Care Home: MacIntyre Residential Home

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What the care home does well Comments made by a relative who returned the survey sum up `What the service does well`: "An excellent run home - with activities organised for the residents. Very happy atmosphere and very caring staff. There may be something (they could do better) but I cannot think what it might be! ... is very happy at Hurst House (one of the three houses that make up the home) and as a mother, I am very assured of her future there". What has improved since the last inspection? There were no Requirements or Recommendations following the last key inspection in September 2007 What the care home could do better: The service should provide the Statement of Purpose and Service Users` Guide, in an alternative format if required, for people (or their representative) who may consider moving to the home, and for people (or their representative) who currently live in the home so that they have information about what services are offered and how to complain if necessary. The Complaints Policy and Procedure should contain the contact details for CQC and for Social Services and their role in managing complaints. As recommended following the last inspection two people should sign any financial records when making deposits and withdrawals on behalf of people who live in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: MacIntyre Residential Home 1-5 Waring Close off Glenfield Frith Drive Glenfield Leicestershire LE3 8PZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Carole Burgess     Date: 0 4 0 8 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: MacIntyre Residential Home 1-5 Waring Close off Glenfield Frith Drive Glenfield Leicestershire LE3 8PZ 01162878330 01162321697 zoey.cussons@macintyrecharity.org www.macintyrecharity.org MacIntyre Care care home 15 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 15 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 Physical disability - Code PD Date of last inspection Brief description of the care home MacIntyre Residential Home is in the Glenfield area of Leicester, very close to the Glenfield Hospital. The home is run by MacIntyre Care, a charity, which provides residential accommodation, and day services, to people who have a learning and physical disability. The home is three houses named Pippin Place, Hurst House and Red Robin Reach and has access to safe gardens at the rear of the property. The houses have been Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 15 15 Brief description of the care home specifically designed for the people who live in them, and the service have their own transport. Local shops are situated nearby with a doctors surgery, post office and hairdressers. The nearest bus stop is only a few minutes away with services to a number of towns including Leicester city centre, which about three miles away. Fees range from £49.515 - £99.555 per year dependent on individual need. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 Stars. This means the people who use the service experience excellent quality outcomes. We as it appears throughout the Inspection Report refers to the Care Quality Commission. The focus of the inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who use the service and their views of the service provided. The previous key inspection was undertaken on 3rd September 2007. The site visit was unannounced and took place over six hours. We selected three people and tracked the care they received through a review of their records, discussions with visitors, the care staff, and observation of care practices. We spoke Care Homes for Adults (18-65 years) Page 6 of 29 with staff members regarding the training and support they received. Planning for the inspection included assessing notifications of significant events, a review of the Annual Quality Assurance Assessment (AQAA) sent to CQC by the service. Surveys were sent to people who use the service, staff and health professionals to provide feedback to CQC. Five people, with the help of their support worker or relative, and one member of staff returned the surveys. All were very positive about the care provided at MacIntyre Residential Home. The Registered Manager and other staff spoken with were positive and helpful during the inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 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 9 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. People (or their representative) have sufficient information to make an informed decision if the home is the right one to support their specific healthcare needs. Evidence: We wanted to find out what information the service provided for people who may be thinking of moving into the home. The home had a Statement of Purpose and Service Users Guide to ensure that people have sufficient and clear information to enable them, or their advocate, to decide if the home is the right one for them. They contained the required information but they were not supplied in any alternative formats i.e. pictorial, so that people with learning difficulties could have access to this information. We discussed this with the Registered Manager, who stated that her client group were profoundly mentally & physically disabled and the Service Users Guide was provided for the relatives of people who lived in the home. However, she said that they were working on a format for the Statement of Purpose and Service Users Guide which would be suitable for their particular client group. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: We also noted that there was currently no information regarding advocacy services for people, or their relatives, who may require independent help or advice. The three plans of care reviewed contained detailed and comprehensive assessments to ensure that the home could meet peoples general physical, mental, emotional and social care needs. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples plans of care were comprehensive, detailed, person centered and reflective of their specific health, welfare, emotional and social care needs. Evidence: We wanted to find out if people were supported to make decisions and choices in their daily lives. We looked at three care plans and spoke with staff and a relative about how people who lived in the home were supported to do this. Many of the people who live at MacIntyre Residential Home are profoundly disabled and those people seen at the time of inspection were unable to provide information about their daily lives. However, a relative spoken with told us that staff were very supportive and this enabled him, with the support and help of two carers, to take his relative who lived in the home on a number of short holidays each year. He was clear that this was a very enjoyable experience that enriched the the lives of all concerned, and that it was greatly enjoyed by his relative. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: The person centered care plans were detailed and covered all aspects of health and social care. They contained pictorial and written information about how people wished to be supported in their daily lives, and their hopes and aspirations for the future. The care plans contained a Family History with Things I Like To Do both in pictures and words and contained thoughtful details such as I have a sweet tooth, I like fashionable clothes and included the ways that the person liked to spend their time such as swimming, going bowling and relaxing to music that ensured an individualised approach to the care for the people who lived in the home. Care plans and risk assessments demonstrated that the home worked with the people who lived there, their relatives (where possible) and health professional to support people to make choices and take appropriate risks and live their lives to their full potential within their personal capabilities and limitations. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff ensure that people who live at MacIntyre Residential Home are provided with opportunities for personal development and live fulfilling lives both in and outside of the home. Evidence: We wanted to assess if peoples life style matched their expectations and capabilities within the limitation of their disability, and enabled them to live meaningful lives. MacIntyre utilise a Life Long Learning programme which provides a personalised timetable to support each person who lived in the home. It was evident from the detailed care plans that each persons educational, physical, social and emotional needs had been considered and addressed. Each person had a detailed lifestyle and activities person centered care plan to ensure that their personal lifestyle choices were well supported. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: On the day of inspection many of the people were out at day care or taking part in other activities. Activities and daily routines were tailored to individual needs and preferences. People attend day care, either full or part time and one person goes to college during term time to ensured that their assessed educational needs were met. Activities included things that people enjoyed on a regular basis included such as bowling, swimming, community walks in Abbey Park, staff supported visits to the bank and shopping, TV, music and cooking (under supervision), pampering time (care of face, hand and feet) and DVD & popcorn nights. Birthdays and festive days were celebrated. The Registered Manager said that Halloween and Christmas were particularly enjoyed as were themed nights when staff from other countries dressed up and provided their national dishes such as the Spanish & Moroccan nights and these were enjoyed by both staff and residents. People who were able were encouraged to assist with chores (staff do all chores such as cleaning etc) to maintain a family style environment. People were able to go on holidays, attended by the appropriate number of care staff: Three people had been to Tenerife in May this year, and two people had been to Malta. Other holidays for people had included holidays in Yorkshire, Scotland, Minehead and an activities holiday with the Calvert Trust in Devon. The home had four cars at their disposal so there was sufficient specialised transport to ensure people can be taken out and about. All activities both in and out of the home had been thoroughly risk assessed to ensure that peoples safety was maintained at all times but also respected their right to take responsible risks within their own personal development plan. Peoples personal achievements such as certificates awarded for developing personal skills were kept in the care files, and one person had just been supported in taking part in the recent Special Olympics in Leicester. Menus and meal times were organised slightly differently in each of the three houses according to the daily life of the people who lived there. For example the Registered Manager said that at Hurst House they did a weekly shop on line from Tesco for all of their staple requirements but people who were able helped with the weekly shopping. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Because there were only a small number of people in each house preferences and choices were well supported by staff. People with communication problems had their likes and dislikes well documented as were their special words for certain foods and their facial expressions to express their preferences so that staff were able to understand if someone was expressing a preference or refusing what was being offered. One person was receiving Percutaneous Endoscopic Gastrostomy (PEG) feed (being fed through a tube directly into the stomach). Staff had been supporting the person with the help of the dietitian and Speech and Language Team (SALT) and had a care plan with guidance and risk assessment in place to ensure the safety of the person receiving the feeds and to enable them to remain in the home. Food and meal times were flexible. People were able to choose what they would like to eat and the meals were cooked by the staff, and people who lived in the home were able to assist under supervision. In the pre-inspection survey (with the help of their support worker) a person told us that the service helped them to live an independent, healthy and active life and that staff provided excellent support, and that they were listened to and shown respect. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples mental, physical and emotional healthcare needs are fully supported and met. Evidence: We wanted to assess how well peoples healthcare needs had been met. We spoke with a relative and the staff, and checked the care files of people who we case tracked. Peoples care plans provided detailed information regarding their specific health and emotional care needs. Visits with GPs, and other health professionals such as hospital visits and visits to opticians, chiropodists, dentists etc were well documented. Relevant care plans and risk assessments had been updated to reflect any changing health care needs to ensure that they would be identified and met. Continence and personal care plans were explicit about individual needs and preferences and ensured that tissue viability was maintained. Peoples preferences regarding bathing were also detailed, describing such things as their preference for baths or showers (one lady had had a bath installed in her en suit in preference to a shower); if the use of bubble bath or talcum powder were required; how to maintain Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: modesty during bathing or showering; and they also described how some people liked to have some private time whilst in the shower (this had been risk assessed) and another care plan described how a person liked to relax and listen to music whilst bathing. They also contained preferences for male or female staff to ensure that personal care needs were provided in a sensitive way. The medicines were checked. No one was self medicating at the time of inspection. Prescription sheets were completed correctly and staff had received medication training to ensure that medicines were given safely as prescribed. A relative told us that staff made sure that his relatives health care needs were always given top priority and that he had no worries or concerns about any aspect of her care. In a pre-inspection survey (completed with the help of a support worker) we were told that the service supports me to achieve my goals and supports me throughout my care plan. 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. Arrangements for receiving and responding to complaints ensure that peoples right are protected. Evidence: We wanted to find out how staff at MacIntyre Residential Home promote the safety of people who live there. The home had a police & procedure for responding to complaints. This was also in a pictorial form on the wall near the office and in the homes Service Users Guide. However, it did require updating to provide information regarding the role of Social Services in managing complaints, and should also include CQCs new contact details. We reviewed the complaints file which included details of safeguarding vulnerable adults procedures. The complaints file and AQQA show that complaints were responded to appropriately. CQC had not received any complaints from the public about the service. The home had the necessary safeguarding policies and procedures which were reflective of local guidance. Staff received appropriate training in safeguarding vulnerable adults and were able to show that they knew what procedures to follow and were aware of whistleblowing procedures to ensure that they know how to protect Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: the people in their care. Some staff were a little unclear about the role of Social Services and CQC in managing safeguarding incidents. The Registered Manager said that she would ensure that this was addressed. The service had referred two incidents to Social Services that were currently being investigated under the safeguarding protocols. The service dealt with these issues in a responsible, sensitive and professional manner to ensure the safety of people in their care. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comfortable, clean and modern environment reflects the specific needs and younger age group of the people who live in the home. Evidence: The home was divided into three houses, Hurst House, Pippin Place and Red Robin Reach. Although similar, each house was adapted and reflective of the specific needs of the people who lived there. All three houses were clean and well maintained. The modern decor was reflective of the younger people who live there. Peoples rooms were large to accommodate wheelchairs, tracking hoists and any other equipment necessary for their care and comfort. Each room had a large en suit bathroom, again large enough to accommodate hoists and or specialized chairs for bathing. One bathroom had a bath as requested by the young women who occupied the room as she preferred baths to showers. Rooms were well personalised and were reflective of the personality of the occupant. Some had been redecorated and refurbished with input from the individual and their family. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: In each house there were pleasant communal rooms with TV & DVD, dining areas and kitchens and lifts large enough for wheelchairs to access the first floor. There were pleasant, safe gardens with raised vegetable beds and a swing adapted to take wheelchairs. The home was comfortable and safe with both specific and generic risk assessments to ensure that the people who lived in the home, and staff who work there, did so within a safe and homely environment. 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. The staff at the home are trained and sufficient in number to meet the needs of the people who live there. Evidence: There were fifteen people living in the three houses at the time of the inspection visit. There were sufficient, well trained staff to meet peoples current health and social care needs. During the day there were seven - ten staff across the three houses depending on individual need and the activities planned that day. There were four staff at night including a sleep-in. Staff numbers were generally higher in the evenings to help with activities. One person who responded to the pre-inspection survey (with the help of their support worker) said that they could do with a bigger staff team but Social Service financial funding prevented this. There was Training Matrix to identify staff training needs. Induction was over a six month period. New staff used E-learning (via the Internet) and kept a Personal Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Development Plan, monitored by the Registered Manager. Staff completed the MacIntyre and the in house induction programme, whilst shadowing a more experienced carer to begin with. There was a three month probationary period with set objectives to complete supervised by the Registered Manager to ensure that staff acquired the necessary skills to care for the people who lived in the home. Mandatory training and updates were arranged for all staff. This included First Aid, Moving & Handling, Communication Skills (including Makaton) Understanding Epilepsy, Food Hygiene, Safeguarding Vulnerable Adults and Health & Safety. Staff also received training in managing challenging behaviors and physical intervention techniques. Staff profiles and certificates for each member of staff were available to demonstrate that they had the skills required to care for the people who lived in the home. Only five of thirty-five staff had an National Vocational Qualification in Care (NVQ) but two staff were about to complete an NVQ and ten other staff were awaiting access to NVQ courses. The Registered Manager had the NVQ Assessors Award and two staff have completed train the trainer to ensure that staff are well supported with their training programmes. There was a Supervision Matrix with dates so that all staff received regular supervision (a record of their personal development and training needs). Those staff spoken with confirmed that they received monthly supervision and that it was supportive and helpful. Four staff files were reviewed. All staff had received an enhanced Criminal Records Bureaus (CRB) check. A recruitment check sheet had been ticked and signed to say that all the necessary documentation had been received and was satisfactory to ensure that staff employed were suitable to work with vulnerable people. In the pre-inspection surveys a member of staff said that they enjoyed their job very much and that the service provided excellent support to staff who worked there, and provided opportunities for them to grow and learn. 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 Registered Manager provides good, supportive leadership for staff to ensure that people who live in the home receive an excellent standard of care. Evidence: The Registered Manager had been with the company since 1996 and had an NVQ, Level 4 in care, and the Registered Managers Award (RMA). She has completed a Train the Trainer course and is also an NVQ assessor so that she had the necessary skills to lead the staff team. Staff said that they felt well supported by the Manager and that the home had a welcoming and relaxed feel. People who lived there seemed happy and secure, and two relatives said that the home was well run and that they could not think of anything that they could do better. The service send Quality Assurance Questionnaire to parents, representative or advocates of people who live in the home. These are collated by the mangers and any actions were addressed to improve the service either for an individual or for the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: service as a whole. Records, as such, were not reviewed but it was noted, that although satisfactory, peoples personal allowance records did not have two signatures, This was noted as a recommendation at the last inspection in 2007 and should be implemented to ensure that financial records are accurately maintained as a safeguard for both staff and the people who lived in the home. The home had a maintenance programme for such things as hot water checks and gas and electrical maintenance, and there was a Fire Risk Assessment for the property to ensure that staff, visitors and people who live in the home live and work in a safe environment. 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 1 The Statement of Purpose and Service Users Guide should be provided in an alternative format suitable for the people who do, or may in the future, receive care at MacIntrye Residential Home. Both documents should be provided for all current and prospective service users or their representative. People should have information regarding access to advocacy services. 2 1 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. 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