Care Home: Mayfield House

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What the care home does well Residents expressed satisfaction with the service they received and stated that they liked living at the home. One resident stated that they always wanted to stay there. The environment has a homely atmosphere and provides a welcoming, clean and safe space for the residents to live. There is a comprehensive programme of training for the staff to make sure they have the skills and knowledge to meet the needs of the residents. What has improved since the last inspection? A revised service user guide had been completed recently, illustrated with colourful symbols, and written in clear and simple language to enable the service users` understanding. The assessment of risks had improved and service users had been enabled to access a wider range of opportunities. Timetables of the activities service users were involved in were held on their files and a record of involvement was kept to confirm service users were doing what they wanted to do. The home had obtained a copy of the local authority safeguarding procedures to ensure the staff had access to referral details and processes, to inform them of appropriate responses to make should an allegation be made. Environmental improvements included a new industrial washing machine and flooring in the laundry room, a new boiler, the converting of a downstairs bathroom into a shower room and toilet, a new shower in one of the upstairs bathrooms and the furniture in the lounge had been replaced. Improvements had been made in the formal supervision process, and the frequency of the managers` meetings with the staff. Records had been kept of meetings held to confirm the staff were receiving feedback on their work. What the care home could do better: Care plans, risk assessments, the complaints procedure, and other information, which is important to the people living at the home, could be presented in communication styles, which are more accessible to them. Additional staff would ensure that residents receive a more individualised programme rather than a programme of group activities. More senior staff, to support the manager, would allow her to concentrate more on staff support and management issues. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mayfield House 41 London Road Liphook Hampshire GU30 7AP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Bowman     Date: 0 4 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Mayfield House 41 London Road Liphook Hampshire GU30 7AP 01428724982 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Gayawotee Rayola Jingree care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users to be accommodated is 12 The registered person may provide the folllowing category of service only: Care home only (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 (LD) Date of last inspection Brief description of the care home Mayfield House is a care home providing personal care and accommodation for up to 12 service users in the category of learning disability and is owned by Mrs Jingree who is also the registered manager. The home is situated within close proximity of the town of Liphook, which has a range of leisure and recreational facilities and public services. Mayfield House has a communal lounge and communal dining room and a garden to the rear with seating. The current fees range from #461.58 to #965.58 per week. Items not covered by fee include hairdressing, chiropody, toiletries, transport and holidays. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection report includes information gathered about the service since the previous site visit on 19th July 2007 under the Inspecting for Better Lives (ILB) process. An Annual Quality Assurance Assessment (AQAA) was completed by the manager, within the allocated timescale. It gave the required, up to date, factual evidence about the running of the home and informed us of what they think they are doing well, how they have improved the service, and of their plans for further improvements for the benefit of the residents. Three staff members completed and returned surveys, giving their views on the service. An unannounced site visit was conducted on 4th June 2009, to assess the outcomes of the key inspection standards for younger adults with respect to the residents living at the home. The registered manager, Mrs Jingree, assisted with the inspection process by making resident and Care Homes for Adults (18-65 years) Page 5 of 29 staff files and other documents available to be sampled. During the site visit, we looked at some of the residents bedrooms and the communal areas of the home. Two residents and two staff were involved in the inspection, and observations were made of staff and resident interaction throughout the day. 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 Care Homes for Adults (18-65 years) Page 7 of 29 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 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements had been made in the provision of appropriate and accessible information to inform prospective residents about what to expect of the service. New residents are not admitted to the home unless an assessment carried out by a professional has been undertaken, to ensure their needs can be met at the home. Evidence: A revised service user guide had been completed recently, illustrated with colourful symbols, and written in clear and simple language to promote the service users understanding. It included all the information a prospective service user would require when making a decision about living at the home, and promised them that the home would be sensitive to their equality and diversity needs. The majority of the residents had lived at the home for some time. One new resident, however, had been admitted since the previous site visit, and a full assessment by a healthcare professional had been carried out detailing their needs. The manager had received this information and visited the prospective resident to ensure their needs Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: could be met at the home. Records confirmed that the prospective resident had made two visits to the home and had stayed to lunch and tea to experience life there. They had been able to meet the other residents and to see their new bedroom before making the decision to move in. The home had a key worker system designed to give new residents individual support and to help them to settle in, and a full statement of terms and conditions had been drawn up, detailing the role and responsibilities of the provider, and informing the resident of their rights and obligations. The service does not offer intermediate care. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have care plans and their needs and goals are recorded but not in format, which they can understand. Improvements have been made in supporting residents to gain more independence, make decisions, take risks, and have their individuality recognised. Evidence: The two residents care plans sampled, included identified needs, goals, action plans, expected outcomes and review dates. The care plans were written about the residents rather than from their point of view and they were not in a communication style that was accessible to the individuals for whom they were written. The manager stated that she was in the process of purchasing a computer programme to enable symbols to be used to make the care plans more person-centred. One care plan sampled described how the individual was supported to gain confidence in expressing themselves by attending and participating in meetings, being supported to use the telephone to contact relatives and to send letters and cards. Another resident had a behaviour plan, Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: which informed the staff of the situations likely to trigger the behaviour, possible consequences and ways of providing support. Care plans viewed identified residents likes and dislikes and interests and one residents plan recorded that they liked bingo, knitting, doing the laundry, writing shopping lists and going shopping. Dates recorded, showed that care plans sampled had been reviewed on a six-monthly basis, but there was little evidence of the involvement of care management. The manager stated that there were no longer allocated care managers for the majority of the residents and invitations to attend reviews had not been taken up. Two of the three staff, who completed surveys, recorded that they always had up to date information about the needs of the people they support or care for, and one that they usually did. Residents spoken with at the time of the site visit were able to communicate their needs verbally and one stated that they had travelled on a train to Guildford to do some shopping, which was something they had wanted to do, and that they also wanted to fly in an aeroplane and plans were in place to take a holiday abroad. Residents stated they were happy that they could make decisions about what they wanted to do. The service user guide gave information on the availability of advocacy to assist people to speak up for themselves or to speak on their behalf if they were unable. In addition to risk assessments with respect to safety such as a falls risk assessments for one resident, the risks with respect to daily living skills and gaining self-confidence in self-help skills were recorded. One residents had a risk assessment for accessing the community unescorted and for using equipment in the kitchen. Levels of risk were recorded and actions to minimise risks to ensure positive outcomes to the residents, when taking risks. The manager wrote in the AQAA, The assessment of risks has improved and residents have been enabled to access a wider range of opportunities. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 to engage in a range of activities that take account of their needs and preferences, encouraged to maintain personal relationships, and provided with a healthy meals which they have been involved in choosing. Evidence: As described in the previous key inspection report, the residents continued to express satisfaction with their lifestyle. Five of the residents were attending day services in Borden on the day of the site visit and the manager stated that some residents attend for three days of the week and some more often. The activities offered included music, dancing and art and craft. Some of the residents, who had reached retirement age, had chosen not to continue to attend day centres. The manager wrote in the AQQA, as a result of listening to the people who use the service, we have made arrangements Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: for early evening social meetings in Alton and introduced special celebratory days at home for parties and barbecues etc. Residents have been allotted gardening space where they are growing vegetables for use in the home. Two of the residents were keen to show the results of their work in the garden, where a variety of vegetables had been planted in raised beds. Timetables of the activities service users were involved in were held on their files and a record of involvement was kept to confirm service users were doing what they wanted to do. Some of the activities recorded on the activity sheets sampled included bingo, knitting, woodwork, painting, attending day service, shopping, one to one time, and kitchen and laundry activities. There were large colourful photographs of visits to the Isle of Wight, Arundel Castle and parties at the home, which the manager was in the process of preparing for display, and a trip to Spain was in the planning stages. A fortnightly communion service continued to be offered by the local Anglican Church and one resident regularly attended another church of their choice independently. The home had two vehicles available for transporting the residents, one of which was large enough to accommodate seven people. Interaction with relatives and friends was promoted and regular contact maintained. One resident was taken out by a relative for the day and to enjoy a meal regularly, another returned to their family home every weekend for a day, other residents were taken out by relatives or friends less regularly and entertained visitors at the home. Contact by telephone and letters was also supported. The six surveys, completed by relatives and representatives as part of the homes quality assurance process, confirmed that the staff make them feel welcome when they visit the home, that they were satisfied with the care and that communication was good. Residents were provided with opportunities for making friends at the social club, which they attended on a regular basis, and through attending day services. Residents spoken with confirmed they enjoyed the meals provided at the home and one resident stated they liked cooking. The manager wrote in the AQQA that the menu is chosen weekly, and stated that one resident in particular, enjoyed making the shopping list, and several residents liked to participate in the weekly shopping trip for provisions. Minutes of residents meetings sampled confirmed that menus had been discussed with the residents. Records were kept of what people ate and fresh ingredients were used in the lunch time meal provided. The manager confirmed that, although meals were planned at regular times, there was flexibility with respect to the time residents wished to eat and where they would like to take their meals. Drinks and snacks were also made available throughout the day and in the evening. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal and healthcare needs are met according to their preferences and safe procedures are in place to ensure their medication is handled safely. Evidence: The manager confirmed that the Skills for Care common induction standards formed part of the homes induction for new staff providing them with an introduction to the caring role, promoting the residents rights to be treated as an individual with respect to their equality and diversity issues, and promoting their privacy and dignity. The staff observed working with the residents on the day of the site visit treated them with respect and sensitivity. A key worker system was in operation providing continuity and consistency. Records confirmed that service users were supported to go shopping to buy personal items such as clothes and toiletries of their choice. The AQAA recorded that, residents are assisted and supervised in private with personal care as needed to ensure individual wishes and preferences are respected. Care plans sampled recorded how residents received support for their personal care needs. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Residents healthcare needs were also recorded in their care plans. A residents psychological needs were explained in their care plan so that the staff would be aware of how to provide their support. There was evidence of specialist involvement, and instructions to the staff from consultations were recorded to inform them. Another resident, whose file was sampled, had a physiotherapist involved in their treatment and exercises to follow. The manager stated that all the residents were registered with local General Practitioners and dentists, and that the local community team for people with learning disabilities also provided support. Medication was stored appropriately and was blister-packed at the local pharmacy for safety and convenience. Records were kept of medication received and returned to the pharmacy, and a sample of one service users medication, confirmed that the balance of medication recorded was correct. Staff records confirmed that medication training, provided by an independent company, had been undertaken to ensure competence. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident about expressing their concerns and are protected from abuse, neglect and self harm. Evidence: The homes complaints procedure had been included in the service user guide. Although this document had been reviewed and contained some symbols to promote the residents understanding, the complaints procedure was not in symbolic format or written in such a way as to make it easy to understand. The manager wrote in the AQAA that she is in the process of producing the complaints procedure in pictorial format to ensure the residents will be able to understand it better and know who to come to in case they want to talk to someone about any concerns they may have. The Care Quality Commission (CQC) contact details had been included to inform residents, relatives and staff, but the CQC also continued to be referred to as the National Care Standards Commission (NCSC) and clarification is needed with respect to ensuring the contact details are correct. A timescale for responding to formal complaints was included, but the manager recorded in the AQQA, that any concerns brought to her attention were dealt with as soon as possible, usually within twenty four hours. She also confirmed that no formal complaints had been made since the previous site visit. The minutes of residents meetings, sampled, recorded that the complaints procedure had been discussed with the residents to reinforce their understanding of the process. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Residents appeared to be relaxed in the company of the staff on the day of the site visit and spontaneous in expressing their thoughts and feelings. The home had obtained a copy of the local authority safeguarding procedures to ensure the staff had access to referral details and processes, to inform them of appropriate responses to make should an allegation be made. No referrals had been made since the previous site visit, when it was reported that the home had responded appropriately to a safeguarding issue raised. The manager stated that she had attended the local authority safeguarding training and staff records confirmed that they had undertaken training in the protection of vulnerable adults. Residents had their own bank accounts and relatives supported them wherever possible, the manager stated. Records were kept of residents monies held in safekeeping and storage was secure. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a comfortable, homely and safe environment, which meets their needs and is clean and hygienic. Evidence: Mayfield House was located in a residential area of Liphook town, within easy walking distance of local facilities including shops and public services for the convenience of the service users. A short drive led to a small car park at the front of the building, and a pleasant garden, with lawn, flowerbeds, mature trees and shrubs, surrounded the home. We looked at the premises, accompanied by two residents. The communal space included a large lounge and separate dining room with views of the garden. Suitable equipment and furnishings were provided to cater for the needs of the residents. New furniture had been purchased for the lounge area since the previous site visit, for the comfort of the residents. Radiators were not covered, but the manager confirmed that the surface temperature was controlled to protect the residents from burning themselves. The AQAA confirmed there were plans to replace the carpets on the ground floor with wooden flooring and the manager stated that this would be Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: completed over the next week. Other environmental improvements included, the converting of a downstairs bathroom into a shower room and toilet and a putting a new shower in the upstairs bathrooms. Residents bedrooms viewed had been provided with adequate furnishings, however some maintenance was required, which the manager stated, was due to be completed. There were nine singe bedrooms and three double bedrooms. However, only one of the shared bedrooms was currently occupied by two people, who had chosen to share, even though a single bedroom had been offered. One resident had a double bedroom, which had been made into a single bedroom. The utility room contained all the necessary equipment for laundering the service users clothes and bedding and the AQAA recorded that since the previous site visit a new industrial washing machine had been purchased and new flooring had been laid. Infection control facilities included a separate basin for hand washing, along with disposable paper towels, and liquid soap. The Control of Substances Hazardous to Health (COSHH) cupboard was secure to safeguard the residents and the manager, confirmed in the AQAA, that four of the staff had received training in the prevention and control of infection. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Safe recruitment practices, appropriate induction and mandatory and specialist training prepare the staff for the supportive role and to meet the residents needs. Evidence: Since the previous site visit, two full and three part-time staff had left the employment of the home, and the manager had made every effort to fill the vacancies. As a result, one member of staff was in the process of induction, another awaiting recruitment checks and another four staff had been interviewed. The manager stated that the residential forum to calculate the number of staff needed to cater for the needs of the residents had been completed some time ago, but as the residents needs were changing it is recommended that this calculation be completed again in the light of the individual needs of the residents, the support required to promote their empowerment, and the extra support required by some of the older residents. The AQAA confirmed that 50 of the staff team had achieved a National Vocational Training Qualification at Level 2 or above or had an equivalent qualification. The two of the three staff, who completed surveys, thought there were always enough staff to meet the individual needs of the service users and one, that there usually were. In Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: addition to the care staff employed at the home, a full time administrator, domestic staff and a gardener were also employed and a maintenance person was contracted to carry out essential maintenance work. The three staff, who completed surveys, confirmed that Criminal Record Bureau checks and references had been carried out before they started work. The files of two staff, one of which had been recruited since the previous site visit, were sampled. Records confirmed that recruitment checks had been carried out prior to the staff working at the home to ensure the residents were protected. Reasons for leaving employment and gaps in employment had been explained to ensure that only suitable people had been considered for employment. The manager confirmed that induction was in line with the Skills for Care Common Induction Standards, which gives new staff a good introduction to the caring role, and two of the three staff, who completed surveys, thought that their induction covered everything they needed to know to do the job, very well and one that it mostly did. Staff files sampled contained certificates for Medication Awareness, Safeguarding Adults (Hampshire County Council), Health and Safety, Fire safety, Person-centred planning, Dementia Awareness, Equality and Diversity, Food Hygiene, First Aid, Infection Control and Moving and Handling. On the day of the site visit, a trainer from an independent agency was updating the staff on Equality and Diversity. The three staff, who completed surveys, all confirmed they were being given training which is relevant to their role, helps them to understand the residents needs with respect to equality and diversity and keeps them up to date with new ways of working. Improvements had been made in the formal supervision process, and the frequency of the managers meetings with the staff. Records had been kept of meetings held to confirm the staff were receiving feedback on their work. A relative commented in the survey completed for the home, all the staff are very helpful and polite. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents can be confident that their home is well managed and run in their best interests and that their health, safety and welfare is promoted. Evidence: Since the previous site visit, the registered manager had completed a National Vocational Qualification (NVQ) at level 4 and achieved the Registered Managers Award (RMA). She stated that she always takes part in consultant led training provided by independent organisations and would have been involved in the Equality and Diversity Training, which was taking place at the home on the day of the site visit, had her input had not been required to support the inspection process. She stated that she continues to put her learning into practice in promoting the empowerment of the residents and the staff and keeps herself up to date by membership of the Hampshire Care Association and by employing an agency to inform her of changes in legislation and other important information she needed to be aware of. There were no other senior staff employed at the home and the manager spent a lot of her time filling in for missing staff, in addition to completing her management responsibilities. An Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: administrator, solely dedicated to office work, was employed to support her. The collated results of the quality assurance questionnaires completed by relatives and representatives of the residents confirmed a high level of satisfaction with the service. All recorded that they felt welcomed at the home, found the staff friendly and courteous, and were satisfied with the level of communication and the care provided. Regular residents meetings were held and minutes recorded to ensure they had the opportunity to give their views on important issues about the running of the home. As a result of listening to the residents, the AQAA recorded that a wider choice of alternatives had been included in the menu, more social activities in the community and in the home had been introduced, and he garden project had been initiated. There were plans to include more day trips to places of interest and to introduce holidays abroad to fulfil the aspirations of some of the residents. The AQAA recorded that equipment had been serviced or tested as recommended by the manufacturer or other regulatory body and certificates for the electrical appliances, fire detection and alarm systems, sampled, confirmed they had been serviced within the previous year. The Control of Substances Hazardous to Health (COSHH) had been appropriately risk assessed to safeguard the residents. Policies and procedures and codes of practice in relation to Health and Safety were in the process of review to keep the staff up to date with current legislation and practice. Staff training included moving and handling, food hygiene, first aid, fire training, infection control and health and safety and certificates held in staff files confirmed the training had been regularly updated to inform the staff. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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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