Care Home: Manchester Learning Disability Partnership

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What the care home does well They assess people`s support needs and have an introduction into the service. This takes into account the views of the people they provide support to and their families and carers. They involve the person and their families in the choice of the service on offer. This means that people can choose which of the houses they stay in. They have redecorated the house and bought new furniture. This means people had a comfortable and pleasant environment to stay in. The offer people the choice of a male or female support worker. This means that people who prefer to be supported by staff of the same gender can do so. Information about the service was available in various formats and languages. This means that everyone using the service had access to information. They supported people with special dietary and cultural needs such as diabetic, Halal and Kosher meals. They support people to attend religious services. This means that they were able to support people to observe their cultural and religious needs. They provide staff training. This means that staff had the right skills and knowledge to meet people`s support needs. They support people to maintain their daily routines whilst staying at the home. This means that people can continue to attend day centre`s or work placements. They have a robust recruitment and selection process. This means that they carried out safety checks on all staff before they began working at the home. What has improved since the last inspection? The house has been decorated since the last inspection and some of the furniture has been replaced. They told us that since the last inspection they now have the use of a mini bus. This means that people can get out and about to different places. They carried out home visits and reviews with families on a 6 monthly basis unless needs have changes or been identified. They set up a schedule of tea time visit or visits in the day or home visits. This is done to introduce they person to the service and can go on for as long as is needed. They have improved support plans these are now more person centred. This means that people are more involved in planning their support and plans read as though the person is telling us how they want to be supported. What the care home could do better: They should continue to develop and maintain the current good practice at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Manchester Learning Disability Partnership Short Breaks Service 8 Broadlands Walk Moston Manchester M40 5LT     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: Susan Jennings     Date: 1 6 0 9 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 30 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 30 Information about the care home Name of care home: Address: Manchester Learning Disability Partnership Short Breaks Service 8 Broadlands Walk Moston Manchester M40 5LT 01612055286 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: lgrant@notes.manchester.gov.uk Manchester Learning Disability Partnership care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The home provides accommodation and care on a respite basis for a maximum of four adults aged between 18 and 65 years old whose primary need for care is by reason of learning disability. The matters detailed in the attached schedule of requirements must be completed within the stated timescales. The organisation must, at all times, employ a suitably qualified and experienced manager. Date of last inspection Brief description of the care home The care home provides 24-hour accommodation and support for up to four learning disabled adults for short breaks to give their carers/families a break from their care role. The home currently provides this service for 35 people. The building is a normal domestic house set on a residential street in the north of Manchester with good access to local amenities. The building is accessible for wheelchair users with a through floor lift to the first floor and tracking hoists on the ground floor. The ground floor has a Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 4 Brief description of the care home kitchen, lounge and dining room, toilet and shower facilities. Bedroom accommodation and further bathroom facilities are on the 1st floor with a staff sleep-in/storage room. There is an enclosed garden to the rear of the building. Information provided to the CSCI detailed that the charges for the service are #13.50 per day. Information about the service can be obtained from the Short-Break Team based at Forrester House. Care Homes for Adults (18-65 years) Page 5 of 30 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 three star. This means the people who use this service experience excellent quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Care Quality Commission) in relation to this service prior to our visit. We also looked at other information we had about the service. Before our visit the manager was asked to complete an Annual Quality Assurance Assessment (AQAA) to provide up to date information. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. The visit was unannounced and took place over the course of 5 hours on Wednesday 16th September 2009. During the course of the site visit we spent time talking to Care Homes for Adults (18-65 years) Page 6 of 30 relatives of the people staying at the home, the manager and 2 members of staff to find out their views of the service. Time was spent examining maintenance records and the residents and staff files. We also spoke to people to ask them what they thought about the service they received. There was evidence to show that the unit managers and staff continued to work hard to develop and improve the service. