Care Home: Manna House

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What the care home does well Detailed assessments are carried out before a person decides to move into the home so that they can be sure it is the right place for them to live. Each of the residents have a person centred care plan, which include detailed information about how they want staff to support them to live independent and safe lives in a way that they choose. Residents health and personal needs are well recorded, supported and monitored to ensure they stay well. Staff treat residents with respect and their privacy and dignity is observed at all times. Residents are given opportunities to take part in the things they like to do both at home and in the local community. Procedures, which were in place at the home, make sure that residents are protected from abuse or neglect and people are confident about complaining if they need to. Residents live in a comfortable and safe environment and they can move about it freely. Staff have been properly recruited to make sure they are the right people for the job. Staff have completed training so that they have the required skills and knowledge to meet the needs of the residents and the aims and objectives of the home. The home is well managed to the benefit of the residents. What has improved since the last inspection? This was the first inspection of the service since it was registered in May 2009. What the care home could do better: Visits to the home, which are required under Regualtation 26 of the Care Homes for Adults, should be carried out by a person who is not involved in the day to day running of the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Manna House 1 Alexandra Drive Bootle Merseyside L20 0EE     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: Janet Marshall     Date: 2 7 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: Manna House 1 Alexandra Drive Bootle Merseyside L20 0EE 01512812034 01512812034 mannahouse@blueyonder.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care In Safe Hands Healthcare Limited Name of registered manager (if applicable) Mrs Jean Carroll Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 category: Learning disability Code LD. The maximum number of service users who can be accommodated is: 7 Date of last inspection Brief description of the care home Manna House is a large three storey Victorian semi-detached house located in a popular residential area of Orrell Park Merseyside, Liverpool. The home is registered as a care home for up to seven adults with a learning disability. Currently there are seven people living at the home. The home is located close to local amenities and public transport. There are several shared rooms on the ground floor including a lounge, kitchen/diner conservatory, toilet and shower room. A residents bedroom is also on the ground floor, the other six are are situated on the upper two floors of the home along with a shared bathroom. The laundry is at the back of the house separate to the Care Homes for Adults (18-65 years) Page 4 of 27 7 Over 65 0 Brief description of the care home kitchen. The home has a passenger lift, which operates from the ground floor to the upper floors. There is a large driveway at the front of the house and a good sized back garden with a patio area. The Home also has an outbuilding at the bottom of the garden called Rainbow House, which is used by residents and staff for recreational activities and training events. Manna House is part of a company called Care in Safe Hands, which is owned by Jean and Shane Carroll. Jean Carroll is also the registered manager of the home. Fees for the home vary depending on the needs of the residents. Care Homes for Adults (18-65 years) Page 5 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: The Quality rating for this service is 2 star. This means the people living at the home experience good outcomes. This was a key inspection. We consider 22 out of the 43 National Minimum Standards for this type of service, Care Homes for Adults (18-65) as the key standards, which have to be inspected during a key inspection. The key standards are highlighted in bold in the different outcome sections of this report. A key inspection is a planned inspection, the report has been put together using information gathered in a number of different ways, which helps us decide the overall rating of the service. We keep all information we receive about the home in a file, we looked at all the information we have received since the last inspection. We sent out a form to the home called an Annual Quality Assurance Assessment (AQAA). The AQAA has to be filled in and returned to us by a set date usually before the site visit takes place. The AQAA was filled in by the registered manager and returned to us on time, it provided us with information we asked for about the service and was used to support some of the judgments we have made. We carried out an unannounced visit to the home, this Care Homes for Adults (18-65 years) Page 6 of 27 is when we visit the home with out any body knowing and is called the site visit. The residents, the manager and support staff that were on duty all helped with the inspection. Also during the site visit a selection of records and certificates, which have to be kept in the home by law were looked at and checked to make sure they were up to date and accurate. Two residents were case tracked. This is a process we use to find out whether the people that live at the home are receiving good quality care that meets their individual needs. It is done by talking to people, looking at results of surveys and reading the records of a sample of people that live at the home to give us a good idea of what it is like for them. Care Homes for Adults (18-65 years) Page 7 of 27 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 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. Peoples needs are assessed before they decide to move in so that they can be sure it is the right place for them to live. Evidence: The AQAA told us that assessment and admission procedures