Care Home: New Lodge

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What the care home does well A social care professional told us in a survey that, "Due to the complex needs of the service users. The staff work very hard to meet the needs of the service users and offer a variety of appropriate activities dependent on individuals abilities. Risk assessments are also of a high standard." We saw that staff have been trained and properly recruited, they also have opportunities to meet regularly as a team and with their manager. We saw that people using the service have access to a complaints procedure in a format they can understand. We saw from the records that complaints and concerns are taken seriously and acted upon. We saw that staff have been trained to recognise and report suspected abuse. We saw that care plans and records are detailed and the service is making every effort to ensure that the information is provided in a format that people who use the service can more easily understand. We saw that there are regular audits carried out to monitor the quality of service provided. Staff said in surveys that, "The home always tries to take service users out to do activities with excellent staff that even come in on days off to do activities outside the home." "At new lodge, all the staff work as a team and help the service users, we support them as much as we can." "The manager and the deputy are very helpful, we give the service users the support we can and New Lodge seems to be a lot more homely now." "We have regular supervisions, training and staff meetings. The manager and deputy are very approachable, good staff team, well looked after service users." What has improved since the last inspection? The service has produced information in formats that are user friendly and more accessible to people using the service. Introduction of swimming as a weekly activity. Medication management is now robust with accurate record keeping and appropriate storage facilities. The home`s environment has been further improved with refurbishment/redecoration of all main communal rooms (lounge, kitchen, bathrooms). Staff have received training in aspects of the Mental Capacity Act should concerns arise.The manager has been approved and is now registered with us the Care Quality Commission (CQC). What the care home could do better: The organisation should ensure that it responds promptly to requests for furniture/fittings repairs or replacements. So that people using the service have a comfortable, safe and clean environment in which to live. To increase further the range of activities available to the client group. Keep staffing levels under review to ensure that people using the service have regular opportunities to access external activities and are safe. Staff said in surveys, "More staff would be better so that service users can do more in the community." "We could get the service users out more." "We could do with more staff to meet our service users needs, to go out in the community on a regular basis as each person requires 2-1 support in the community." Key inspection report Care homes for adults (18-65 years) Name: Address: New Lodge 971 Lightwood Road Longton Stoke on Trent Staffordshire ST3 7NE     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: Wendy Jones     Date: 0 1 0 2 2 0 1 0 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 29 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) © 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 29 Information about the care home Name of care home: Address: New Lodge 971 Lightwood Road Longton Stoke on Trent Staffordshire ST3 7NE 01782388370 01782269187 stoke.enquiry@caretech-uk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Delam Care Ltd Name of registered manager (if applicable) Miss Tracy Anne Baddeley Type of registration: Number of places registered: 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 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 categories: Learning disability (LD) 4 Date of last inspection Brief description of the care home New Lodge is registered for four younger adults with learning disabilities. The home was commissioned specifically for the people currently using the service. The specific needs of the user group are complex including autism spectrum disorder, severe learning disability, challenging behaviour and physical disability. The home is located on the main road in a semi-rural location on the outskirts of a small village. It is a spacious four bedroom detached house with a large front and a paved patio area at the Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 0 9 0 3 2 0 0 9 Brief description of the care home rear, that is set back from the road with parking facilities for staff and visitors. The home provides single bedroom accommodation for all people living there. Three bedrooms are provided upstairs and one on the ground floor. The home is not suitable for permanent wheelchair users. There are few facilities in the immediate area and the people using the service have their own transport which they fund, this enables them to access to the local community and educational, social and leisure activities away from the home. The fees charged for the service are recorded for each individual in the Service User Guide. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We carried out an unannounced key inspection visit on one day. The focus of our inspections is upon outcomes for people who live in the home and their views of the service they receive. This process also considers the homes capacity to meet regulatory requirements, national minimum standards of practise and focuses on aspects of the service that may need further development. To prepare for the visit we looked at the last inspection report and our records of the information we have received about the service since the last inspection visit. Each year the service has to complete and return an Annual Quality Assurance Assessment (AQAA) to tell us how they meet the needs of the people who use, or may Care Homes for Adults (18-65 years) Page 6 of 29 use the service. This focuses on what they do well, how they evidence this, and any areas they feel are in need of improvement. Before key inspections we send out surveys to people using the service, staff, relatives and anyone else who has involvement with people who live there. We have used the information in the surveys, we received, to help us make a judgement about how the service supports people living at the home. People using the service have been supported to answer the questions in the surveys, but have limited understanding or ability to communicate their views. When we were at the home we focused on a small number of people who use the service. This involves discovering individual experiences of living at the home by meeting and talking with them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people. This helps us to understand the experiences of people who use the service. We looked around the home to make sure it is safe, clean and comfortable and we looked to see whether people who use the service are being protected, and the arrangements the service has for listening to what people think about living at New Lodge. We have made recommendations as a result of this visit. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? The service has produced information in formats that are user friendly and more accessible to people using the service. Introduction of swimming as a weekly activity. Medication management is now robust with accurate record keeping and appropriate storage facilities. The homes environment has been further improved with refurbishment/redecoration of all main communal rooms (lounge, kitchen, bathrooms). Staff have received training in aspects of the Mental Capacity Act should concerns arise. Care Homes for Adults (18-65 years) Page 8 of 29 The manager has been approved and is now registered with us the Care Quality Commission (CQC). 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. 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have had their needs assessed. Information about the service, terms and conditions and costs have been produced in an user friendly format so that prospective users of the service can make an informed decision about the suitability of the service. Evidence: The service told us in their AQAA that, There have been no changes to the current client group for many years (since 1999) although there is a considerable amount of information available for prospective clients such as an up to date service user guide (in user-friendly format with photographs and pictures), and an up to date statement of purpose. A full written assessment would be completed by the manager and discussed with the prospective clients care manager/social worker. All care costs and terms and conditions of the placement would be made available to the prospective client and their care team. Relatives are invited to be as involved as they wish during this process and also during the clients placement should it go ahead. Because people using the service have lived at the home for many years we did not Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: look at the pre admission assessments for them. We note that previous inspection reports have concluded that the service has an admission policy and procedure for staff to follow. We understand should a vacancy become available any prospective person would have their needs assessed and would have the opportunity to visit the home prior to making a decision to move in. We saw at this visit that the Statement of Purpose has been updated since we last carried out an inspection. It and the service user guide have been produced in a format that people using the service may more easily understand using simple language, picture and photographs. We saw that a copy of the service user guide is included in peoples care files, it has been personalised to the individual including the specific costs and charges for the service. We saw that it had been signed by the persons Representative. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has evidenced that staff know how to meet peoples needs and provides information to them in a format they can easily understand. This ensures that they can be involved in planning their goals. Evidence: The service told us in the AQAA that, All of the clients at New Lodge have individually tailored support plans that focus on achieving the best possible outcomes for them. The plans have adopted a person centred approach ensuring that the clients needs and wishes are absolutely paramount, although will take into account the views of those closely involved in that clients care. All relevant risk assessments are in place. The home has also developed positive intervention plans (PIPs) with a number of external agencies. We looked at the care records of one person. We saw that there is a detailed assessment of need and a person centred plan(PCP). Support and positive intervention plans(PIP)have been developed where needed. We saw that the service is making Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: considerable efforts to provide people using the service with information in a form that they are able to more easily understand. An example of this includes the creation of a photo and picture board for each persons bedroom which identifies their goals and what is important to them. We saw that care records are now more easily accessible to staff, this means that they have all the information they need to deliver the support needed. We saw that reviews of care are carried out on a monthly basis and saw evidence that a holistic review of the individuals goals and PCP is carried out twice per year. We saw that a social work review has been carried out since the last inspection visit. We saw that risk assessments are in place that have been reviewed regularly and provide staff with a good standard of information about the level of risk and how it can be minimised. We spoke to the key worker about the support needed by the person we case tracked, it was clear from our discussion that they are familiar with the support needs of the individual and how to meet them. We looked at a sample of financial records to ensure that the service manages peoples money properly. The records show that the service has robust procedures in place to account for and to manage money on behalf of people using the service. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for people using the service to engage in a varied range of activities is improving and linked to the person centred planning approach adopted by the service. This means activities are individualised. Evidence: The service told us in the AQAA that, New Lodge provides a homely and relaxed environment. People using the service are free to move around the home as they wish, as staff are well trained in their work and are able to direct and encourage them toward appropriate and fulfilling activities. This relaxed person centred approach means that each person is treated as an individual and their personal preferences are recognised and respected. All birthdays, and cultural events and holidays are celebrated. We looked at the records of the person we case tracked to see what type of things Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: they do with their time. We saw that the persons wheelchair has had to be repaired, this has affected the individuals ability to access some of the things they like to do. A key worker stated it has also been positive because the individual