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 8 of 30 They should continue to develop and maintain the current good practice at the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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 were given enough information to make a decision about using the service and peoples needs were assessed prior to them being offered a service. Evidence: The home is one of a group of short-break services provided within the Manchester Learning Disability Partnership (MLDP). We saw that there was a referral and introduction system for people thinking about using the short-break service for the first time. This involved a Care Management Team completing a detailed referral form and comprehensive assessment of the persons needs. Where needed, specialist health care professionals would be asked to contribute to the assessment of need. They would also provide guidance and training for staff. This is to make sure that appropriate equipment was provided and to make sure that staff at the service were able to fully meet peoples health and social care needs. We looked at a sample of peoples support plans and saw that community care and specialist health assessments had been carried out. This showed us that a full and detailed assessment was carried out before people were offered a service. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: As an introduction to the service people were offered tea visits. The period of introduction is flexible and depends on how well the person settles. Although the introductory visits are called tea visits, people can visit at any time stay for meals or for overnight stays. The introduction period can go on until the person feels they are ready to stay for a longer period. The home would provide people with information about the service and offer as many tea visits and overnight stays necessary for them and their carers to decide whether or not they wish to use the service. They told us that people using the service usually live in the area and may know some of the other people using the service. This means that people sometimes settle in more easily. We saw that they information about the home was available in easy read formats and in a variety of languages. This means that everyone using the service regardless of their cultural background and ability had access to the information. We spoke to relatives of people staying at the home. One persons relative told us we were given a brochure from the home and the social worker gave us some information, they give me a list of available dates. Another told us I was invited to an open evening and they told me all about what was on offer. Care Homes for Adults (18-65 years) Page 12 of 30 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 health needs were met and they were encouraged to persue their chosen lifestyle. Evidence: As previously stated each person has a needs assessment before receiving a service. The information in the assessment forms the basis of a support plan. This is a detailed plan of the persons care needs and the action staff need to take to meet those needs. The plan is person centred and focuses on peoples strengths and personal preferences. This means that people are more involved in planning their support and plans read as though the person is telling us how they want to be supported. The support plans contain an information sheet with a traffic light system. This is an information document to be used in case of emergency admission to hospital that is divided into red orange and green sections. The most important health information is contained in the red section and is easily accessible to medical staff. One persons relative told us they ask all about their medicine and what sort of medical support they need. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: The people using the service were out on the day of our visit but we spoke to relatives who told us that they had been involved in developing their relatives support plan. They were very complimentary about the service. One person told us they asked me about their likes and dislikes and what sort of social activities they like to do and they try to keep those up while they are there. Another told us loves going and tells everybody when they are due to stay. We saw a sample of peoples support plans. We saw that the plans were all different and personalised. We saw that they were detailed and person-centred. This means that they were written as though the person them self had written it. We saw that people were asked about their preferences in relation to whether they wanted a male or female carer and how they prefer to spend their days. This shows that people were involved in the planning process and that their choices and preferences were taken into account. One persons relative told us we were asked questions about the best way to help them and how they preferred to be helped. We saw that support plans gave details of peoples personal, health care, social and emotional needs. We saw that important health care information was recorded. This included epilepsy care plans and risk assessments and detailed information from specialist health care professionals on how to support people with eating and drinking. This means that staff have enough information to support people safely. We saw that key workers provided one to one support and were responsible for keeping support plans up to date. This means that they make sure that the persons current needs and wishes were recorded. We saw that the support plans were detailed. This means that staff who do not work with people on a regular basis would be able to provide the right level of support. We saw that peoples preferred communication style was recorded and various methods were used to enable the person to fully participate. We saw that support plans included a sheet entitled my circle of support and included peoples preferred communication styles, interactions, objects of reference and photographs. We saw one persons care plan that told us how to communicate with the person for example, I understand simple sentences and mime. We saw that support plans gave peoples preferred time to get up and go to bed. There was a care plan reviewing system where people and their carers were contacted before the