Care Home: Moss Cottage

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What the care home does well Transport is provided to promote access to the community, including a vehicle for general use, and one service user has their own mobility car. Service users visit local pubs, restaurants and cafes, a social club set up specifically for vulnerable adults, enjoy many excursions to places of interest and holiday breaks. Service users have their own healthcare plans, illustrated with diagrams, promoting a healthy lifestyle with exercise, a balanced diet and regular appointments with healthcare professionals. No staff had left the home`s employment over the previous twelve months and no new staff had been employed, which means that the service users benefit from this stability, by receiving continuity and consistency of support. There is a happy and relaxed atmosphere within the home and the service users commented that the staff always treat them well and listen and act on what they say. One service user stated, `the staff are very friendly and helpful`. A staff member thought, what the home did well, was that, `the service users` needs are always put first, that they are encouraged to be independent and guided to achieve their personal goals.` What has improved since the last inspection? Since the previous site visit, person-centred care plans had been developed and reviewed in consultation with the service user or their relative or representative. The information required to protect service users from abuse, including the local authority safeguarding policy and procedures, had been obtained to inform the staff. Since the previous site visit, staff personnel records had been updated appropriately and important missing documents had been located. Proof of identity was held on staff files sampled. Environmental risk assessments had been undertaken to protect the service users from harm, showing actions to be taken by the staff to minimise risks. Over the previous twelve months, the AQAA recorded that new double-glazed windows and doors had been installed, to enhance the environment and to reduce heat loss. New smoke alarms had been fitted throughout the home and a new garden gate had increased the security in the garden. One service user`s bedroom had been redecorated and they had been involved in making choices with respect to colours and soft furnishings. A call bell had been installed in the bedroom of the service user, located on the ground floor, to enable them to call for assistance from the staff sleeping in an upstairs room. What the care home could do better: Infection control procedures within the home could be improved by the introduction of paper towels to replace the hand towels and the provision of waste bins with foot pedals.For future recruitment, the organisation`s application form should be revised to include a full employment history of the applicants with gaps in employment explained, to ensure only people who are suitable to work with vulnerable adults will be considered for employment. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Moss Cottage 7 Western Road Liss Hampshire GU33 7AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Bowman     Date: 3 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Moss Cottage 7 Western Road Liss Hampshire GU33 7AG 01730894242 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Community Integrated Care care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Moss Cottage is a small residential service providing care and support to four adults with a learning disability. Community Integrated Care provides the care and support and the building is owned by the health authority who are responsible for the maintenance of the property. Service users are accommodated in single rooms, one of which is on the ground floor and there is a lounge, kitchen/dining room, a bathroom and shower room. There is an office, which is also used as a sleep over room, on the first floor. The gardens are to the rear of the property. The home is located in a residential street and is indistinguishable from the other houses in the street. Cars are currently parked on the road outside the home. Discussions are taking place, to provide parking space at the rear of the property, for the two vehicles used by service users. The home is close to the shops and railway station in the small village of Liss Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 4 Brief description of the care home which is in a rural part of Hampshire. The cost of living at the home is 826 pounds per week, which does not include hairdressing, chiropody and personal items. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection report includes information gathered about the service since the previous site visit in May 2006 under the Commissions Inspecting for Better Lives (ILB) process. The registered manager, Mr Snowden, completed an Annual Quality Assurance Assessment (AQAA) giving some up-to-date factual evidence about the running of the home and informing us of what they think they are doing well, how they have improved the service and of their plans for further improvements. Service users completed four surveys giving their views on the running of the home. Four staff and one healthcare professional also returned surveys, giving their views on the care and support given to the residents. An unannounced site visit was conducted on 30th December 2008, to assess the outcomes of the key inspection standards for younger adults with respect to the service users living at the home. The registered manager Care Homes for Adults (18-65 years) Page 6 of 30 was on compassionate leave at the time of the site visit and a senior representative of Community Integrated Care, which is