Care Home: Minehead Road

What the care home does well The service fully involves residents in any decisions that affect them. Residents had a smooth transition to this home six months ago. The move was well planned and all relevant parties were involved. Over the preceeding months residents made several visits to the home, to choose their bedrooms and decor they preferred. Residents indicated that they are happy in their new surroundings. Residents that verbalise said, "it is lovely, " I really like my new home and I like the staff"". Residents that are non verbal were in a jovial mood, they were calm and displayed great pleasure by nodding and smiling. We examined the outcomes of recent reviews undertaken, these were all positive with good outcomes for each individual. The service is well run, the home benefits from the presence of an experienced competent manager who has excellent leadership skills. Clear direction is given which staff appreciate. Residents feel secure and safe as their needs are fully understood by the staff members they are familiar with. Communication is good, there are thorough handovers at change of each shift. The home is run in the best interest of residents, the accomodation provided is of a high standard. Equality and diversity, and person centered planning are given priority in this service. Management and staff demonstrate a high level of understanding and demonstrate best practice in all of these areas. Residents` needs, likes and dislikes are documented and their choice and independence is respected and promoted. Risk taking is well supported by providing guidance and support to enable individuals follow their ideals and aspirations. Staffing levels are good, as a result the range of activities available ensure that people living in the home are supported to lead a fulfilling lifestyle. Documentation is of a high standard, files are well organized with up to date records maintained. Relatives feel confident in the service as they are kept fully informed of individual`s well being. One family told us, "we value very much the information supplied every month by the manager". Care managers too spoken to reported positively on the service, they were impressed by how quickly residents settled in new surroundings, one of the care managers said "it demonstrated the confidence residents have in the staff team". What has improved since the last inspection? This was the first inspection for this service What the care home could do better: Maintain the excellent standard experienced. Key inspection report Care homes for adults (18-65 years) Name: Address: Minehead Road 18 Minehead Road London London SW16 2AW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Magee     Date: 0 2 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Minehead Road 18 Minehead Road London London SW16 2AW 02086711508 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Amin Mohammed Lakhani Name of registered manager (if applicable) Miss Julie Shirley Hobbs Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who may be accommodated is 6 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability, Code LD Whose primary care needs on admission are in the following category Learning Disability Code LD Date of last inspection Brief description of the care home This is a small care home owned by Saffronlands. It first registered in July 2009. It offers a service and accomodation to people with learning disabilities. The house is a semi detached victorian property, and has spacious accomodation. Individual bedrooms are spacious, each room with its own shower and toilet facilities. The home offers a range of communal space for residents to relax and enjoy their Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 6 6 Brief description of the care home pursuits. The premises is environmentally friendly and are fitted with latest technology that are energy effecient. Fees range from £1800, to £1875 per week . Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: One regulation inspector undertook this unannounced key inspection. The site visit lasted over one day. During our visit we met with the manager and all the other six staff on duty. We met with all six residents over the course of the day. We looked at other records that told us how the home is run. This included resident and staff records, and health and safety documentation. We spoke to four family members on the telephone. We heard from two care managers allocated to residents at the home. We used case tracking to evaluate the service. Communication with residents was made easier, as we were familiar to three of the residents from their previous home. Prior to the inspection we received a completed AQAA (Annual Quality Assurance Self Assessment). The inspection was facilitated by management, staff and residents who were helpful Care Homes for Adults (18-65 years) Page 6 of 31 and courteous and assisted the inspection process. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Adults (18-65 years) Page 8 of 31 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals living in the home are fully assessed in order to inform and develop the support plans required. Individual needs assessments are comprehensive and consider all areas where assistance is required. Evidence: This home was newly registered six months ago. Saffronlands the owner purchased the premises in order to develop a more suitable environment for accomodating younger adults. As landlord of the premises the organisation has full control over the maintenance of the home. Residents and support staff from the other two services were fully involved in the preparation. Significant time me and effort was spent planning to make admission to the home personal and well managed. We heard from residents that prior to the move that they were involved in choosing colour schemes for their new home. The many good practices experienced at both homes transferred with the service. Each resident has a copy of the needs assessment, this focuses on achieving positive outcomes for people. One of the many strengths of this service is the consideration given to a complete person centred approach from the base line of needs assessments. This service demonstrates that the facilities, staffing and Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: specialist services provided by the home meet the ethnic and diverse needs of each individual. The service has excellent facilities, each resident indicated their sense of satisfaction in the new home, for those non verbal it was demonstrated either by body langauge and sounds. Residents too say the new home is a great place to live. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: The service places residents at the heart of the service. The support provided makes sure that people using the service are in control of their lives and that they can direct the service as much as possible. From direct observations made, and from talking to residents and staff there was good evidence that, staff are fully committed in supporting individuals to lead purposeful and fulfilling lives. Independence is promoted. We saw from the records of risk assessments that residents are enabled to make their own informed decisions and have the right to take risks in their daily lives. We examined the care planning for two of the residents. Plans are all different and highly individualised. They demonstrated that the service values improving outcomes for people living in the home. A variety of different and creative methods are used to help residents to contribute to the development of their care plan and to the ongoing review process. Care managers reported positively on the support arrangements for Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: residents, Some residents have settled much more quickly than anticipated, the support arrangements we heard were very good. Staff are highly skilled, they have the specialised training and skills to support, engage and encourage the individual to be fully involved. Staffing levels are excellent, Key workers actively provide one to one support for twelve hours each day. Up to date care plans are maintained, each resident had a statutory review completed. Information sharing is good, seniors/team leaders make sure that at handovers other staff always know the persons current needs and wishes. Staff know and record the preferred communication style of the individual, and use this to enable the resident to fully participate. Care planning is excellent, it is person centred and written from the residents perspective. The evidence on the files confirms that residents are involved in drawing up the care plans. Each resident has three files, (1) contains the care and support arrangements, (2)health care plans, and (3)financial plans. Documentaion is well organised so that it is to follow for the reader. The service acknowledges what the resident is able to do, also the risks and areas wherethe resident needs support with. The person centred plan seen for both individual were detaileed and informative. each included information about the individuals likes and dislikes, feelings, relationships, abilities and health. It also contained a section on their achievements and aims and aspirations. The manager described how residents are encouraged to be independent within a risk-assessed framework. Each of the residents has a key worker which helps to ensure continuity of care.We found that documentaion is kept up to date. named keyworkers are responsible for updating the care plans and risk assessments of their key resident. They involve the residents in this process to help encourage their independence. Daily records of progress and well being are maintained. Monthly reports on well being are sent to social workers , also to next of kin. Care Homes for Adults (18-65 years) Page 14 of 31 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. The home promotes good practice, equality and diversity are fully considered with the emphasis on valuing people as individuals. Residents have the opportunity to lead a lifestyle of their choice. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: Residents were familiar with each other prior to moving to the home. They previously socialised at many of the events organised by Saffronlands. Since moving to this new home in the summer of 2009 residents were able to continue with pursuits followed at previous home. The manager told us how they encourage an increase in life skills through development plans. They are actively encourage and support links with family and Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: local communities. Residents are involved in care planning/review process. Two care and support plans were examined. These were totally individualised and centred on the relevant resident. We found that residents are able to pursure their interests due to good staffing levels with one to one support workers, as well as flexible rostering of staff. Each resident has a keyworke. Residents enjoy a full and stimulating lifestyle with a variety of options to choose from. Further education is pursued. We heard how family members are encouraged to participate in individuals lives. We also viewed copies of resrictive orders placed on a parent. In line with the court injunction order that this contact be supervised staff support this in accordance with the order. The one to one support worker available means that each resident has the support needed to pursue hobbies and leisure interests. The home gets