is mobilising more than they would have done normally. We saw that the service is continuing to make efforts to find suitable activities out of the home for people using the service to access and engage in. This includes weekly swimming sessions. We saw in the care records that one individual used to attend a hydro therapy session but this has been discontinued. The key worker told us that the service is hoping to find an alternative venue so this activity can continue as the person using the service enjoyed it. We have also been told other activities arranged for this person include sensory sessions, day trips and holidays, meals out and shopping. We saw that people using the service are supported to maintain contact with relatives and friends. Saff surveys include comments such as, We support the needs of the service users most of the time but need more staff to take them on activities in the evening. We saw that the service has made efforts to improve the meal choices for people using the service by providing food passports which have photographs of food and meals to choose from so that people can select their food choices themselves. Menus are planned based upon known likes and dislikes and also have to ensure that any special dietary requirements are met. Efforts are being made to promote healthy eating while respected the choices made by people using the service. We saw that people using the service have access to the kitchen and are supported by staff to prepare food and drinks if they choose to. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their health and medication needs are met by the service. Evidence: The service has told us that, At New Lodge each client has an individual Health Action plan, which provides details of their health needs. Privacy and dignity are promoted in all aspects of personal support. Personal support is also offered in a way that promotes independence encouraging clients to partake as much as they are able to in their own personal care needs. Appropriate staff allocations on a daily basis ensure all personal care needs are met throughout the day. Individual communication methods are understood so that staff are able to recognise ill-health. We have been told that the service deploys at least one male staff per shift to ensure that the personal care needs of people using the service can be met by a person of the same gender. We saw that the person we case tracked had a Health Action Plan (HAP), this is a record of the health needs of people using the service and the action required to ensure that their needs are met. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: We saw that people living at the home are supported to attend health appointments and have been able to confirm from the records we saw that the service works well with health professionals to ensure that peoples needs are met. We saw that the management of medication is robust and concerns identified at the last key inspection re storage, record keeping and administration have been addressed. We carried out an audit of a sample of medication records including stock control information and found these to be accurate. We have been told that staff have received medication training. We confirmed this from discussion with a support worker and the training records we saw. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have access to user friendly complaints procedures and are supported by a staff team who have received training to ensure that people are safeguarded. Evidence: The service told us in the AQAA that, A copy of the organisations complaints policy is displayed in the hallway at New Lodge. This ensures easy access for relatives and visitors to the home. This has recently been updated and a copy sent to clients families. It is a user-friendly format and is pictorial. There is a complaints and compliments file in the office. All new recruits to the staff team undergo thorough checks. Staff do not commence employment until their POVA and CRB checks are completed and returned satisfactory. Two satisfactory references also need to be provided for all new staff. We saw that there is a complaints procedure available in the home that is in a user friendly format, we spoke to a support worker who was able to confirm that they know what to do if they receive a complaint. We saw that the complaint records show that the service has received two complaints in the last 12 months, these have been resolved. We have not received a complaint about this service since our last key inspection of 09 February 2009. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We have been told that staff have received training to recognise and report suspected abuse of people and that the service has policies and procedures in place. We are aware of one safeguarding referral, our records show that the service acted appropriately in making the referral and assisting in any enquiries. We have also been told that staff have received training re the Mental Capacity Act and Deprivation of Liberties. We recommend that the service reviews the needs of each person to ensure that their rights are not compromised by any actions undertaken by the home. We looked at two staff recruitment records and found these to be satisfactory, with evidence that all pre employment checks are carried out to ensure that each support worker is suitable to work in the home. The organisation has introduced a checklist for managers to follow, so they can confirm they have received all the information they need before a member of staff commences employment. We looked at a sample of financial records, these have been maintained to a good standard. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are safe, but all areas need to be well maintained, clean and well furnished to ensure that it provides a comfortable place for people to live. Evidence: The service told us in the AQAA that, New Lodge is a detached house situated in a rural area, five minutes walk to the country side. The house has one large lounge where clients can enjoy watching T.V. and DVDs, one large fitted kitchen where clients can help to prepare meals. At the back there is a patio with table and chairs. All Clients are encouraged to personalise their own bedroom. One bedroom as an en-suit with a toilet, sink and a shower. Cleaning schedules are in place for all communal rooms. Staff encourage clients to assist in cleaning their rooms. The home is maintained in a clean and hygienic manner. Health and Safety Audits are completed regularly, any repairs being completed as required. One clients room is decorated to reflect their ethnicity. We have noted that there has been progress in improving the environment as recommended at the last key inspection. Staff confirmed that new flooring has been provided on the