Care Home: Mid Meadows Care Home

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What the care home does well Mid meadows is a clean, comfortable and homely place, with a stable, relaxed atmosphere. People have personalised their rooms.The staff were seen supporting and caring or the people. Staff always approached people with care and respect. People were directly seen to respond well to the staff manner and approach. One person commented that "the staff are very kind and listen to us".People living at Mid Meadows felt comfortable asking staff for advice or talking about the things that mattered to them. All people surveyed said that they knew how to make a complaint or who to talk to if they were sad.One person who uses the service commented, "I am really pleased I moved here, it was the best move I ever made". One survey received back commented in relation to what the home does well, "everything".Records kept about the people using the service were detailed and showed that the people using the service are offered support which is tailored to their individual needs, wishes and preferences.Staff are employed, inducted and trained well. What has improved since the last inspection? The service told us that the induction, supervision and training of staff has improved since that last inspection. The service ensures that it monitors works and progress made of staff and the peopleliving their. Some areas of the service have been redecorated, this includes a new wet room, refurbishment of the bath room and a hoist. What the care home could do better: Carpets should be replaced where worn and staff must receive training in Deprivation of Liberty’s and Safeguards. Key inspection report Care homes for adults (18-65 years) Name: Address: Mid Meadows Care Home 72/74 Elm Tree Avenue Frinton On Sea Essex CO13 0AS 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: Louise Bushell Date: 0 8 0 4 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 33 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 33 Information about the care home Name of care home: Address: Mid Meadows Care Home 72/74 Elm Tree Avenue Frinton On Sea Essex CO13 0AS 01255675085 F/P01255675085 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.blackswan.co.uk Black Swan International Limited Name of registered manager (if applicable) Mrs Violet Ruth Ann Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 18 18 0 0 care home 18 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 18. The registered provider may provide the following category of service: Care Home only - Code PC To service users of the following gender: Either Whose primary needs on admission are within the following categories: Physical Disability - Code PD Learning Disability - Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Mid Meadows is a detached two-storey property on the outskirts of Frinton-on-Sea. There are 15 bedrooms on the ground floor and 3 bedrooms on the first floor that are used by residents who can access stairs independently. A copy of the most recent report by Commission for Social Care Inspection is displayed on the notice board and a copy of the homes service user guide is present in service users rooms. The current fees for the service range from £770:00 to £900:00 per week. This information was provided during this inspection. Care Homes for Adults (18-65 years) Page 5 of 33 Care Homes for Adults (18-65 years) Page 6 of 33 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 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home We visited the service on the 8th April 2010. The last visit took place on the 23rd April 2008. We spoke to the manager, staff and people using the service. We asked them questions about the care service. We received records about the people using the service to see how well peoples needs were being met. We looked around the service to ensure the environment was well maintained and that people were comfortable. Care Homes for Adults (18-65 years) Page 8 of 33 What the care home does well Mid meadows is a clean, comfortable and homely place, with a stable, relaxed atmosphere. People have personalised their rooms. The staff were seen supporting and caring or the people. Staff always approached people with care and respect. People were directly seen to respond well to the staff manner and approach. One person commented that the staff are very kind and listen to us. People living at Mid Meadows felt comfortable asking staff for advice or talking about the things that mattered to them. All people surveyed said that they knew how to make a complaint or who to talk to if they were sad. Care Homes for Adults (18-65 years) Page 9 of 33 One person who uses the service commented, I am really pleased I moved here, it was the best move I ever made. One survey received back commented in relation to what the home does well, everything. Records kept about the people using the service were detailed and showed that the people using the service are offered support which is tailored to their individual needs, wishes and preferences. Staff are employed, inducted and trained well. What has got better from the last inspection The service told us that the induction, supervision and training of staff has improved since that last inspection. The service ensures that it monitors works and progress made of staff and the people Care Homes for Adults (18-65 years) Page 10 of 33 living their. Some areas of the service have been redecorated, this includes a new wet room, refurbishment of the bath room and a hoist. What the care home could do better 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 Louise Bushell Care Homes for Adults (18-65 years) Page 11 of 33 CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 12 of 33 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 13 of 33 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 who use the service can be assured that there needs will be identified through a detailed assessment process, including a visit to the service. Evidence: The service has developed a statement of purpose, which sets out the aims and objectives of the service, and