the provider organisation, helped with the inspection process by making service users and staff files and other documents available to be sampled. A partial tour of the premises was undertaken and some of the service users bedrooms and communal areas were viewed. A number of staff and all of the service users were spoken with throughout the day and observations were made of the service users and of staff as they carried out their duties. Service users and staff records, maintenance certificates, the Statement of Purpose, the Service User Guide and some policies and procedures were viewed. What the care home does well: What has improved since the last inspection? What they could do better: Infection control procedures within the home could be improved by the introduction of paper towels to replace the hand towels and the provision of waste bins with foot pedals. Care Homes for Adults (18-65 years) Page 8 of 30 For future recruitment, the organisations application form should be revised to include a full employment history of the applicants with gaps in employment explained, to ensure only people who are suitable to work with vulnerable adults will be considered for employment. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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. Accessible information is provided to service users to enable them to decide if this home could meet their needs, and an assessment is carried out to demonstrate how the home is able to support them and to meet their assessed needs. Evidence: Each service user had been provided with their own service user guide, which was illustrated with photographs and was also available on audiotape. Up to date information with respect to fees had been included to inform the service users, and they all confirmed in the surveys they completed, that they had been asked if they wanted to move into this home, and that enough information had been supplied to help them decide if it was the right place for them. A change of provider organisation for the home prior to the previous site visit resulted in the original assessment documentation, which had been completed when the service users were admitted to the home, being unavailable to be sampled. No new service users had been admitted to the home since the previous site visit and re-assessments Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: of the current service users needs had been carried out since that time. Areas of need explored in the assessments sampled, were medical history, personal hygiene, eating, medication, social relationships, independent travel, personal finances and cooking skills. Objectives to be achieved and desired outcomes were recorded. Details of individuals specific needs were explained along with their likes, dislikes and preferences, showing how the staff would support them to achieve their desired outcomes. One service user had a dietary need, which meant they required softtextured food that was easy to chew and swallow. To access the community and enable them to develop a social lifestyle, a service user attended college, staff support was required to accompany them because they did not like or respond well in crowded places. Care Homes for Adults (18-65 years) Page 12 of 30 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. Service users care plans, which they had been involved in producing, were in an appropriate format for them to access and demonstrated how they would be supported to achieve their aims with support from the staff. Service users are supported to take risks and to remain as independent as they were able. Evidence: Personal information included in service user files included ethnic group, religion and cultural practises to be observed to ensure that service users equality and diversity needs would be considered when drawing up the care plan. Person-centred care plans sampled contained diagrams and were written in language which was accessible to service users. They had also been signed by key workers and service user to confirm acceptance. Care plans covered personal, healthcare, social, recreational, working and learning needs. Staff were informed of how the service users preferred to be supported and of their likes, dislikes and preferences. One service user liked lots of gravy on their dinner, liked to spend a long time in the shower and could make their own drinks. One Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: service user had a behaviour plan to inform the staff of what action to take, should they become frustrated in the community and to avoid crowded places, which could trigger this behaviour. The four staff, who completed surveys, confirmed that they were always given up to date information about the needs of the people they support, and one commented, the care plans are always up to date. Throughout the site visit, service users were observed being supported to make decisions about their daily lives. They decided what they were going to buy at the local supermarket and one service user accompanied a staff member to do the shopping. One service user was attending a day centre, one was enjoying their Christmas presents of bricks, meccano and a wooden boat, and another had been out shopping in the sales for new clothes the day before and appeared to be very pleased with their purchases. They all looked happy and content and were able to access their bedrooms to be alone if they wished, play music, make drinks and watch the television in the sitting room. It was clear that service users were encouraged to be as independent as possible. Two of the four service users, who completed surveys with support from their key workers, recorded that they always made decisions about what they do each day and two that they