are in place at the home. Seven residents have moved into the since it opened. Assessment records for two residents were looked at during the site visit, they showed that the correct processes were followed for assessing and admitting them both. The manager carried out a full assessment of each persons needs covering areas such as health and personal care, mobility, communication, finances, relationships and skills. Residents and their relatives were also invited to view the home and meet the other residents and staff, they were also invited for a meal and over night stays. One resident said, yes I came to see the home before I moved in. Another resident said my mum came to see the home with me. Care Homes for Adults (18-65 years) Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs and lifestyle choices are well recorded to enable staff to support them to live independent lives in a safe way. Evidence: Each of the residents had a care plan, which were kept in a locked cabinet. Staff spoken with showed a good understanding of care plans. One staff member said, Care plans tell us about the person and how they want to be supported. Care plans for two residents were looked at in detail. Records in both showed they have been reviewed and updated at regular intervals with the involvement of the residents, their relatives and keyworkers. Care plans were set out in a person centred way and they were very well orgainsed and easy to follow. Care plans, which were looked at included detailed information about the persons individual needs and choices they have made about how they want to live their lives. During the inspection visit residents were seen making choices about things such as what to eat and what activities they wanted to do. Staff spoken with said they always encourage residents to make choices and decisions for themselves and they give them Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: all the help they need to make difficult decisions. Choices and decisions that residents can make and the help they need to make others were recorded in their care plans. Some residents have limited verbal communication skills although they are able to communicate in a number of other ways such as by use of signs, sounds and gestures. Information about how they communicate was recorded in their care plans. Staff appeared to have no difficulties understanding what residents were communicating and they responded to each other in a positive way. Each of the residents have their own bank account in their own name and address. They are supported to access their money as and when they need to. Risk assessments were part of each of the residents care plans. They have been carried out for tasks and activities, which are likely to pose a risk to the resident and or member of staff supporting them. They detailed the action, which staff need to follow so that residents can lead independent lives in a safe way. Risk assessments, which were looked at were detailed and up to date. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to lead active and healthy lives. Evidence: The AQAA showed that residents are offered opportunities to take part in a variety of activities both at home and in the local community. Care plans, which were looked at included detailed information about residents preferred hobbies and interests as well as activities, which are important to them. Each of the residents had an activities plan detailing what they have chose to do and when. A resident who attends a day centre several days a week said they really enjoy going. Another resident said, I choose what I want to do each day. Some residents went out to an art club during the afternoon of the inspection, another resident went shopping with a member of staff to buy personal items. The AQAA told us that residents access community facilities such as colleges and Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: churches. Residents spoken with, said they visit shops, cinemas, restaurants, social clubs and pubs. Residents use public transport such as buses and trains they also get about in the homes minibus, which is driven by staff that work at the home. Daily records, which were looked at showed that residents get out and about a lot. Activities at home include watching TV & DVDs, listening to music, board games, karaoke and computers. At the bottom of the garden is an outbuilding, which residents have named Rainbow House. It is an additional area way from the main house where they can chill out, watch TV, have a game of snooker or listen to music. One resident said they are looking forward to going on holiday this year. The manager said the residents have each chosen a holiday destination for this year. Each of the residents have relationships, which are very important to them. Information about those relationships and how they need to be supported by staff was recorded in their care plans. During discussions staff showed that they respect the important relationships that residents have with each other, their family and friends. All of the residents have regular contact with their families through visits, telephone contact and letters. Residents are all encouraged supported to help around the house with things such as cleaning and cooking. One resident, said they always clean and tidy their own room and help with other chores around the house such as hovering and polishing. Their care plans included information about the things they are able to do independently and the help they need from staff so they are able to do other things. The AQAA told us that residents are fully involved in meal choices. On the day of the inspection visit residents were seen sitting together at the dining table eating their lunch, they were relaxed and chatted with each other and staff during their meal. One resident said that they liked the food very much and are involved in putting together the menus. residents spoken with said they help with the weekly food shop as well as daily trips to local shops for essentials such as bread and milk. One resident said they like to help shop for their food. Care