includes a guide, which provides information about the service and the specialist care the service offers. The guide details what the prospective and current individuals can expect and gives a clear account of the specialist services provided, quality of the accommodation, qualifications and experience of staff and how to make a complaint. All new people are given a copy of the guide and the services makes one available for all to view as they wish. Nine surveys were received from the people who use the service. All of the surveys stated that they had enough information regarding the service before they moved in. One person using the service stated I had quite a bot of information before I moved in here, it was the best move I ever made. Two care files were observed of two of the individuals using the service. Assessments tools were observed for both of these people. It was evident that admissions are not made to the service until a full needs assessment has been undertaken. A skilled and trained person always completes the assessment prior to admission to the service. Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: The assessment was detailed and appropriate to the policy and procedure in place. The assessment explored some areas of diversity including preferences, religious and cultural needs, involvement from family. The service has the capacity to support people who use the service and respond to diverse needs that may have been identified during the assessment process. Information was also gathered from all relevant other professionals in order to ensure that the needs of the person were placed at the centre of the care and support being provided. It was evident on each occasion that essential links had been gained and maintained with, for example the community nursing team and social workers. Surveys returned determined that the care services assessment arrangements ensure that accurate information is gathered and that the right service is planned for people. One person directly commented I feel safe here. The AQAA tells us that we complete a comprehensive pre admission assessment of needs by way of visits to potential service user, invitation to visit the home, eat at the home, meet staff and other residents, free trial overnight stay at the home. Provide a sensitive, supporting reassurance during the admission process. One person who uses the service commented, the staff are really supportive and talk to us as equals. Files seen showed that each person had a statement of their terms and conditions The AQAA also identifies that the service is able to highlight its own developmental areas and is stating that over the next twelve months it is aiming to develop and introduce quality assurance surveys covering the admission process which will be given to those involved in the process. Improve detail of pre admission process. This was discussed in brief with the Regional manager at the time of the inspection. Care Homes for Adults (18-65 years) Page 15 of 33 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 who use the service can be assured that staff have detailed information available in order to meet their needs. Evidence: A total of two care plans were case tracked fully. It was established that people who use the service receive personal and healthcare support, which is suitable to meet their needs. Personal healthcare needs including specialist health and dietary requirements are recorded in each persons care plan. The care plan provides information and a guide for staff to know how to support the person. The care planing process enables peoples needs to be linked to aspirations and risks. The format is person centred and puts the person at the focus of the care plan. The care plan presented as a working document with regular reviews. The plan of care identifies the specific need of the individual, the agreed objectives and or action required to meet the need, who is responsible and a target date. Each plan is then agreed monthly and updated on a monthly basis. Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: The care plan is generated from the pre admission assessment and includes guidelines, risk assessments for the management and control of a range of issues, manual handling and where appropriate behavioural support guidelines. The guidelines and care plans are specific to the person and direct the staff on how to meet that specific individual persons needs, wishes and or preferences. An example of this was shown in a persons care plan with regards to their personal communication method and techniques. The AQAA tells us that, following the initial assessment of needs prior to admission, on admission we proceed to individually risk assess each resident on an ongoing basis. We then compile an individual plan of care covering the health, personal, social and emotional needs of each Resident. This care plan is compiled with the involvement of the resident who signs to agree the plan where possible. The care plan is reviewed on an ongoing basis and formally rechecked every month and fully reviewed every six months. One person using the service commented, I know about my care plan and I have a copy in my bedroom. The AQAA states that residents are encouraged to participate in the running of the home and to take risks where appropriate. Independence and choice over personal care is promoted so that Residents can live their own lives with dignity and privacy. Staff must read and comply with the Homes policy on confidentiality. Evidence of appropriate risk assessments were seen and reviewed as part of case tracking. It was evident that risk assessments were enabling people to take every day risks as part of developing an independent life style. It was observed that personal support is responsive and tailored to meet the individual choices, needs and preferences. Staff were observed to respect the privacy and dignity of all people. An example of this was seen during the inspection with staff communicating with individuals in a respectful manner and offering them personal hygiene tasks discreetly. The service listens and responds to individual