Care Home: New Redvers

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What the care home does well People who live at New Redvers are encouraged to speak up and say what they want. This is recorded in their care plan and they are helped to do what they want.People are helped to get the health care they need. There are good staff and Managers at New Redvers, to understand and support people. There is a lively social life at New Redvers,with residents taking an interest in each other. Most residents have their own room, and there is a big garden.People enjoy their holidays. What has improved since the last inspection? People who need individual support now get it regularly and can go out every day.People are enjoying a bigger choice of activities.One resident said, `Things are better now. We sit together and say what meals we want and what we are going to help with`. Residents are supported to go shopping, make dinner, and wash their clothes in the laundry. Residents` money is well organised, and they are supported to manage it themselves if they can.There are more staff and they are better trained and supported. What the care home could do better: This home is very big, and some people find it difficult to live in a group of 19 people. The managers are making plans to help people live in smaller groups, with people they like. The home could provide a lockable box or cupboard in peoples` own rooms, where they could keep their own things like money, medicines, and cigarettes and still be supported to use them well. Management should continue their efforts to make sure another Support Worker can come to work when a staff member is off sick, so that staff don`t get tired and residents don`t have to change their plans.No requirements or recommendations were made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA 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: Stella Lindsay Date: 1 5 0 4 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 30 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 30 Information about the care home Name of care home: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA 01803409174 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): newredvers@yahoo.co.uk Diamond Care (2000) Limited Name of registered manager (if applicable) Mrs Karen Barnes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 19 0 care home 19 learning disability Additional conditions: The maximum number of service users who can be accommodated is 19. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection 2 7 1 1 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home The last inspection took place on 21st and 23rd April 2009. New Redvers is a big house. It is close to shops and a swimming pool. 19 people live there. The home is for people with learning disabilities. Most people have their own bedroom and toilet. There is a lounge and a dining room, and a big garden. There is a place by the kitchen where people can make their own hot drinks and snacks. There is a minibus. 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 Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home We went to New Redvers on Tuesday afternoon and on Thursday. We met most of the people who live there, and some of the staff. We met the Registered Manager and the Assistant Manager, and went to see the Company Secretary in her office. We looked round the house. We saw what everyone was doing. We looked at care plans, medication records, and policies and procedures. We did this to see how the home was run. What the care home does well People who live at New Redvers are encouraged to speak up and say what they want. This is recorded in their care plan and they are helped to do what they want. People are helped to get the health care they need. There are good staff and Managers at New Redvers, to understand and support people. There is a lively social life at New Redvers, Care Homes for Adults (18-65 years) Page 7 of 30 with residents taking an interest in each other. Most residents have their own room, and there is a big garden. People enjoy their holidays. What has got better from the last inspection People who need individual support now get it regularly and can go out every day. People are enjoying a bigger choice of activities. One resident said, Things are better now. We sit together and say what meals we want and what we are going to help with. Residents are supported to go shopping, make dinner, and wash their clothes in the laundry. Residents money is well organised, and they are supported to manage it themselves if they can. There are more staff and they are better trained and supported. Care Homes for Adults (18-65 years) Page 8 of 30 What the care home could do better This home is very big, and some people find it difficult to live in a group of 19 people. The managers are making plans to help people live in smaller groups, with people they like. The home could provide a lockable box or cupboard in peoples own rooms, where they could keep their own things like money, medicines, and cigarettes and still be supported to use them well. Management should continue their efforts to make sure another Support Worker can come to work when a staff member is off sick, so that staff dont get tired and residents dont have to change their plans. No requirements or recommendations were made at this inspection. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 9 of 30 If you want to speak to the inspector please contact Stella Lindsay Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 10 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 11 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. Clear information about the service is available. Service users needs are being comprehensively assessed in order to offer support in a way that is most beneficial to them. Evidence: The Service Users Guide had been produced using symbols and pictures, to make it more attractive and to encourage people to read it. The Manager is planning the production of a video to represent some parts of the Service Users Guide, in order to engage peoples attention and help them understand what the service can offer. The homes Statement of Purpose and previous CQC inspection reports are made available to any potential client and their representatives. A procedure was in place with respect to assessing the needs of prospective residents, but it had not been implemented since the last inspection, as there had been no vacancies. Work was in progress to assess all service users needs and consider whether they would continue to need residential care for the longer term, or whether they would benefit from being supported to move to more independent living. This is a major task. The Manager Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: was embarking on training. She had convened core groups for each resident including themself, their keyworker at New Redvers, a family member or other representative and their Care Manager, to consider all aspects of planning for their future. It is expected that this process will result in the residential service being reduced in size in due course, if it is found that the current service users needs can be better met in different ways. Care Homes for Adults (18-65 years) Page 13 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. Each service users needs had been clearly assessed, and risk assessments carried out to ensure that people could be safe in daily life in their home, and activities could be enjoyed in safety. Evidence: Each service user had a detailed care plan. We examined a sample of three. We found they were clearly written and constructed, with useful details of peoples individual requirements, and had been updated and reviewed several times recently. Details of peoples daily routine included information that was highlighted in red if there were safety implications, of which staff must be aware. There were additional care plans for personal hygiene, and Keeping me safe around the home. There were records of meetings with health and social care professionals, and in-house reviews. Action plans were broken down to small elements, to enable people to see how their goals could be met. We saw the records that were kept with respect to service users who had been assessed as needing 1;1 staff time for their personal development or to enable activities. This time was recorded by the half hour, showing who had spent time with the resident, and diaries were kept to show how the time had been spent. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Care plans included information about the residents needs for support in managing their money. There was a page to show where their money came from, how it was organised, and the help they would need to keep and spend it. One of the files we examined had the signature of the service user, showing that they had been consulted and were in agreement. We checked records of money kept safely on behalf of service users. It was accurately recorded, with the balance signed and witnessed, and audited weekly by the Registered Manager. It was suggested that in preparation for people moving towards more independent living arrangements, their money could be stored safely in their own room, even though they might continue to need support to access it. People could be supported to use this facility for their medication, and other items such as cigarettes for some people. All service users now have their own bank account. Three service users are assessed as able to go independently to the bank, without staff support. Care Homes for Adults (18-65 years) Page 15 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. Individual needs are being assessed and met, with careful planning to enable people to meet their own goals. Staff are provided and trained where necessary to enable activities. Evidence: Most of the nineteen people who live at New Redvers have been together for many years, and take an interest in each other. Four people are sufficiently independent to come and go without support. When we arrived for this visit, two service users had been for their regular weekly visit to the bank, followed by lunch together. Some service users attend day services regularly. Residents who need support to go out now are given the opportunity for outings that suit them every day. A Support worker was just leaving with two service users on their way to Babbacombe Downs and a cafe as we arrived for this visit. Two other residents told us that they enjoy dog walking. Action plans had been drawn up with service users to enable them to meet their goals, by breaking the effort needed into small steps. For example, one person who rarely left their room a year ago had said they would like to go to Church. By making the changes into Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: very small steps, their keyworkers in the home had enabled them to achieve this, in spite of health issues. Three residents had been attending cookery classes at a local college, others had been to evening classes for arts and crafts, and an exercise session. A music group had been provided weekly,and had proved to be popular with some residents. We saw that residents had been pleased to join this group, during our visit. One person was later playing a guitar in their own room, and clearly enjoying it. Holidays have been very important to New Redvers residents, and are provided by the company. Residents were pleased to tell us that they were going on holiday the following week. Three different venues had been chosen, so that all could go to a place