes Statement of Purpose and Service User Guide were recently reviewed and they now include all of the required information. A copy of both documents is available in the hallway of the home. One of the people using the service said when spoken with that they were provided with copies of the Statement of Purpose and Service User Guide when they first moved in and the care plans showed that people were given these documents as part of the pre-admission process. We looked at three care files and we found that each of them contained an assessment report, which provided full details of the care needs of the individual. The third care file that we looked at contained an additional form entitled Longcroft pre admission assessment and this was a handwritten document that described the care needs as identified at the initial meeting. The pre admission assessment form looked at the presenting complaint, problem, diagnosis or situation, it looked at the persons Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: mental health history and treatment and if there had been any family history of mental illness. Other issues identified in the pre admission assessment included other relevant medical conditions, investigations or allergies, the persons current medication and their social history. The assessment looked at the persons current mental state including their mood, if they had any suicidal thoughts, their memory, their orientation, their concentration and their motivation. The document identified if the person had alcohol and drug use disorder, psychotic disorder, depression, anxiety disorder, unexplained somatic disorder or any other diagnosis. This form also showed the date and time of any planned visit that was to made as part of the pre admission process. People using the service confirmed that they visited the home prior to moving in and the home now confirms in writing that they are able to meet the needs of the individual. The manager said that the new pre admission assessment form would be used together with the assessment report for all new admissions. All three of the care files that we looked at included signed copies of the individuals contract with the home. Care Homes for Adults (18-65 years) Page 11 of 27 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. People receive appropriate individualised care based on their identified needs. Evidence: We looked at three care files which were person centred and showed that the needs of people living in the home were fully met. The manager said in his AQAA we have invested a lot of time and money setting up a new computerised system for Longcroft which is more personal to those living at the home. We looked at the computer programme entitled Care Docs and saw that it allows individual staff members to make entries to the daily records and it identified the staff member that made each entry. The manager said that inputting the original data took some time but that the new system provides a much clearer picture of the needs and support that people need. The new system showed each element of care that was required including personal care such as bathing and personal hygiene and it identified any risks associated with the tasks and provided clear plans on how any risks were to be managed. The care plans were clear on the level of support that each individual required and people using the service confirmed that they were happy with the level of Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: support that staff offered. The daily notes were well written, detailed and informative. The three people that we spoke with told us that they have regular meetings with the owners, the manager and the homes staff and that they discuss all areas of the running of the home including their preferred meals and mealtimes and the activities that they undertake. There were notes of the meetings that had taken place and they showed that people living in the home are fully involved in decision making. People told us that they were very involved and that they made decisions about their lives on a daily basis. People using the service are encouraged to take responsible risks and the care plans showed that risks had been identified and management plans put in place to eliminate or minimise the risk. People spoken with confirmed that they are supported by staff to take reasonable risks as identified in their care plans. Care Homes for Adults (18-65 years) Page 13 of 27 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 are well supported to live a lifestyle that meets their identified needs and preferences. Evidence: We looked at three care files and these showed that people using the service had been involved in a range of activities including walking the dogs at Hockley Woods, shopping in Wickford Town Centre, trips out to Southend, Basildon and to the theatre. The manager said in his AQAA we have created more external activities for the service users. People spoken with told us that they liked to choose their own activities and that the staff always tried to accommodate them with their wishes. People confirmed that they regularly went out and that there was plenty to do inside the home. One person said I regularly go into the town and look around the shops and buy my videos and CDs. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: On the day of our visit people went out to Wickford Town Centre and had a coffee and a walk round the charity shops and on their return they watched the movie Grease which they all appeared to enjoy. One person keeps rabbits and they told us they take some looking after and they need regular cleaning and feeding. They also told us that in the warmer weather the rabbits go out into a run, which means that the hutch does not have to be cleaned out quite so often. This person also said I enjoy looking after my rabbits and we bought a new hutch recently as the old one was a bit small for two rabbits but we are keeping the old in case we get any more rabbits. Another person said in their survey I am happy here, I have a lot more company and people to talk to and I am supported when I want art materials. The care plans showed that people are encouraged and supported to carry out the activities they choose with the people they choose and people confirmed this when we spoke with them; one person regularly spends time with their parents. People using the service participate in the homes daily routines; the manager said that they are supported to keep their individual space clean and tidy and that they are able to access all areas of the home. One