choices and decisions about who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs. One person using the service commented the staff really do care and help us. During the inspection it was directly observed that confidential records were being stored appropriately. Care Homes for Adults (18-65 years) Page 17 of 33 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 who use the service are provided with support to make choices about their lifestyle and to develop their life skills. Evidence: People who use the service are supported to enjoy a full and stimulating lifestyle with a variety of options to choose from. Staff members were able to report that people who use the service were supported to attend various activities, go to the theatre, cinema, shows, and many other appropriate activities. The people who use the service have opportunities at internal meetings to voice their wishes regarding social events and all other issues they wish to discuss. One person using the service commented I like to go to the sea front, keep myself occupied. I am taking up golf soon, I have plenty of mates in the area to. On the day of the inspection one person confirmed that they go away on holiday. The individual stated I have been to Norfolk and the Blackpool, we had a really good time. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: The service sought the views of the people who use the service and their representatives and considered these when planning the routines of daily living and arranging activities. Routines and activities were flexible and focused around individuals changing needs and choices. Records are maintained where people have engaged in activities. The service supports people to voice their opinions and holds regular Tenant groups. One person using the service stated every three to four months we have a tenants meeting and we talk about trips, changes to the menu and any views or concerns we may have. The AQAA tells us that residents choices of activities, interests, food, drink, religion, personal care and personal relationships are listened to and respected. Residents can feel free to request changes which effect their lifestyle. Staff are approachable and are trained to treat Residents with dignity and privacy. Contacts with family friends and the community are encouraged and supported. Independence and personal preference is always encouraged. Choice and range of menu is driven by the residents with an overall view of providing a nutritious, wholesome, balanced and an enjoyable diet. Mealtimes should be an enjoyable experience. Residents choose in which areas they would like to personally develop whether it be educational courses, outside vocational courses, activities and hobbies. One person using the service stated last year I did some voluntary work for the British heart foundation, we can generally do what we like and come and go as we please. It was observed that meals were well balanced and nutritional, catering for the varying choices and dietary needs of the people living at the service. Food stocks were of good quality and in appropriate quantities. One person commented I like the food, its nice. A further person nodded their head and smiled when asked if they liked the food. Care Homes for Adults (18-65 years) Page 19 of 33 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 who use the service can be assured that their health needs are being met in their best interest. Evidence: Individuals files included information of individuals health needs and how these were to be met, however the information was contained within a variety of sources such as the daily records, the assessment and the care plan. It was identified that the holistic needs of each person using the service was available. The care plans and health needs documentation put the person at the centre of their care. It was evidenced on numerous occasions where different specialists are involved directly with the care and support of the person. Examples of this included community nursing team, outreach services and mental health support services. Records were well maintained. The AQAA details information regarding a good practice example of working in the best interests of the person using the service and linking with other multi disciplinary teams. It states we have a desire to treat residents with dignity, respect and privacy. The homes ethos is that the home is the residents home and they have the right to decide how their personal care is provided. Staff respond to care needs with sensitivity whilst ensuring Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: health and personal care needs are met via the care planning process. The service currently does not provide a specific Health Action Plan, however all the information required was available. One person using the service commented my feet get checked over and nails cut. If I need to see a doctor I tell the staff and its always arranged. Personal care and support was provided in private and by a person of the same gender where possible. Documents were in place as agreed by the individual regarding gender sensitivity issues. Guidance and support is provided with personal hygiene tasks where required although where people are able to attend to their own personal hygiene needs they were encouraged to do so. The AQAA tells us that residents are encouraged to self administer medication following a risk assessment. All staff who administer medication are suitably trained. The homes policy on the safe storage, administration and disposal of medication is adhered to. Policies and procedures relating the medication had been reviewed. It was observed that all staff member read and sign each policy and procedure. A newly recruited staff member confirmed that she has recently received training in the polices and procedures and medication. One staff member surveyed commented our home looks after the individual need of the person in our care. It encourages them to be themselves and make their own choices. Care Homes for Adults (18-65 years) Page 21 of 33 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 who use the