Care Home: Maple Court

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What the care home does well The manager makes sure that people have their needs assessed before they move in.PRE SERVICE ASSESSMENT REPORTPeople are encouraged to make their own decisions on their everyday lives such as food and activities.People have lots of opportunities to go out in the local community to colleges, shops and for fun.Staff gets lots of training. What has improved since the last inspection? The support plans have got better; they now give staff a lot of detail about how people want to be looked after.There are now plans in place that show staff how to support people in taking everyday risks.ABUSE POLICYThe abuse policy now shows that abuse must be reported to the Local Authority.The staff duty rota now includes the full names of staff and no staff member starts work before the home has all of their clearances.FIRE DRILL RECORDSThe home now has regular fire drills. What the care home could do better: MAINTENANCE RECORDSAll jobs that are done in the building should be written up in the home`s maintenance book so that jobs do not get missed and that they are done in good time.All of the staff should have infection control training so that they know what to do to reduce the risk of infection.TRAININGAQAAThe registered manager should make sure that he fully completes his AQAA each year to ensure that he has done a full assessment of his service. Key inspection report Care homes for adults (18-65 years) Name: Address: Maple Court 247 Berechurch Hall Road Colchester Essex CO2 9NP The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Pauline Marshall Date: 2 2 0 6 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 35 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Maple Court 247 Berechurch Hall Road Colchester Essex CO2 9NP 01206768671 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Maple Health UK Ltd Name of registered manager (if applicable) Mr Keith Walters Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 10 0 care home 10 learning disability Additional conditions: The registered person may provide the following categories of service: Care Home CRH 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 The maximum number of service users who can be accommodated is: 10 Date of last inspection 0 4 1 1 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Maple Court consists of two bungalows with five bedrooms in each that have been built for people with learning disabilities that have Autistic Spectrum Disorder. There are plans to make Maple Court bigger and Maple Health UK Ltd intends to build a further three bungalows on the same site; each bungalow will have five large bedrooms. Each person has their own bedroom, this means that nobody has to share a room and there is plenty of other space for people to use. Care Homes for Adults (18-65 years) Page 5 of 35 There is a bus route and two railway stations nearby and the home has its own people carrier for people to use for shopping, trips out and going to college. The home is in the centre of Colchester and near to the local shops. There is enough space to park six to eight cars at the side of each bungalow. The gardens have grassed areas with borders of flowers and shrubs. The manager gives people that want to move to Maple Court a copy of his Statement of Purpose and Service User Guide. Care Homes for Adults (18-65 years) Page 6 of 35 People pay between £2091.00 and £2697.00 each week and they pay extra for their toiletries, hairdressing, chiropody, holidays and for any personal items. Care Homes for Adults (18-65 years) Page 7 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 35 How we did our inspection: This is what the inspector did when they were at the care home We visited the home and looked at some of the files belonging to people living in the home and the homes staff. We also looked at the policies that explain how the home does things. We looked around the home and spoke to the staff and to some of the people that live there. The registered manager was on holiday at the time of the inspection but came into the home for a short time to give us access to some of the paperwork that he keeps locked away. Care Homes for Adults (18-65 years) Page 9 of 35 AQAA We read the information (AQAA) sent to us by the registered manager. The AQAA is a form required by law for the manager or provider to carry out a self-assessment of how well the outcomes of people using their services are being met. We sent surveys to the all of the people that live at Maple Court and to six of the homes staff, to see what they think about it. All of the people using the service returned their completed surveys and they were all happy with the service. Nine staff sent us back their completed surveys and we have included comments from all of these in the report. What the care home does well Care Homes for Adults (18-65 years) Page 10 of 35 The manager makes sure that people have their needs assessed before they move in. PRE SERVICE ASSESSMENT REPORT People are encouraged to make their own decisions on their everyday lives such as food and activities. People have lots of opportunities to go out in the local community to colleges, shops and for fun. Care Homes for Adults (18-65 years) Page 11 of 35 Staff gets lots of training. What has got better from the last inspection The support plans have got better; they now give staff a lot of detail about how people want to be looked after. There are now plans in place that show staff how to support people in taking everyday risks. Care Homes for Adults (18-65 years) Page 12 of 35 ABUSE POLICY The abuse policy now shows that abuse must be reported to the Local Authority. The staff duty rota now includes the full names of staff and no staff member starts work before the home has all of their clearances. FIRE DRILL RECORDS The home now has regular fire drills. What the care home could do better Care Homes for Adults (18-65 years) Page 13 of 35 MAINTENANCE RECORDS All jobs that are done in the building should be written up in the homes maintenance book so that jobs do not get missed and that they are done in good time. All of the staff should have infection control training so that they know