sometimes did. Risk assessment were included for the activities of daily living, showing the positive benefits of taking the risks and actions to be taken by the staff to reduce them. Care Homes for Adults (18-65 years) Page 14 of 30 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. Service users are supported to engage in a range of activities that take into account their individual needs and preferences. They are supported to maintain personal relationships and to be involved in the local community. Service users rights are recognised and they are offered a healthy diet, which reflects their individual tastes and dietary needs. Evidence: All the service users completed surveys and confirmed they could do what they wanted during the day, in the evenings and at the weekend. The AQAA recorded that, over the previous twelve months, new college provision for two of the service users had been found, offering a programme designed to promote their independence. One service user was attending a day service on the day of the site visit. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Transport was provided to promote access to the community, including a vehicle for general use, and one service user had their own mobility car. The AQQA recorded that the provision of vehicles enabled the service users to access the community in a variety of ways. They visited local pubs, restaurants and cafes, a social club set up specifically for vulnerable adults, enjoyed many excursions to places of interest and holiday breaks. Service users essential lifestyle plans included service users comments such as, I like going out for trips in my car and taking my girlfriend out for a meal, taking a holiday is important to me and under the heading of what I want to achieve, to be as independent as possible. This summer two service users had taken a holiday in Weymouth, another had been to Worthing and the a service user, who did not like staying away from home, had taken day trips of their choice. Care plans recorded family contact and the homes transport was used to facilitate visits. The AQAA recorded that, over the last twelve months, a service user had developed a friendship locally, which had been encouraged with visits to each others homes. Personal preferences and individual needs with respect to diet were recorded in the service users care plans sampled. There was flexibility with respect to the menus and service user involvement in planning meals, assisting in the kitchen and preparing their own drinks and snacks, as observed on the day of the site visit. Care Homes for Adults (18-65 years) Page 16 of 30 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. Service users personal and healthcare needs are met according to their preferences and wishes and safe procedures are in place to promote access to their medication. Evidence: Care plans sampled, recorded service users preferences with respect to support for personal care. Independence was promoted, and care plans indicated to the staff, the level of support required to enable the service users to maximise their self-care. One service user liked to take some time in the shower and another needed support to make regular trips to the barber for a hair and beard trim. A service user, who had been shopping the previous day, had chosen the clothes they were wearing and appeared to be very pleased with their purchases. Service users had key workers assigned to them to provide consistency and continuity. A service user, whose hearing deficiency required them to use a hearing aid, had regular checks recorded in their care plan, to ensure it was in good working order and that the battery supply was maintained. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Records sampled, confirmed that service users had access to healthcare professionals including a General Practitioner, dentists, opticians, a psychiatrist and a chiropodist. Service users had their own healthcare plans, illustrated with diagrams, promoting a healthy lifestyle with exercise, a balanced diet and regular appointments with healthcare professionals. Records were kept of visit to and from healthcare professional, keeping the staff up-to-date and ensuring the service users received the correct treatment, as had been recommended. A healthcare professional, who completed a survey commented, The staff liaise well and act on my advice appropriately. A risk assessment was in place for a service user, who took responsibility for selfmedicating, and a lockable storage cabinet had been supplied in their bedroom to provide secure storage for their medication. Medication in the home was safely stored and records kept of medication received into the home, administered and returned to the pharmacy. A local pharmacy provided the medication in a monitored dosage system for safety and convenience. Staff files sampled, contained certificates in the Care of Medicines, medication workbooks and up-to-date assessments undertaken by the manager to promote the safe handling of medication to protect the service users. Care Homes for Adults (18-65 years) Page 18 of 30 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. Service users are supported to raise concerns and issues, are aware of the complaints process, and confident they will be listened to. The care home safeguards the service users from abuse, neglect and self-harm and ensures the staff are aware of the action to take, should they encounter such incidences. Evidence: Service users files contained a pictorial version of the complaints procedure to help them to decide what to do if they were not happy, and the AQAA recorded that an audio tape was also available, making the procedure more accessible. Records confirmed that key workers spent one to one