the views of the residents and considers their varied interests when planning the routines of daily living and arranging activities both in the home and the community. Routines are very flexible and residents can make choices in major areas of their life. The service promotes healthy menu plans based on known individual choices. Staff sensitively support residents in cultural requireemnts. The service sources and supports opportunities for continuing education and creative expression as appropriate. Two residents attend college in pursuit of personnel development, another participates in communication and drama courses. All residents may have access to their records in accordance with the Data Protection Act and with regard to the Mental Capacity Act. All staff maintain daily records incorporating internal/ external participation sheets. For each resident there is a weekly programme of activities developed with the individual. Residents enjoy a full and stimulating lifestyle with a variety of options to choose from. A care manager carried out reviews for two of the residnets recently. He told us that the move to the service was positive for both, the residents had settled quickly and made themselves at home. Each one had choosen their favourite places in the lounge and this was respected. The one to one support worker available means that each resident has the support needed to pursue hobbies and leisure interests. The home gets the views of the residents and considers their varied interests when planning the routines of daily living and arranging activities both in the home and the community. The routines, activities and plans are person centred, individualised and reflect diverse needs. Menus are rotated on a four weekly basis, and residents are involved in choosing their meals each week. We observed the preparation of lunch for residents present. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Food likes and dislikes are recorded in residents care plans in pictorial format. Residents are also encouraged to participate in the preparation of meals. The home is good at making provision for cultural needs of those who live in the home, Nigerian Greek, and Mauritian based meals are included in the menu. This also applies to support in going to relevant restaurants in the community. Residents expressed satisfaction with meals served. During our visit we observed some residents choose to have additional helpings, they were enjoying very much the meal served. Mealtimes are flexible, and relaxed during our visit. Staff were oserved to be patient and helpful, and allowed individuals the time they needed to finish their meal comfortably. Care Homes for Adults (18-65 years) Page 17 of 31 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. The home actively supports residents with health and personal care needs, each resident has a health action plan to address individual health needs. Good practice is experienced by residents, with the principles of respect, dignity and privacy put into practice by the staff team. Evidence: The service planned in advance to make sure that the move to this home was as smooth as possible for residents. Relatives, healthcare professionals and care managers were kept informed of the planned move. Residents were supported to register with a local GP as previous GP was outside the catchment area. At this home good practice is evident throughout. Residents receive effective personal and healthcare support using a person centred approach. Support provided is based upon the rights of dignity, equality, fairness, autonomy and respect. The service offered at the home is effectively delivered through a skilled, trained and knowledgeable staff group that work in a person centred way. Staff are highly aware that the way in which support is given is a key issue for younger adults experiencing positive outcomes. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: For both residents that we choose to case track there was evidence of how healthcare is promoted. There are records maintained daily of individual progress reports. The records we viewed confirmed how each individual is monitored. We found that if a resident is unwell staff respond promptly and appropriately. They seek advice and alert the relevant health professional. Staff make sure that residents attend planned hospital appointments. Individual plans clearly record peoples personal and healthcare needs and detail how they will be delivered. These needs are recorded in a separate health action plan, health action plans link to care plans. Residents are encouraged and supported to manage their own life and circumstances. Residents are encouraged to do as much as possible for themselves within a supportive and creative service. For example one resident experienced seizures, guidelines are in place to manage these episodes. Risk assessments in place were updated to reflect necessary changes that are needed as a result of these. Good staffing levels facilitate access to community health services, regular check-ups with dentist, optician, and the GP take place. Evidence of the communication with psychology were present on the care files for another resident. Follow up blood test results were also held with progress reports. Healthy lifestyles and healthy eating plans are promoted, we spoke to a resident that regularly attends the gym. Weight monitoring is recorded in each residents file. We viewed evidence of best interest meetings for those lacking capacity. The majority of residents have recently had the flu vaccine. All residents had recent medication reviews as part of the medical assessment undertaken by the new GP practice. We examined medication procedures. Staff administering prescribed medication are trained and deemed