staff member said in their survey people are encouraged to keep their rooms clean and tidy and to change their bedding regularly. The home operates a four week rolling menu that is subject to change to meet the needs of the people living in the home. The manager said in his AQAA menus are changed more regular as per requests from service users. The menus did not show an alternative meal option, however, the manager said that people were able to choose from a range of other options if they did not want the meal that was shown on the menu. People spoken with confirmed that there was always other options available and that staff would offer them alternatives all of the time. The benefits of showing an alternative meal on the menu were discussed and the manager agreed to amend the menus to show a choice of meals. Care Homes for Adults (18-65 years) Page 15 of 27 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 will receive good personal and healthcare to meet their individual needs. Evidence: The manager said in his AQAA we try and offer support as privately as possible and we ensure that peoples privacy and dignity is respected at all times. We spoke to the three people that live in the home and they all told us that staff supported them with their personal care in a dignified way; they told us that staff were respectful towards them and that they were encouraged to maintain their independence in respect of their personal care and hygiene. One staff member said in their survey we care for the individual needs of each person and maintain their independence by making sure that they eat and drink well, they keep themselves clean and are wearing clean clothes. The health records showed that people living in the home have attended regular health care appointments, this was recorded in the daily notes but the information was difficult to access quickly as we had to go through all of the daily notes to establish when the last appointment occurred. The manager said that before the computerised care planning system was in place he used to record all health care appointments on a Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: professional visits sheet making it easier to see the individuals health related appointments at a glance; the system was recently stopped. The benefits of the old system were discussed and the manager has since arranged for a similar system to be added to the Care Doc computerised system. People spoken with confirmed that they attended regular health care appointments and there was documentation on each of the three files that we looked at to confirm this. The manager reviewed the homes medication policy and procedure in December 2009. The medication is stored in a locked cabinet in a locked cupboard together with the medication administration sheets (MARS). Medication information sheets were available for all of the medication that was in the medication cabinet. There was PRN protocols in place for all as and when prescribed medication to show when, why and how the medication was to be given. All staff have had medication training and the manager carries out regular medication competency checks. The home uses a monitored dosage system, however some medication was not included in the system and was still in packets; the manager said that he hoped to rectify this at the next prescription request. We checked a random sample of medication together with the medication records and we found that all open boxes showed the date that they were opened and a medication count showed that all but one were correct. The manager has since undertaken an investigation and has put in place weekly checks of the medication and more frequent staff competency checks to minimise the risk of this occurring again. Care Homes for Adults (18-65 years) Page 17 of 27 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 know that their concerns will be dealt with and that they will be protected from harm and abuse. Evidence: The manager last reviewed his complaints policy in December 2009. No complaints have been made either to the home or to the Commission; the manager has a document in place for recording complaints and he said in his AQAA we have a good complaints audit trail and our procedure is displayed on the wall. People spoken with were fully aware of how to complain and they appeared confident to do so if they felt the need. We looked at two cash and cash transaction records belonging to the people living in the home and we found them to be accurate and up to date. We looked at the homes abuse policy and it was clear and detailed and advised staff of the actions they needed to take should they suspect abuse. We spoke to a member of staff and they had a good awareness of the need to report any suspicion of abuse to the Local Authority. The training matrix showed that all staff had received abuse training in the past twelve months and there were certificates on each of the staff files that we looked at to confirm this. Care Homes for Adults (18-65 years) Page 18 of 27 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, comfortable safe environment. Evidence: We looked around the home and each of the bedrooms had en-suite facilities, were individual and contained many of the occupants personal belongings. One staff member said in their survey we encourage the people living in the home to keep their rooms clean and tidy and to change their bedding regularly. People living in the home said that they were happy with their rooms and one person said I like to keep my room tidy and staff help me when I want to clean it up. The home has a good sized lounge, an open plan kitchen and a dining area; the furniture and fittings are of a good quality and are in good condition. The home has a small laundry room; the manager said that people are encouraged to do their own washing with the support of staff and people using the service confirmed this. There is a good sized secure garden that overlooks Wickford cricket pitch and one person living in the home told us that the manager is going to purchase a summer house where they can sit and watch the cricket in the warmer weather. In the past year the manager has utilised a separate outbuilding that is accessed from the garden and made it into a gym; there is also a snooker table for people to use. The manager said that people make good use of this facility and people using the service confirmed Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: this. The home was clean, pleasant and hygienic and maintained to a good standard and all staff have received training