service can be assured that their concerns are listened to and acted upon. Evidence: The service has an open culture, which allows people to express their views and concerns through a variety of methods. Feedback gained from one of the people who uses the service confirmed that they are aware of what to do if they are unhappy and wish or wish to make a complaint. The individual stated, I can talk to staff if I am unhappy or sad, they are good and help me. The service has a clear complaints policy and procedure. A detailed complaints and compliments record is maintained and this is also internally monitored each month and actions clearly recorded. The AQAA tells us that the service provides a complaints procedure to each resident and put one on the wall at entrance for visitors. We have an open policy of welcoming suggestions and complaints which will be acted upon. We keep a record of complaints. A discussion was held regarding the recognition of complaints and the positive way in which they could be used as tools to drive the quality of service provision forward. One person using the service stated If I was not happy I would make a complaint, issues are always sorted out quickly. The service understood the procedure for safeguarding vulnerable adults. Training in the Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: safeguarding and protection of vulnerable people is scheduled periodically. The policies and procedures relating to recruitment promotes the safety of the people who use the service through the completion of an enhanced Criminal Records Bureau (CRB) disclosures and two written references before a new staff member starts work at the service. The AQAA tells us that all staff are trained in Safeguarding of Vulnerable Adults. All staff go through a rigorous recruitment procedure including employment history, written references and CRB. Care Homes for Adults (18-65 years) Page 23 of 33 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. The people using the service reside in a suitable, safe, hygienic and homely environment. Evidence: The service continues to be homely, clean, and safe and reflects the individuals needs by design and adaptations provided. The people who use the service are fully involved in decisions about the decoration of the service and furniture this includes individual bedrooms and all communal areas. Peoples rooms are very personalised with pictures, and furnishings that the person has been supported in choosing. One person using the service commented I like my room which has recently been painted, I have my own home entertainment centre, its great . The AQAA tells us that the home is safe and warm providing a comfortable homely environment where residents can individualise their own bedrooms. Communal rooms, bathrooms and toilets are upgraded as required. The home offers access to local amenities and support services including use of the homes minibus. The service provides a range of disability aids and equipment to meet the needs of its Residents including mobile hoists, overhead hoists, wheelchairs, stair lift, bathroom and toilet fittings, communication aids, computer equipment. Individuals choose to meet with families or friends in communal settings or privately. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: They also have access to a phone where they can make calls confidentially. One person using the service stated we can have visitors back here any time, no restrictions as far as I know. Individuals have full access to all facilities, enabling their independence to grow. One person stated I like my room. A further person expressed satisfaction with the patio area which they were able to access from their bedroom. The AQAA indicates that the service continues to make improvements. It states refurbishment of many bedrooms and bathrooms. New minibus. Recruited a second maintenance person to ensure all works are completed quicker. Strengthened all infection control policies and procedures. During the inspection it was noted that new sofas had been purchased, a new Arjo bath and over head hoist had recently been installed and a new wet room has been developed. It was noted that a number of carpets were worn. The outdoor space available is of a good size and enables people to move around freely. The garden is maintained and there is a large covered pergola area with seating available. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service can be assured that their care and support needs are met and are provided by a competent qualified staff team. Evidence: People who use the service have confidence in the staff who care for them. People using the service were relaxed within their own environment and staff were directly observed communicating with individuals in a dignified manner. People using the service feedback in the survey that they feel that the staff and manager treat them well and act upon what they say. Rotas show well thought out and creative ways of making sure that the service is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. There are enough staff on duty to meet the needs of the people using the service. The service also operates an on call support system. The AQAA tells us that new staff go through a rigorous recruitment process including interview, references, ISA checks. Staff go through an Induction process on joining which may involve Skills for Care induction training. Staff training requirements are reviewed during staff supervision and are trained both internally and externally. Staff are aware of their role within the home and are trained to support the residents within the home. Staffing levels are determined by the Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: needs of the existing resident group. Staff members undertake qualifications. The person in charge encourages and enable this and recognise the benefits of a skilled, trained workforce. Records showed that some staff have completed or are in the process of completing their National Vocational Qualification. Training records showed that there is a structured training plan in place and that all mandatory training