time with service users, offering opportunities to share concerns, and meetings provided them with an opportunity to voice their views and raise issues. All the service users, who completed surveys, indicated that they knew who to speak to if they were not happy, and three of the four knew how to make a complaint. No complaints had been recorded over the previous twelve months and the Commission for Social Care Inspection had received no complaints on behalf of this service. Since the previous site visit, a copy of the local authority safeguarding procedures had been obtained, to raise the staff awareness of how to make a referral, should they need to do so. Certificates held in staff files confirmed that training in the Protection of Vulnerable Adults had been undertaken to inform the staff and to safeguard the Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: service users. No safeguarding referrals had been made since the previous site visit. Service users finances were protected by safe storage, the completion of records for all transactions and the retention of receipts to evidence the process. Care Homes for Adults (18-65 years) Page 20 of 30 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. Service users live in a home which meets their needs in a homely and comfortable way, and which is clean and hygienic. Evidence: The home was an ordinary semi-detached house on a residential street and was indistinguishable from other homes on the street. Parking was restricted and both sides of the road were used. A plan was in place to take part of the homes rear garden to provide parking for the homes two vehicles, but this remained in the discussion phase, and progress had not been made since the previous site visit. Over the previous twelve months, the AQAA recorded that new double-glazed windows and doors had been installed, to enhance the environment and to reduce heat loss and consequently the homes carbon footprint. New smoke alarms had been fitted throughout the home and a new garden gate had increased the security in the garden. One service users bedroom had been redecorated and they had been involved in making choices with respect to colours and soft furnishings. The home had been adapted to enable a service user with mobility needs to use their wheelchair. They had been provided with a ground floor bedroom with an adjacent Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: shower room. A call bell had been supplied to enable them to call for assistance should it be required. It had been noted in the previous inspection report that assistance may be required in the night and the sleeping-in room on the first floor had been fitted with a monitor to receive night- time calls. A tour of the premises confirmed the home was well maintained, clean, homely and comfortable for the service users and that it was their home. Communal space consisted of a combined kitchen and dining room with sufficient seating for all the service users to eat at the dining table and socialise, if they chose to do so. A television, music centre and compact discs were available for the service users entertainment. The sitting room, at the front of the home, was provided with a large television and comfortable seating. Domestic furnishings and lighting, ornaments and plants created a homely ambiance in both the communal living rooms. Service users bedrooms viewed, had been personalised and reflected their individuality, with photographs and items of special interest displayed. There was a garden to the rear of the home, which was used for bar-b-cues in the summer months. Garden furniture was provided and one service users care plan recorded that they really enjoyed this space when the weather was fine. A utility area located between the kitchen and the rear entrance to the home provided space for the laundry equipment, and a staff member stated that service users were encouraged to be involved in the laundering of their clothes. Service users, who completed surveys, confirmed that the home was always fresh and clean. The AQAA recorded that all the staff had received training in the prevention and control of infection. However, infection control procedures within the home could be improved by the introduction of paper towels to replace the hand towels and the provision of waste bins with foot pedals. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Safe recruitment practices, appropriate induction and mandatory and specialist training prepare the staff for the supportive role and to meet the service users individual needs. Evidence: The AQAA recorded that there were six permanent carers working at the home, four of which, were full time and two part-time and that there were equal numbers of male and female staff. The organisation had a team of bank workers, located in the area specifically for supporting the two homes based in Liss. The AQAA recorded that the original staffing had been reduced in April 2006 by approximately thirty hours per week and the home was currently awaiting the results of a reassessment of needs by adult services to improve the staff ratios and enable the service users to enjoy more individual, person-centred activities. Two staff were on duty on the day of the site visit and a senior employee of the organisation was providing support for the staff due to the unscheduled absence of the manager for compassionate reasons. Staff observed working with the service users on the day of the site visit, did so in a sensitive and empowering way and gave their full attention when communicating with them. Four of the six permanent staff had achieved a National Vocational Qualification at Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: level 2 or above in Social Care or Health and