Homes for Adults (18-65 years) Page 14 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. Residents are treated with respect and their healthcare needs are well supported to ensure they stay well. Evidence: Each of the residents care plan included a section about their health and personal care needs and their preferred routines. This section provided staff with important information about these needs and how best to support them. Residents spoken with said they get up and go to bed when they choose. One resident said, I like to sleep in sometimes and I do sleep in when I want. During discussion staff said they encourage residents to carry out what ever personal care they can for themselves. During the inspection visit, staff were seen talking to residents in a polite and respectful way and they talked about the some of the things they do to ensure residents privacy and dignity. They knock on doors before entering bedrooms and bathrooms and make sure the rooms are clean and warm. One member of staff said, I always knock on doors and wait for a response before entering a bathroom or a residents bedroom. I talk to residents and explain the help I am going to give them. Residents spoken with all said that staff are polite and treat them very well. One Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: resident said, The staff always say please and thank you. The AQAA told us that residents are supported to attend regular health care checks with their doctor, chiropodist, dentist and opticians as well as attending hospital appointments when they need to. Medical records, which were seen also showed this, they were well kept and up to date. Records showed that residents are registered with doctors in the local community. On the day of the inspection visit residents were clean in appearance and smartly dressed. Three residents who were spoken with all said they choose what clothes they wear each day. Medication and medication administration records (MAR) sheets for two residents were checked and they were found to be in good order. The AQAA told us that available at the home are up to date policies and procedures for the safe handling and administration of medication. It also told us that staff have received training in the subject. Staff training records also showed this, copies of up to date certificates for attendance to medication training sessions were seen in staff files. Care Homes for Adults (18-65 years) Page 16 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. Residents are protected by the homes protection procedures and staff are trained in recognising and dealing with abuse. Evidence: The AQAA told us that no complaints have been made directly to the home since the last inspection and the Commission have not received any complaints about the home during this time. The AQAA detailed a number of policies and procedures, which are in place at the home, which aim to protect both residents and staff. They included procedures about complaining, whistle blowing and protection of vulnerable adults. Copies of these procedures were available in written and picture format so that people can refer to them whenever they need to. Residents care files contained copies of the homes statement of purpose and service user guide, the documents explain the homes complaints procedure in large print and pictures. There was a visitors book in the hallway, which all visitors have to sign each time they enter and leave the home. For the protection of residents no visitor is allowed to gain entry unless they produce some form of identification. Staff spoken with were able to clearly describe how they would deal with a complaint made to them and make a complaint if they needed to. Residents spoken with knew about the homes complaints procedure and said they were confident about complaining if they needed to. One resident said, I would tell someone if I was unhappy. Detailed in the AQAA and available at the home were a number of policies Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: and procedures relating to the protection of vulnerable adults (POVA). They included the companies own version and a copy of Sefton Local Authority procedures. Staff training records, which were looked at and discussion with staff showed they have received POVA training . Staff spoken with were able to describe correctly what they would do if they witnessed or suspected abuse of a resident. One member of staff said, I would definitely report abuse with no hesitation, I would make sure the residents are safe and then report the incident. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All parts of the home were comfortable and safe. Evidence: The home is a three storey Victorian semi detached house located in a popular residential area of Orrell Park Liverpool. There are seven single bedrooms, which are all currently occupied, there are sufficient bathrooms and toilets throughout the home and several shared rooms on the ground floor. The home has a passenger lift, which operates from the ground floor and there are ramps and other equipment to help residents get around the home independently. There is a large driveway at the front of the home with off road parking for at least three vehicles. There is a large garden at the back of the house with lawns and a patio area. One resident said they are looking forward to the warmer weather as they have plans to help keep the garden tidy and are hoping to plant vegetables. A tour of the home took place on the day of the inspection visit. There was a warm and friendly atmosphere at the home and residents were seen moving around freely. At the time of the visit all parts of the home were clean, warm and bright and there were no hazards found. Residents bedrooms were spacious and they were nicely decorated and furnished. Bedrooms were personalised to suit each persons individual tastes. Residents said they helped to choose colour schemes and the new furniture for their home. The AQAA told us that available at the home are all the required policies and procedures, relating to the environment, they Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: included disposal of clinical waste, infection control, health and safety and food hygiene. Records, which were looked at showed that the environment is checked on a regular basis to ensure it is well maintained and safe. There were cleaning routines in place, which staff and residents follow to make sure the house is clean, tidy and hygienic. 