person came for their stay to check whether their had been any changes or other information that the home needed to be aware of. In addition to this ongoing review process, peoples support plans and support were formally reviewed by the home and by the relevant Care Management team on an annual basis. We saw samples of reviews in peoples support plans. We saw that support plans and any amendments were being signed and dated. This means that the most accurate and up to date information about a persons needs was available to staff. They told us that staff work with the person and their family and other relevant people Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: to find out what the person likes and does not like in terms of diet, activities, environments and communication. This enables them to offer people day to day choices and decisions that reflect their needs. Restrictions of choice were only made to safeguard the person and only as a result of a full risk assessment. Risks had been identified and risk assessments completed. We saw that detailed instructions were available so that staff would know what they had to do to keep people safe. We saw samples of risk assessments that included moving and handling, medication, finances and health care. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were encouraged to maintain their usual daily routines and they are enabled to make choices about what they want to do. Evidence: The home provides short periods of respite support. This means that people and their carers have the chance of a break away from their usual routines. We saw that there were no strict routines and people were encouraged to make choices about their dayto-day activities and enjoyed a full and varied lifestyle. We saw that people were involved in planning the activities they wanted to take part in. They told us that since the last inspection they now have the use of a mini bus. One person staying at the home told us its great we go out, we went for a meal at weekend and I went to a football match on Saturday. Another person told us I go to the day centre and the driver will be here to collect me soon. We saw that people were able to continue to attend day centre placements whilst Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: staying at the home. We saw that people were were encouraged to be as independent as possible during their stay. This includes carrying out tasks such as cooking and other domestic tasks. This means that the home promotes peoples rights to make informed choices and take responsibility for shopping, planning menus and cooking. They told us that people usually eat their meals together and that staff give additional support where needed. The choice of meal is flexible and depends on peoples individual dietary needs. We saw that support plans gave clear details about specialist foods or support people need. We also saw that peoples likes and dislikes regarding meals were recorded. We saw a sample of menus in peoples support plans. They showed that fresh fruit and vegetables were used and that people were encouraged to eat a balanced and healthy diet. We spoke to people staying at the home who told us they were able to choose what meals they ate. This shows that people were encouraged to make decisions about daily activities. We saw that people were able to continue to take part in community activities such as visits to local pubs and restaurants. The manager told us that people also went out on planned trips and local events. We spoke to three people staying at the home. They told us they looked forward to their stays. One person told us about the day centre they went to, they were happy that they were still able to go while they stayed at the home. They told us that they liked to take part in arts and crafts at the day centre. We spoke to other people who told us they were able to attend football matches. People told us that they were able to walk to the local pub and restaurants and that they went for walks in the local park. We saw that there was a lot of conversation and laughter between the people staying at the home and the staff. This showed us that people were familiar with the staff and felt comfortable at the home. We spoke to relatives. One relative told us that they support my relative to go to the club and they go out for meals. Another told us they ask about favourite foods and give people choices and people can carry on with their usual day to day things when they are on respite. Care Homes for Adults (18-65 years) Page 17 of 30 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. People were supported with their personal and health care needs whilst staying at the home. Evidence: We saw that peoples health care needs were assessed before people came to stay at the home. We saw that support plans clearly recorded peoples personal and health care needs and the level of support staff needed to provide. Support plans were person centred and personal support was flexible, consistent and able to meet peoples changing needs. We saw that regular reviews were carried out and any changes to a persons support plan were recorded. We spoke to one persons relatives who told us they asked us all about their likes and dislikes and what they like to do in the evenings. Aids and equipment were provided such as overhead hoists and adapted bathing facilities. This means that people were encouraged to be as independent as possible. Any equipment was regularly maintained and replaced to take account of peoples changing needs. Specialist advice was sought by staff at the home to make sure the equipment was used safely. We saw that people using the service were encouraged to manage their own health care this includes visiting opticians, dentists and support with continence care. People stay at the home for short Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: breaks and have access to their own GP. People also have access to other health care facilities in the local community. One persons relatives told us they let us know if they see a Dr. or go to the