what to do to reduce the risk of infection. TRAINING AQAA The registered manager should make sure that he fully completes his AQAA each year to ensure that he has done a full assessment of his service. Care Homes for Adults (18-65 years) Page 14 of 35 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact: Pauline Marshall 03000 61 61 61 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 of 35 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 16 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People get good information about the service and they know that their needs are fully assessed. Evidence: The registered manager last reviewed the homes Statement of Purpose and Service User Guide in May 2010 and both documents provide people with up to date information about the service. There was a copy of both documents displayed in the entrance hall at Maple House and the registered manager told us that they are available in an alternative format that uses pictures and symbols. We looked at four care files and we found that each of them contained a thorough and detailed functional assessment showing information on the persons needs for assistance with getting up, going to bed, dressing, grooming and communication. Each of the assessments that we looked at had been signed by the registered manager, however not all of them were dated. Re- assessments had been carried out on all of the care files that we looked and all had been signed and dated. People spoken with confirmed that they had been fully assessed before moving in to Maple Court. Care Homes for Adults (18-65 years) Page 17 of 35 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive appropriate individualised care based on identified needs. Evidence: We looked at four support plans and we found that there had been a vast improvement since the last inspection; they are now colour coded and show what the person is able to do for themselves and what staff needs to do to support them. All of the support plans that we looked at were written in a person centred way and showed general information such as the persons profile, their likes and dislikes, their activity programme, their medication reviews and any Mental Capacity Act assessments. Each of the support plans provided very detailed information on all areas of care including behaviour, social skills and activities, mental health and cognition, education and occupation and future planning and decision making. People using the service had signed wherever possible to show that they had been involved in their support plan. All of the support plans that we looked at had been regularly reviewed and are clearly a working document as some of the recent changes had been handwritten. The daily notes are recorded on daily journal sheets; information included on the sheets included time of Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: rising, name of staff providing personal care, whether the person had a bath or shower, who administered medication and who had checked it. Dietary intake and continence is recorded on the daily journal and there is a small body chart where any marks bruises or cuts are recorded. The Lodge manager told us that the body map in the daily journal is no longer in use and that a larger version is now completed; we were shown a completed version. At the end of each shift a member of staff also completes a short report which includes details of the persons activities, their general well-being and their behaviour. The daily journals that we looked at were detailed and informative and included information on the individual’s mood. The registered manager told us in his AQAA that service users meetings take place every two months. We looked at the notes of some of the meetings that had been held for the people living in the home and we found that meetings had taken place on 07/09/09, 02/12/09, 11/01/10, 30/03/10, and 26/05/10. A range of subjects had been discussed at the meetings including every day things such as what food people wanted to eat and what activities people wished to do. The meeting notes showed that people had discussed healthy eating, their preferred meals and their plans for an annual holiday. People spoken with told us that they participated in all areas of decision making and that they had regular meetings. All of the surveys that we received were positive about people being supported to make decisions on their every day life. Each of the support files that we looked at included completed risk assessments and management plans for all areas of identified risks such as washing and dressing, mobility, communication and behaviour. Each of the risk management plans clearly showed what staff had to do or did not have to do to support people to manage the identified risk. Staff members said when spoken with that the risk management plans were clear and fully informed them of the actions that they should take if the risk presented itself. Each of the support files that we looked at included an infringement of rights document and a Mental Capacity Act assessment. Care Homes for Adults (18-65 years) Page 19 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported to live a lifestyle that meets their identified needs and preferences. Evidence: The registered manager said in his AQAA we ensure that all service users are offered the opportunity to develop their independent living skills and we ensure that service users have the opportunity to access the community on a regular basis and participate in a range of meaningful occupational, educational and leisure activities to further their education. The activities plans and records showed that people regularly access local amenities such as the gym, the swimming pool, the bowling alley, local shops, the college and various day centres. People told us that there was plenty to do and that they go bowling, football, do pottery, go on bike rides and go to clubs. Staff also told us that many activities take place including trampolining, trips to the library, college courses such as arts and crafts and drama and pub visits as well as visits to the hydra pool and the sensory room. Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: The expert by experience told us in their report I found that in both houses service users participate in various activities outside the home but there did not appear to be a lot of stimulating activities to do inside the home. Staff told us and the activities records showed that people do have more outside activities, which they said they prefer, however, the records showed that they do participate in a range of indoor activities such as cooking, playing sports such as cricket and football in the garden, arts and crafts, quizzes and film nights. The expert by experience told us in their report that staff had told them that people do painting and jigsaw puzzles in addition to outdoor activities. The expert by experience told us in their report that service users were unable to answer their questions, so they were answered by the staff in the presence of the service user; the following is an extract from the expert by experiences report: Maple House 1. The service user could go out on public transport but only with a member of staff. 2. They could have friends in if they wished. 3. They could choose when and where to go out, but only with the support of a member of staff. 4. The kind of activities the service user liked doing were Bowling, Cinema, going for walks and to watch Colchester F.C. (they are a supporter and go to watch most home games). They could choose their own food with the help of a picture menu. 5. The service users go shopping for food with staff weekly. 6. The service users go to the local pub and attend two clubs, Monday Club and Gateway Club on a weekly basis. At weekends the service user goes on picnics in the summer, goes to football matches in the football season and visits family. The service user can choose to either bath or shower and can also choose who helps with bathing and dressing either male or female. 7. The member of staff said on the service users behalf that they felt safe and were happy living in the home. 8. When asked what the service user did to stay healthy and well the member of staff said they liked walking and playing on their bike in the garden. 9. The service users had regular checkups with the doctor and dentist. 10. Maple House held monthly meetings for service users to put their ideas and grumbles across to staff and management. The service user helped with household chores and kept their room tidy. Maple Lodge 1. The service user could only go out on public transport accompanied by two support workers because of behavioural problems. 2. The service user could choose when and where to go out. 3. The activities that the service user participated in consisted of swimming, going to the cinema, painting, jigsaw puzzles, cooking and bowling. 4. The service user could go to the local pub and to the Monday club and the Gateway club but only with support workers. 5. The service user could choose their meals and went shopping weekly for food. At weekends the service user went for walks in the woods with family and in the summer family would take him to the seaside. 6. The service user likes to go out with family on their bicycles. 7. The service user could choose either to bath or shower and who they preferred to help them to bath and dress. 8. The member of staff said that service users were happy in the home and that they felt safe. 9. The service users went for walks and went swimming to stay healthy. 10. The service users have regular checkups with the doctors and dentist. 11. I was told by the member of staff that Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: there were no meetings for service users to put their ideas and grumbles across because it was not practical due to the nature of their disabilities. 12. The service users helped with household chores like hoovering and dusting and tidying their rooms. The records confirmed that people living in the home had regular contact with family and friends and one of the people spoken with told us that they regularly go home and spend time with their family. People told us in their completed surveys I receive an excellent care package and I am very happy in my home, it is excellent and I am very settled and happy. People using the service do their own food shopping weekly and they choose the meals that they prefer with the support of the staff. Mealtimes are flexible and staff told us that there is no set menu but that the people using the service choose what they want to eat. Staff told us that people are choosing a more healthy diet and that people chose to regularly eat fresh fish and fresh fruit. People were eating a fresh fruit salad made up of seasonal soft fruits such as strawberries, raspberries, grapes, nectarines and blue berries. People confirmed that they ate well at Maple Court and the expert by experiences report supports this. The nutrition records and weight charts showed that people were eating a healthy balanced diet. One person, who was overweight, has succeeded in losing a considerable amount of weight since taking up a healthy diet and a regular exercise routine. Care Homes for Adults (18-65 years) Page 22 of 35 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care in a way that suits them and their health care needs will be fully met. The homes medication policy and practice will protect people from the risk of medication errors. Evidence: We witnessed staff interacting with some of the people that live in both of the bungalows and the interaction was good, staff was seen to treat people respectfully, explaining any actions in a pace that appeared appropriate for the individual. People spoken with told us that they were happy with their personal care and two people made these comments in their surveys I am happy with this home and the home cares for me very well. Staff spoken with said that the support plans are flexible to ensure that they meet peoples changing needs. The support plans identified the persons preferred times to get up and go to bed and the daily notes confirmed that people regularly make choices on all areas of their personal care. The registered manager said in his AQAA we monitor service users general health, and there were records to confirm this such as weight charts, epilepsy charts, behaviour charts and GP and hospital visits. The care files that we looked at contained