Social Care and the AQAA recorded that one of the other two staff had also been nominated to receive this training. No staff had left the homes employment over the previous twelve months and no new staff had been employed, which meant that the service users benefited from this stability, by receiving continuity and consistency of support. Staff records sampled confirmed that appropriate checks had been carried out to ensure that only staff suitable to work with vulnerable adults had been selected. Since the previous site visit, records had been updated appropriately and important missing documents had been located. The four staff, who completed surveys, confirmed that their employer had carried out checks such as CRB and references, before they started work. The two staff files sampled contained application forms, equal opportunities monitoring forms to ensure the process was carried out fairly, interview notes, proof of identity, Protection of Vulnerable Adults first checks, Criminal Record Bureau (CRB) numbers and two references. The organisations application form for future applicants should require a full employment history with gaps explained. Two of the four staff, who completed surveys, recorded their induction covered everything they needed to know to do the job before they started, very well and the other two staff thought it mostly did. However, the staff had been initially inducted by a different organisation prior to being taken over by Community Integrated Care (C.I.C.) before to the previous site visit. One staff member commented, at the beginning of working with C.I.C. I completed a full induction and foundation workbook and Health and Safety workbook and found this very useful. The homes induction was in line with the Skills for Care Common Induction Standards, which give new staff a good introduction to the caring role and help them to understand and meet the individual needs of the service users with respect to equality and diversity issues. Records showed that staff had accessed mandatory training including first aid, moving and handling, fire training, medication administration, the protection of vulnerable adults and food hygiene. Specialist training to meet the individual needs of the service users included person centred planning and non-violent crisis intervention. The senior representative of the organisation stated that they provided some training for the organisation and a training manager was involved in assessing the training and development needs of the staff and providing the required training. The four staff, who completed surveys, recorded that they were being given training, which is relevant to their role, helps them to understand and meet the individual needs of the service users with respect to equality and diversity issues, and keeps them up-to-date with new ways of working. Care Homes for Adults (18-65 years) Page 24 of 30 Care Homes for Adults (18-65 years) Page 25 of 30 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. Service users benefit from living in a well managed home which is run in their best interests. Their health, safety and welfare is promoted and protected. Evidence: Since the previous site visit, the manager had applied to the CSCI to be considered for registration, as manager for the home, and his application had been successful. He had completed the Registered Managers Award, attended six days of management training arranged by the provider organisation, completed the Mental Capacity Act, Deprivation of Liberty, Risk Assessment and up-dated mandatory training, demonstrating that he kept himself up-to-date with current practise. He was also scheduled to complete Investigation and Disciplinary training in January. The registered manager was also responsible for the management of another small home in the same area and was supported in each home by a deputy manager. Staff who completed surveys, commented on the approachability of the manager and one stated, I feel I can always ask for advice from the manager. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The AQAA recorded that satisfaction questionnaires were sent out regularly to gain feedback from all stakeholders and that service users views were listened to by the staff and acted upon. Views of service users were also gained in regular key worker meetings with service users and annual reviews attended by service users, their relatives/advocates, case managers and other interested parties. The AQAA recorded improvements in the outcomes for service users over the previous twelve months and planned improvements to be completed over the next twelve months. The AQAA recorded that equipment had been serviced or tested as recommended by the manufacturer or other regulatory body and certificates for the gas appliances and fire equipment, sampled, confirmed they had been serviced in 2008. The Control of Substances Hazardous to Health (COSHH) had been appropriately risk assessed to safeguard the service users and the COSHH cupboard was secured to protect them. Some of the homes policies and procedures and codes of practice in relation to Health and Safety had been reviewed in a timely manner to ensure the staff were kept up-todate with current legislation and practice, however others were in need of review. Staff training logs confirmed that mandatory training in moving and handling, food hygiene, first aid, fire and infection control training had been undertaken. Records were kept of accidents and other serious incidences and the home kept the Commission for Social Care Inspection appropriately informed of such events. There was an ongoing programme of maintenance and repair. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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