hospital. Peoples health care appointments were seen as important and there were systems to make sure they were not missed. The home arranged for health professionals to visit people at home when necessary. We saw good examples of person centred planning in particular where people had specific health care needs such as epilepsy. We saw that staff had the skills and knowledge to support people with their health care needs. The manager told us that health care professionals provided support and we saw detailed epilepsy care plans had been developed for some people using the service. We saw that people had a detailed medication profile that lists current medication and a medication assessment to show the level of support needed. We saw a sample of medication administration records (MAR). These were well maintained and accurate with no gaps in recording. The manager told us that they carried out regular medication audits and that staff check the medication at the end of each shift. This is to make sure that there were no errors. We saw that they had developed a medication administration sheet for medicines prescribed as take when required (PRN). We saw that the administration of such medicine was recorded separately. This is to make sure they can account for all medication in the home. Care Homes for Adults (18-65 years) Page 19 of 30 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 were encouraged to express their concerns and there were policies and procedures in place to safeguard people from harm. Evidence: The home forms part of the Manchester Learning Disability Partnership MLDP Short Break service and as such links into the formal Manchester City Council Adult Social Care departments complaint procedures. The complaint process was clear and established and people and or their carers families had access to it. Information about how to make a complaint was available to people and their carers. People using the service and their representatives had a clear understanding of how to make a complaint and when to expect a final response. We spoke to one relative who told us I would ring them and tell them what my complaint was and I feel that I could speak to them about anything and am confident that they would take on board what I said and deal with it. Another said I am very satisfied with everything they do. We saw that the complaint procedure was available in a variety of formats including large print, other languages, Braille, audio and pictures. The complaints procedure was clearly displayed in the home and each person was given a copy. We saw that records were kept of any complaints. We saw that where a complaint had been made people were regularly updated on the progress of any investigation into their complaint. We saw that a number of compliments had been received. These were in the form of Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: letters and thank you cards from relatives expressing gratitude for the support they received. We saw that they used the Manchester Multi Agency Adult Protection Procedures. The staff team had access to a rolling programme of adult protection training provided by the local authority. We saw that staff were aware of the procedures to follow in the event of an allegation of abuse being made. Staff on duty were able to explain the procedures to follow in the event of an allegation of abuse or and incident that affected people using the service. As people only stayed at the home for a short time a specific system of recording peoples monies and spending had been developed. The system clearly shows what money had been spent, what it was spent on and how much was returned home with the person. We saw a sample of financial records and found them to be accurate. Staff checked the money balances every day and the finance sheets were audited on a regular basis by the team co-ordinator. Care Homes for Adults (18-65 years) Page 21 of 30 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. The home provided a clean, safe and homely environment for people to live in. Evidence: The house was close to public transport links into Manchester city centre and was close to public amenities such as library, pubs, cafes and restaurants. This means that people using the service were easily able to take part in community activities. We saw that people often went out to the local pub for a meal and drink. We walked around the building and saw that the home was clean, safe and comfortable and well maintained. We saw that the physical environment of the home provided for the individual requirements of the people who use the service. This included specialist lifting equipment and adapted bathing facilities. There were a number of areas for people to sit and relax. This means that people were able to choose where they wanted to spend time. They told us that all the bedrooms. kitchen, bathrooms and toilets, lounge and dinning room, and upstairs lounge had been redecorated since the last inspection. They told us that they were in the process of choosing plants for the planters in the garden. They told us that people using the service would be encouraged to help with the planning and planting of the plants. People were encouraged to carry out some domestic tasks as part of developing or maintaining independence. Where there were concerns about the health and safety of anyone using the kitchen and laundry these were fully risk assessed with the Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: involvement of the person. We saw that the furniture was domestic in nature, modern and of a high quality. This means that people were able to live in a homely environment. We saw that staff had received training in relation to infection control and that protective clothing was available. This included sanitising hand gel, plastic aprons and latex gloves. This means that staff understand the importance of good infection control and how to keep people safe. Care Homes for Adults (18-65 years) Page 23 of 30 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 were protected by the homes