competent to undertake this task. For residents receiving medication a medication profile is held. We examined the records of medication adminsitered to residents. We found that records were accurate with no omissions. Care Homes for Adults (18-65 years) Page 19 of 31 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. The home has robust procedures in place to safeguard residents from abuse or neglect. There is an open cullture fostered, where individuals feel safe and supported to share any concerns in relation to their protection and safety. Evidence: Individuals and others associated with the home say that they are extremely satisfied with the service, residents feel safe and well supported. None of the residents have raised concerns or made complaints. The home has developed the complaints procedure in widget format so that it is more accessible to residents. Copies of the complaints procedure are displayed throughout the home. Staff are encouraged to support residents to make complaints. A complaint was received from a neighbour, it related to sounds made by a resident. The organisation has acknolwedged this and is investigating it further before it responds further to the complainant. All staff working at the service know the importance of taking the views of residents seriously, and of listening to and responding to issues raised. We had discussions with four members of staff during our inspection , also the manager and deputy spoke with us. We found that staff are trained in adult protection. They also demonstrate that they are familiar with policies and procedures for this, and all staff are aware of the Whistle Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: blowing policy. We heard from management that these areas are also covered in the Skills for Care induction procedures developed for new staff. External Trainers are employed to provide Adult Protection and Pova training for all staff. Procedures in place to safeguard residents include the use of a daily log book recording visitors to the home. Security to the home is good. We examined financial procedures for two residents. The management process in place ensures that two staff sign for each transaction. These are thorough and safeuard the finances of residents. Staff are trained in how to deal with challenging behaviour. The recruitment procedures are through and make sure that staff are not employed unles they are fully vetted first. Staff are trained in Health and Safety that includes COSSH rules and regulations and to ensure that all cleaning materials and products are stored securely at all times. Day and night Health and Safety checks are carried out and recorded. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well equipped home with some of the latest technology available. The premises provide a comfortable pleasant, and homely environment. It is safe and well maintained. Evidence: We toured all of the premises. The organisationhas invested significantly to make the house suiatble for purspose. The home is a spacious six bedroomed house with an abundanceof communal space. Internally the environment is pleasant and welcoming. Residents were involved in choosing the decor of their bedrooms. We found that each bedroom is personalised to represent the choice and preference of the resident. For example a resident was supported to select and purchase artwork to display in his bedroom, the carvings represent his cultuarl heritage. Each bedroom is ensuited with its own shower and toilet facilities. In addition there are two more bathrooms for residents who prefer bathing. In adition each bedroom is fitted with a television. Bedrooms are layed out over three floors. Two communal lounges are available on the ground floor, both furnished with comfortable suites, and with flat screen televisions. A computer is also available for staff and residents. The office is located on the first floor . Each communal area is fitted with the smart system and is environmentally friendly. Movement in toilets and bathrooms triggers the light switches on and off,the central heating system is also connected to this. We observed that staff try to Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: encourage residents to use the recycling collections. A small landscaped garden is available at the backofthe house for residents. Care Homes for Adults (18-65 years) Page 23 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. . Evidence: The home is staffed by nine permanent support workers. Six to eight regular agency staff are employed as part of the staff team. Staffing levels are good, for twelve hours of the day residents have one to one support. There are two waking night staff on duty. We examined personnel files for three members of staff. All of these were employed by Saffronlands at homes where residents lived previously. All the files contained evidence of good vetting procedures. Applications forms were observed to be fully completed. CRB Enhanced Disclosures were received for all three staff before they began work, as well as work immigration status. Appropriate supporting documentation was available on each file to support the candidates application. We found that the home seeks and retains evidence of thorough vetting of the supplying agency for staff supplied. The home invests in staff training and development.Agency staff are very much included on the staff team and receive the same training Each staff member has an individual training needs assessment, training and development plans are in place to respond to these. We found records of the training completed by staff members.Over 83 of staff have achieved NVQ or above in care.All staff are up to date in mandatory training. In addition the staff have Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: a member of staff on duty that is a First Aider.In addition to mandatory training staff receive additional training that makes sure they are skilled and knowledgeable on the conditions affecting residents.The training and development programme we found is well developed, and is reflected on the competencies and skillsin the staff team All staff are trained in adult protection and there is a robust policy and procedure for this and all staff are aware of the Whistle blowing policy. Adult Protection policy is clear regarding the lead agency and local procedures are followed and incorporated the organisational policy. Each staff member receives regular supervision,team meetings take place regularly. Communication is good within the service. At handovers staff are kept fully informedon the welfare and wellbeing of each resident. The organisaion provides staff with a good induction and foundation training to equip them for the role. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from the presence of a competent experienced manager, who places the interests of residents. Evidence: The manager is experienced and qualified. She communicates a clear sense of direction. The service demonstrates in staff practice a sound understanding and application of best practice . Equality and diversity, human rights and person centred planning are given priority by the manager. We found that she is able to demonstrate a high level of understanding, and demonstrates best practice in these areas. We viewed copies of Regulation 26 visit reports, these visit reports demonstrate that audits are completed that link into quality assurance processes. The organisation operates effective quality monitoring systems. The quality assurance system operated focuses on outcomes for residents, it is accredited by Investors in People. A copy of the IIP certificate is displayed in the reception area of the home. The manager is an excellent role model for other members of staff. Other professionals see the manager as an imaginative and effective leader who consistently Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: provides high quality services. Staff undertake regular training and understand and value opportunities for their continuing professional development. One of the relatives spoken to said, we know the manager for some time, she wasan excellent member ofstaff at another service. We found the new home to be welcoming and inviting, attention is given to maintaining a comfortable safe environment. Relatives value the reports they receive from the manager every month, one family told us ,we love to hear how our relative is progressing,and value the monthly reports sent to us by the manager. An inspection was completed by the local fire authority to make sure the premises was appropriately equipped for the purspose of a home. The home has developed a fire risk assessment, we viewed a copy of this. Attention is given to servicing an maintaining Fire fighting equipment including emergency lighting. Regular fire evacuation procedures take place. Radiators are fitted with stay cool surface to prevent residents injuring themselves. There is a dedicated maintenance team that respond to requests to correct any problems within the service. The team also carry out compulsory checks along with outside agencies to ensure that the service continues to be a safe place for residents to live, and for staff to work in. We viewed the log of staff supervisions, and minutes of team meetings Supervision is provided consistently to staff members. Practice and performance are discussed during one to one supervision, staff training and team meetings. The manager operates quality monitoring systems that provide management evidence that practice reflects the homes and organisations policies and procedures. Morale among the staff team is very good. We found that staff enjoy working in the service, they tell us how they value the direction and support received from the manager. We observed the positive interaction between staff and management, also the relationship between residents and the manager. There is strong evidence that the ethos of the home is open and transparent. Residents told us that they find it easy to communicate with the manager. The views of both residents and staff are listened to, and valued. The AQAA we received contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they listen to residents. The home has efficient systems to ensure effective safeguarding and management of residents finances. including record keeping. We examined the records held for two residents. People are supported to manage their own money where possible. Those who do not currently have the skills are encouraged and supported to be as independent as possible. The majority of residents lack capacity to manage finances independently.They have access to their records whenever they wish. Record keeping is of a high standard. Records are kept securely and staff are aware of the Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: requirements of the Data Protection Act. Residents can gain access to their records and contribute to them. All the working practices in the home are safe and there are no records of preventable accidents. The home has a comprehensive range of policies and procedures to promote and protect residents and employees health and safety. Staff are trained, understand, and consistently follow these. There is full and clearly written recording of all safety checks and accidents, including analysis, and there is no evidence of a failure to comply with statutory reporting requirements and other relevant legislation. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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