first floor landing, the stairs and hallway. The lounge and kitchen have been redecorated and new furniture has been provided in the lounge. But further work is in progress and is needed to ensure that people have a comfortable and well Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: maintained environment in which to live. Staff reported that dining furniture needs to be replaced because some of the chairs have been broken, a new TV and cabinet have been requested. We have also been told that requests have been made for further development of the gardens. We saw one persons bedroom has been accessorised with his belongings and items of particular interest to him. But was also saw that the carpet in this bedroom is badly stained and had an offensive odour. The support worker we spoke to stated that a new carpet has been ordered and is due to be delivered. While we accept that the service is acting to make improvements that are necessary we cannot accept that people live in an environment that does not smell very pleasant and appears to be dirty. The service has a very large garage area, that is currently used to house the washing machine, clothes dryer, a large freezer and secure storage for cleaning materials/liquids. This area is is not heated and is also used to store broken furniture which could be potentially a risk and means people using the service have limited access to it. We saw that Health and Safety audits of the environment are carried out by the management team regularly. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that staff are properly trained and receive the support they need to deliver good quality care. Evidence: The service told us in the AQAA that, All staff are provided with mandatory training and are offered further training to ensure that a good standard of care is consistently provided. CareTech offer a wide and varied amount of training courses that cover all aspects of the work that is done within its homes. Staff are nominated for training following schedules being issued by the training department of the regional office. New starters are subject to a two-week induction period in addition to mandatory training and the LDQ. Staff are encouraged to work toward NVQs which will increase their knowledge and skills thus ensuring a better quality of service delivered in the home. The home now has two team leaders both holding NVQ level 3. These were recruited from the existing staff team which allows the benefit of them knowing the client group and the staff very well. We found that staffing levels are satisfactory but should be kept under review to ensure that peoples social and recreational needs can be met. We saw that staff meetings are taking place regularly, and have been told that staff supervision sessions are up date. Staff confirmed this. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: We talked to staff about training, they stated that opportunities for training have improved. We have been able to confirm that the number of staff trained to National Vocational Qualification (NVQ) at level 2 and above exceeds the recommended minimum. We saw the records of staff training and can confirm that staff have undertaken mandatory training or have up dates planned. We looked at sample of staff recruitment records to confirm that the service undertake pre employment checks before an applicant is approved to work at the home. We can confirm that we saw evidence of good practise in this area. We saw that the service doesnt have any staff vacancies and has not had to use agency staff for some time, this is an improvement since the last key inspection visit. We have been told that the organisation has its own bank list of staff, so that if casual staff are needed, they are familiar with the needs of the people who live at the home. This ensures a better consistency of care. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that the service is well managed in their best interests and the management team know what they need to do to further improve and develop the service. Evidence: The service told us in the AQAA that, The manager is a graduate with NVQ4/RMA and 18 years experience in care, over 12 as a registered manager in other homes. The home benefits from a deputy manager who holds NVQ3 and has considerable experience in other care settings. The Deputy Manager supports the home manager in their duties day to day and acts accordingly in the absence of the home manager. The management team ensure that clients rights are promoted. These rights are safeguarded by the importance placed upon the accurate recording of events, and close attention paid to policies and procedures. The manager has been approved and is now registered with us. We received the AQAA when we asked for it. We note that is contains detailed Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: information about what the service does well, how it has improved and what it can do better. It also provides statistical and numerical information about the service. We found that policies and procedures are in place as the AQAA stated they are. We saw that staff are encouraged to sign to say that they have read and understood them. We found that the performance of the service is monitored by the organisation on a monthly basis and an audit of the quality of the service has been completed. The deputy manager confirmed that the management team are working on the action plan from the last audit of 08 December 2009, to address those areas that need further development. We saw that peoples financial records are properly and accurately maintained. We have been provided with evidence that staff have received Mental Capacity Act training or that it is planned. We found that the service has addressed all of the requirements we made at the last key inspection visit. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 The service should continue to pursue suitable and regular activities outside the home for people using the service to be involved in. The service should keep staffing levels under review, to provide staff in sufficient numbers to support people using the service when activities outside of the service are arranged. The service needs to review the needs of people using the service to ensure that there are no concerns about deprivation or restrictions under the Mental Capacity Act. The garage should be cleared of unnecessary furniture to ensure that it is safe and accessible environment. The organisation should ensure a swift response to requests for repair or replacement of furnishings and fittings. The service should ensure that the carpet in the ground floor bedroom is cleaned or replaced. 2 12 3 23 4 5 24 24 6 30 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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