information on peoples healthcare appointments; the entries showed the outcomes of the appointments together with any follow up action that was required. There were copies of Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: medical letters on all of the files that we looked at. Maple Court has a range of policies and procedures that cover all areas of medication administration, which includes ordering, administering and disposal of medicines and good practice guidelines. The member of staff that assisted us with the inspection told us that regular audits of the medication system take place and this was confirmed by the administration records. Maple Court uses a monitored dosage system for administering medication and all staff are trained. There were records to show that staffs competency to administer medication had been checked and any issues highlighted were dealt with appropriately. There was PRN protocols in place for all as and when prescribed medication to show when, why and how it was to be administered. We checked a random sample of medication and its corresponding medication administration record sheets (MARS) and it was all found to be correct. Staff spoken with told us that they had read the policy and that they had received medication training and updates. Care Homes for Adults (18-65 years) Page 24 of 35 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 will be protected from harm and abuse. Evidence: The registered manager told us in his AQAA that the home had not received any complaints in the past twelve months; however, the commission are aware of a complaint that was made in January 2010. The registered manager told us that the complaint had been dealt with fully, however, there was no records available for inspection to confirm this as they were locked in a secure cabinet and the registered manager holds the keys and had left the building. The complaints policy was reviewed in November 2009 and it contained clear information on how to make a complaint. The home also displays an easy read version of the complaints and abuse policies, (which uses picture and symbols), on the notice board in the hallway of Maple House. People spoken with told us that this version was easier for them to understand and people told us in their completed surveys that the staff always listen to me and give me a positive response to my concerns and I would speak to the staff if I was not happy and they would sort it out for me. We examined a random sample of the cash and cash transaction records belonging to people living in the home and we found them to be accurate and up to date. The registered manager told us in his AQAA that there had been no safeguarding issues in the past twelve months; CQC are aware of seven safeguarding issues that have occurred since January 2010. All but one of these issues has been closed under adult Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: safeguarding procedures and although there were issues around the way in which safeguarding issues had been dealt with in the past, it is clear that the registered manager and the Lodge manager now follow the correct procedures. At the last inspection it was identified that the abuse policy did not provide staff with sufficient information; it did not inform them that the suspicion of abuse must be reported to the Local Authority. The policy and procedure has now been amended to include this important information. Staff spoken with told us that they had received training in abuse when they first started work as part of the induction process and there were entries on the staff training matrix to show that abuse training had taken place recently; there were also copies of certificate on the staff files to confirm this. The registered manager told us that when completing his AQAA he only provided information about complaints and safeguarding for Maple House. A discussion took place around the importance of the information provided in the AQAA and the need to provide information for the whole of the service; the registered manager told us that he would ensure that he includes all of the information for the service in future. Care Homes for Adults (18-65 years) Page 26 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable safe environment. Evidence: We looked around both bungalows and each of them had five large en-suite bedrooms. Each of the bedrooms in use was personalised and nicely decorated with good quality furniture and fittings. Each of the bungalows has a large lounge, a conservatory, a dining room, a kitchen, a utility room, a bathroom, an office and a visitors cloakroom. Most of the walls inside the buildings are rounded to ensure that there are no sharp edges for people to hurt themselves on. Both bungalows have a different feel to them as they provide a service to people with different needs. Maple Lodge had a very lively atmosphere and Maple House had a calm and relaxed feel to it. We were shown around Maple House by one of the people using the service and they were very proud of their living environment. There is plenty of outside space and secure gardens around each bungalow; there are grassed areas with borders of shrubs and flowers. Each of the bungalows has parking space for six to eight vehicles and the home has its own people carrier to enable people to access the community. The maintenance records showed that repairs had been reported, however, it did not always show the date that the repair had been carried out. The maintenance records should show the date that any repairs took place to ensure that they are carried out in a timely manner. The expert by experience noticed that there Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: were cracks in the walls of the lounge and in one of the bedrooms. The Lodge manager told us that these were settlement cracks as the building is still quite new and that they would be repaired in the near future. Both of the bungalows had a nice clean fresh feeling to them and the expert by experience said in their report both Maple House and Maple Lodge were clean, tidy and well laid out. The registered manager did not tell us, when asked; in his AQAA if staff had received training in infection control, however, the training matrix showed