needs have been identified and plans in place to provide the training. It was noted that Deprivation of Liberty and Safeguards training had not been provided to the staff. The system used is effective a identifies any shortfalls. During the inspection records were seen of the structured induction programme that staff undertake. One staff member commented I have completed my induction, it was very detailed and informative. Feedback received from the staff surveys reflected that staff have information available to them regarding the needs of the individuals and that the induction programme covered the areas of the job that they would be doing. The service indicates in their AQAA that further improvements over the next twelve months include redevelop staff files and the storage of staff files. Head Office to be responsible on audits of staff information and receiving all staff documentation. Increase staffing to include an activities person. All staff to achieve LDQ qualification as mandatory. To achieve dementia care mapping qualification. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff recruited confirm that the home was clear about what was involved at all stages and was robust in following its procedure. Supervision records were observed. A number of records were seen and explored personal development issues, key working and training and development. Care Homes for Adults (18-65 years) Page 27 of 33 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 who use the service can be assured that the person in charge has appropriate leadership skills and offers guidance and direction to all staff. This means that the people live in a well managed service. Evidence: The person in charge at the time of the inspection was the person who had recently taken over the running of the service as the Manager. Discussions during the inspection determined that the person would be applying for registration as the Registered Manager. Time was spent with this person, a manager from another service and the Regional Manager for the company. It was clear that the person communicates a clear sense of direction to staff is able to evidence a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. This was evidenced on the day of the inspection by the people using the service and the staff both making positive comments regarding his leadership and management style. One staff member commented works with the team, good team work.In addition to this staff surveyed stated that they felt Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: fully supported within their roles. The AQAA tells us that the home has an experienced, qualified and competent manager. The management approach is open, positive and inclusive. There is a comprehensive quality assurance system in place. Policies, procedures and records within the Home are clear, comprehensive and accessible. Health and Safety policies and procedures are clear, comprehensive and adhered to. The home is managed to be financially viable with suitable insurance cover. The ethos and leadership style of the service supports and enables people to express their diversity needs including their race, gender, sexuality and age. The manager is able to demonstrate through robust operational systems and professional experience that they are knowledgeable and highly competent in a range of areas. Examples include people being supported and empowered to make personal choices and the documentation of preferences. The person in charge ensures that staff follow the policies and procedures of the service. These are available in the office and were seen to be working documents. The staff are also required to sign each of the guidance and polices once they have read and understood them. There is strong evidence that the ethos of the home is open and transparent. The views of both people who use the service and staff are listened to, and valued. The AQAA contains good information that is fully supported by appropriate evidence. The service demonstrates a good level of self-awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. The service has efficient systems to ensure effective safeguarding and management of residents money and valuables, including record keeping. People are supported to manage their own money where possible. Those who do not currently have the skills are encouraged and supported to develop to become as independent as possible. They have access to their records whenever they wish. Record keeping is of a good standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. Risk assessments are in place regarding financial management and risk for all individuals. Further discussions occurred with the management team about safeguarding people who are supported with the management of their finances and how this could be further supported for their protection. The service has a comprehensive range of policies and procedures to promote and protect residents and employees health and safety. Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: There is full and clearly written recording of all safety checks and accidents. The person in charge, senior team, and staff at all levels have a good understanding of risk assessment processes which is underpinned by promoting independence, choice and autonomy. These principles are taken into account in all aspects of the running of the service. The person in charge ensures that all staff are trained in health and safety matters. Individual training records reflect this and regular updates are planned Care Homes for Adults (18-65 years) Page 30 of 33 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 31 of 33 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 1 32 18 Staff must received training in the Deprivation of Libertys and Safeguards. 30/06/2010 To ensure that they are suitably skilled to meet the needs of the people using the service. 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 24 Carpets should be replaced where they are worn. Care Homes for Adults (18-65 years) Page 32 of 33 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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