in infection control as part of their health and safety training. The manager said that any repairs are reported to the owner and that they are always carried out promptly; there was no written records to support this. The benefits of keeping a record of repairs and maintenance was discussed and the manager has since confirmed that he has set up a maintenance book so that he can record the date of the request and the date the repair was carried out. Care Homes for Adults (18-65 years) Page 20 of 27 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 a competent, well-trained and supervised staff team, who are safely recruited. Evidence: The staff duty roster showed that there was always two staff on duty throughout the day and that one staff member is awake at night. The manager now has two days each week where he is supernumerary, which he says is sufficient for him to carry out his management tasks. The staff duty roster was clear and showed the full names of the staff working and the hours they worked but it did not show who was in charge of each shift. We looked at three staff files and we found that they all contained a completed application form, a criminal records bureau check (CRB) and evidence of staffs induction. Two of the staff files that we looked at contained two written references as required, but the third file contained only one and two requests for references. The manager had informed us about this situation and said that the staff member was known personally to him and as they had recently left college and they had no work history. There was evidence that this staff member had been closely supervised, had a thorough induction to care and to the home and has had training in medication, safeguarding adults, health and safety, food hygiene, fire safety, first aid and is in the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: process of doing his NVQ2 in care. A considerable amount of training has taken place in the last twelve months and there is more training arranged in the coming months, which includes updates in subjects that staff were trained in last year. The training matrix showed that training in the past year has included medication, safeguarding adults, moving and handling, health and safety, food hygiene, first aid, fire safety, control and restraint (including challenging behaviour) and mental health. There were certificates on staff files to confirm that the training shown on the training matrix had taken place. The manager said that he is looking at the possibility of providing staff with on-line training through E-Learning and that he hopes that all staff can undertake this training in the Mental Capacity Act and the Deprivation of Liberties. Staff spoken with confirmed that the training offered was good and they said in their surveys that the training covered all that they needed to know to carry out their work. We looked at three staff files and they all contained records of supervision sessions. The manager said that these are scheduled every four to six weeks and more often if necessary; the records confirmed this. There was notes of regular staff meetings and seven had been held in the past year and they showed that issues were discussed freely and that all staff participated in them. Staff spoken with and surveyed said that they felt well supported and supervised Care Homes for Adults (18-65 years) Page 22 of 27 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. People live in a well run home that is run in their best interests Evidence: The manager has been in post since November 2008 and is in the process of applying to be registered; he has more than eight years experience in the caring field and has managed a home for older people. The manager has achieved an OCN in elderly care, an NVQ3 in care, a diploma in care and the registered managers award; he regularly updates his practice and has recently completed training in health and safety, food hygiene, fire safety, mental health, control and restraint (including challenging behaviour), medication, safeguarding adults. The manager has also completed training on line via E-Learning on the Mental Capacity Act and the Deprivation of Liberties and he intends to roll this out to all of his staff. The manager has put in place many improvements since the last inspection and has met all of the outstanding requirements. All of the surveys that we received were positive about the manager and the way the home is run and one staff member said in their survey the home has changed a lot since I started a year ago and it seems to be improving on a monthly basis. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager completed his annual quality assurance assessment (AQAA) and returned it within the required timescales; it provided us with all of the information that we had asked for and detailed the many improvements that the home has made in the past twelve months. Regular meetings take place and there were records to show that all of the people using the service are fully involved in the running of the home; in addition to the recorded meetings the manager said that the owners visit weekly and meet with people to discuss any issues and people living in the home confirmed this. The manager has recently undertaken a survey to establish that peoples views are sought and he said that he intends to do this every six months to ensure that people are getting what they want from the service. A discussion took place around the benefits of writing a short report to identify any actions that needed to be taken as a result of the survey and the manager said that he would do this for all future surveys. We checked a random sample of safety certificates including the homes electrical installation test, fire safety checks and drills and the gas soundness check. All were up to place and in date with the exception of the gas soundness check, which could not be found; there was evidence of the boiler being serviced in February 2008 and the manager said that he felt the test had been carried out but as the certificate could not be found he has arranged for this to be done on 4/2/10. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 2 32 42 It is recommended that the staff duty roster shows the name of the person in charge of each shift. It is recommended that a check is kept on all safety certificates to ensure that essential safety checks are carried out regularly. Care Homes for Adults (18-65 years) Page 26 of 27 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). 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