that five staff in Maple Lodge and seven staff in Maple House have had this training. Care Homes for Adults (18-65 years) Page 28 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by well trained and supported staff. Evidence: We looked at the staff duty rosters over a four week period and they showed that sufficient staff had been deployed and were scheduled to work in both of the bungalows. Maple Lodge has a higher number of staff due to some of the people using the service requiring two staff to support one person. The Lodge manager told us that staffing ratios are amended to suit the needs of the people using the service. The staff duty rosters clearly showed any amendments that had been made. The registered manager told us in his AQAA that three members of staff had either completed or were working towards their NVQ qualification; the records showed that ten staff in Maple Lodge and seven staff in Maple House had either completed or were working towards their NVQ. We looked at three staff files and we found that they contained all of the required documentation such as completed application forms (any gaps in employment had been identified and the discussion recorded), interview notes, two written references and satisfactory Criminal Records Bureau (CRB) checks. Independent Safeguarding Authority (ISA) checks had been undertaken where necessary. Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: Each of the three staff files that we looked at contained copies of the staff members induction records. Maple Courts induction process is carried out over a three month period and it includes training in areas such as health and safety, safeguarding adults, moving and handling and epilepsy. The training matrix showed that staff training in the past twelve months included manual handling, fire safety, food hygiene, first aid, health and safety, safeguarding adults, medication, infection control, the Mental Capacity Act, The Deprivation of Liberties, epilepsy, risk management and autistic spectrum disorder. Staff spoken with and surveyed told us that the training was good and that they received regular updates when needed, they also told us that any training needs were identified through the supervision process. We saw certificates of training on all of the staff files that we looked at. The expert by experience said in their report I questioned the staff in Maple House on their training and they told me that the training was excellent and that they had regular courses on various topics relevant to their work and I questioned the staff in Maple Lodge and was told that the training they received was very good and they had refresher courses on a regular basis. Each of the staff files that we looked at contained supervision agreements and completed supervision notes. Each of the bungalows had their own supervision matrix which detailed the dates that supervision had taken place and the dates they were planned for in the future. Staff spoken with and surveyed told us that they have regular supervision and one member of staff said to us I feel really well supported in my work and I can go to the registered manager for advice an guidance at any time. Care Homes for Adults (18-65 years) Page 30 of 35 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home that is run in their best interests Evidence: The registered manager has many years experience working in care homes with people who have Autism Spectrum Disorder (ASD) and has worked in both the private and the public sector; he holds the registered managers award and an NVQ level 4 in care. The registered manager regularly updates his practice and has recently undertaken training in fire safety, food hygiene, health and safety, COSHH (control of substances hazardous to health), manual handling and moving, first aid and medication. The registered manager returned his completed annual quality assurance assessment (AQAA) by the due date. The information provided by the registered manager in the AQAA was limited. This was discussed with the registered manager and the outcome of the discussions is recorded in the concerns complaints and protection section of this report. Maple Court was registered on 22/05/09 and has been operational since 31/5/09 and the registered manager has not yet carried out his first quality assurance survey for the Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: people using the service. There were records to show that the registered provider visits Maple Court on a monthly basis and that they compile a report on their findings as required in Regulation 26. There were notes of staff and residents meetings that looked at all areas of the running of the home. The people living in the home told us that they had regular meetings and there was a list of planned meeting dates displayed in the office. We checked a random sample of safety certificates including the electrical system, the heating system and the fire alarms and equipment and we found that all but the fire alarm checks had been carried out. The registered manager told us that the fire alarm check was overdue and that it would be arranged as soon as possible and we have received confirmation that the fire alarm system was serviced on 2/07/10. There was a fire risk assessment in place and the fire records showed that regular fire drills now take place. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 35 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 It is recommended that all pre-admission assessments are signed and dated by the person completing them to ensure that they have been completed prior to the service commencing. It is recommended that the date of any repairs is recorded in the maintenance records to ensure that all repairs are carried out in a timely manner. It is recommended that all staff have infection control training to ensure that the risk of the spread of infection is minimised. It is recommended that the registered manager fully completes his AQAA and provides all of the information that the Commission has requested to ensure that the quality of care provided at Maple Court is evaluated. 2 24 3 30 4 37 Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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