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. Residents are supported by the right amount of staff who are well trained. Evidence: The AQAA told us that there are the right amount of staff employed at the home to support the needs of the residents that live there. Staffing rotas were discussed with a staff member, this showed that there are at least three staff on duty during the day and two staff each night. A member of staff said, Yes I think there is always enough staff on duty to meet the needs of the residents and if we need more staff for planned activities they are brought in. There were three support workers, the deputy manager and manager on duty at the time of the inspection visit with all residents at home. Staff spoken with showed good knowledge and understanding of the needs of the residents and clearly explained what their role and responsibilities were. Staff recruitment, selection and equal opportunities policies and procedures were available at the home. The AQAA told us that all the required checks are carried out on new staff before they are allowed to start work at the home and that all staff have completed induction training. Examination of two staff files provided evidence of this. The manager explained that the induction programme, which all staff have completed is based around the common induction standards and covers things such as health and safety, the needs of the residents and the homes policies and procedures. Staff spoken with Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: confirmed they had completed induction training, which covered everything that they needed to know about the job when they started work at the home. Information we were given in the AQAA, discussion with staff and training records looked at during the inspection showed that staff have completed mandatory training, which is training they have to complete by law so that they have the right knowledge and skills to do their jobs. Mandatory training recently completed by staff includes, manual handling, POVA, health and safety, medication, fire awareness and food hygiene. Staff have also completed other specialist training to help them understand and manage certain conditions that residents have. A member of staff said, We get a lot of training and yes I feel well trained for the job I do. The AQAA told us that more than half of the staff team have got or are working towards a National Vocational Qualification (NVQ) in Care level 2 or above. The manager explained that training is provided by an external trainer in Rainbow House, the outbuilding separate to the main house. A record of training, which was seen showed further training has been planned for the future, including updates in all mandatory subjects and NVQ training. 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. The home is well managed to the benefit of the residents and staff. Evidence: Jean Carroll is the Registered manager of the home. Jean has many years experience of working in the field of care and has NVQ Level 4 in Health and Social Care and the Registered Managers Award. Staff were complimentary of the manager and the way she runs the home, they made the following comments to support this, The manager is very good at her job, She is supportive and approachable, Jean runs the home really well and she cares a lot about the residents and staff. The manager explained the processes, which are in place to check the quality of the service. They include giving out questionnaires to residents and their families to find out what they think about the home and the way it is run. Questionnaires which were recently filled in by residents and their relatives were looked at during the inspection. The responses were positive and showed that everyone is very happy with all aspects of the home. Regulation 26 of the Care Homes Regulations requires the provider to visit the home each month to check on things such as health and safety records, residents care records and the environment. After the visit a report has to be written detailing the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: findings. The manager said she has been carrying out these visits and writing the reports. She was advised that it is not appropriate for her to do this because the regulation requires the visits to be carried out by a person that is not directly responsible for the day to day running of the home. The manager said she will arrange for somebody else to carry out the monthly visits. Other quality checks, which are carried out by the manager and staff include monthly care plan reviews and regular checks on the environment and residents finances. Records for all of the quality checks were seen and found to be very well maintained and up to date. The AQAA told us that the home has available all the health and safety policies and procedures, which they have to have by law to ensure the health safety and welfare of the residents and staff. It also told us that the required checks have been carried out on the gas and electricity systems and equipment used at the home to make sure they are safe. Discussions with staff during the inspection visit and information provided in the AQAA showed that staff have recently received training in subjects of health and safety such as fire awareness, lifting and handling and first aid. 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 39 Visits to the home, which are required under Regualtation 26 of the Care Homes for Adults, should be carried out by a person who is not involved in the day to day running of the home. 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). 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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