recruitment and selection process and staff had the skills, knowledge and experience to meet peoples needs. Evidence: The staff group was made up of a registered manager, an assistant network manager and network support workers. Staffing was based on the needs and daily routines of the people using the service. On the day of our visit people were attending day centres so there was only one member of staff on duty. There were two staff allocated to work during the morning, evenings and weekends when people were not at the day centres and a member of staff sleeps in each night. We saw a sample of staff recruitment files. We saw that all staff had two written references, a Criminal Records Bureau check (CRB) and were checked against the protection of Vulnerable adults list (POVA) before they started work. People completed an application form and had a face to face interview. they told us that where possible people who use the service are involved in the recruitment of new staff. We saw that all new staff underwent an induction period that usually lasted twelve weeks. This period could be extended if the person was not confident. Staff were only given permanent employment when competence and progress has been shown to be satisfactory. The induction programme was based on the Learning Disability Award Framework which meets the skills for care induction standards. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: We spoke to staff at the home. They told us that they had an induction period where they shadowed experienced staff. This means that the staff team support each other and share skills and knowledge with colleagues. They told us that they had access to a wide range of training and received regular one to one supervision from a manager. One member of staff told us we can approach the manager at any time and they always have time for you. We saw that the staff team had the skills, knowledge and experience to meet peoples support needs. They told us that the short break service has a training needs plan. This plan is submitted to the Manchester City Councils adult social care training department. Manchester City Council provide a range of training and staff are nominated based on their training needs. We spoke to staff who told us that they had attended various events. We saw a record was kept of any training provided. This means that staff have the skills and knowledge required to meet peoples needs. We saw that any shortfalls in staffing levels were covered from staff in one of the other homes in the group. This was to provide some level of continuity for people using the service. They had developed a training matrix since the last inspection that showed at a glance what training people had received and when refresher training was due. Care Homes for Adults (18-65 years) Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems and practices promoted independence and choice and peoples views and opinions were listened to. Evidence: The manager had the skills, knowledge and experience to run a care service. They were responsible for running other homes within the short break group. The manager was supported by assistant network managers and is responsible for staff supervision and maintaining the standards of support people received. The manager spent time at each of the short break houses and spent a great deal of time with people who use the service. This means that they were able to monitor the systems and procedures in the houses and people knew they were able to approach the manager at any time. We spoke to the manager and saw that they had a clear sense of direction and a good understanding of best practice and how to improve the service. They were keen to improve the standards of support and customer satisfaction. They asked people what they thought about the service they received. This was done during regular reviews that looked at the support people were receiving. They also met with people and their Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: families or carers to talk about their experiences of using the short break service. We saw that they carried out quality assurance surveys the most recent was done in May 2009. They sent out questionnaires to 150 families and carers, they received 56 completed questionnaires. From the results we saw that people were generally happy with the support they got from the short break service and felt that any concerns would be dealt with quickly and effectively. People commented in the questionnaires that they enjoyed the coffee mornings and being able to read the Care Quality Commission (CQC) report. We saw that people wanted to know more about the role of CQC and that the manager was providing this information. As a result of this information we will send out some information brochures to the service. We saw that the manager and staff promoted peoples rights. We saw that the manager showed a good understanding of equal opportunity issues and the organisations policies and procedures. We saw that the manager had good people and leadership skills and was responsive to peoples individual needs. This means that peoples rights to live a full and active life were promoted by the manager and staff. The home sent us their annual quality assurance assessment AQAA when we asked for it. It gave us the information we asked for. The AQAA is a self assessment that focuses on how well outcomes were being met for people using the service. We saw that equipment such as hoists, lifts and specialist bathing facilities had been maintained on a regular basis. We also saw that fixed electric and gas appliances had been serviced at regular intervals. We saw that fire alarms and equipment were tested on a regular basis and that they had a fire risk assessment in place. We saw that they had been taking the temperature of the fridge and freezers and the hot water in the home. This means that they were identifying and reducing risks and that people were kept safe from harm. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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