that suited them and provided activities they wanted, and also to be staying with people whose company they enjoyed. One person told us they chose to visit family. The Deputy Manager had introduced weekly meetings with interested residents in the dining room, where they discussed and chose meals for the forthcoming week, worked out the shopping needed, and decided which residents would be involved in cooking and other household tasks. I washed up yesterday, one person told us. I like cooking with the staff in the kitchen. One resident enjoyed making pastry for the meat pie. Three residents regularly went with staff support to the supermarket for the main weekly shop, which they enjoyed. People also had the opportunity to do their own shopping. Most people eat together in the dining room. Vegetarian alternatives were always available, lasagna on the day of this inspection, and we were told that salad is always available as an alternative to the main evening meal. At lunch, we saw that people were eating a variety of snacks, and one person had a hot meal. We were told that people had enjoyed home made soup during the winter. Tinned fruit and yoghurt were offered for dessert. At night the kitchen has to be locked to assure the safety of some residents. Cold drinks are available. We saw a resident preparing supper with a Support Worker. Care Homes for Adults (18-65 years) Page 17 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. This service promotes the residents good health, helping people to access health care, and ensuring they receive the medication as it has been prescribed for them. Evidence: Peoples personal care needs were detailed in their care plans, with their preferences recorded. One service user told us, I have a shower every morning at 6 or 7 oclock, and that is what I like. Another told us that they appreciated back and head massage that they were given. Assessment and guidance had been sought from a Speech and Language therapist for an older service user, who is now able to indicate when they want to go for a walk. Another has been taught a way to show when they want a drink. A Support Worker told us how they trying to build on this and develop different ways for service users to express themselves. Staff had received training in Total Communication to help them with this work. There was advice on display by the medication for staff on the procedure to be followed in the event of a resident suffering a seizure. Staff received training, starting during their induction, to ensure they know how to deal with the situation. Supervision notes showed that their understanding was monitored. The homes protocol had been reviewed recently Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: by the Deputy Manager, and staff had to receive training before taking certain residents out of the home for trips. All service users had Health Action plans, which ensured that their health care needs were considered comprehensively. Residents care records included good evidence to show that the home works well with health care professionals for the benefit of the residents. Peoples medication had been reviewed, and in some cases altered, with beneficial effects. When assessment showed that a service user lacked capacity to make a decision about medical treatment, consultations were convened, including health and social care professionals, to consider the persons best interests and take action accordingly. Nurses from the Learning Disability team had visited to explain and advise residents about preventive measures, so that residents could take advantage of NHS screening services. We inspected the medication system in the home. There were no Controlled Drugs at the time of this visit, and no insulin or other substance needing to be kept refrigerated. The homes policy had been reviewed by the Deputy Manager, who has been given responsibility for arranging for peoples repeat prescriptions to be delivered regularly so that they will not run out, and also for auditing the system monthly to ensure that accuracy is maintained. All staff had received training in the safe management of medication. The pharmacist had come to New Redvers for five evening training sessions, to ensure that night staff were included. Care Homes for Adults (18-65 years) Page 19 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. Residents are protected from abuse by good policies implemented in the home, and by arrangements for service users and staff to be open and able to discuss any difficulties. Evidence: The complaints procedure is available to residents and visitors, in easy-read and picture forms. Service users had all been given the contact number for someone outside the home to contact if they so wished, and CQC contact details were displayed in the entrance hall. No complaints had been received since the last inspection. Of the seven service users who completed CQC surveys, all said they knew who to speak to if they were unhappy, and all but one said they knew how to make a formal complaint. They said they were able to speak to the staff, and that carers listen to them and act on what they say. Management and staff have undertaken training in the Mental Capacity Act, and have been putting it into practice in order to promote the best interests of service users, for instance, when decisions about medical procedures had to be made, and the service user was assessed as lacking capacity. The persons core group was convened, including their care manager from the Learning Disability Team. Work had begun to promote service users safety and ability to protect themselves while moving to more independent living arrangements. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The Manager is aware that some staff still need training in the Protection of Vulnerable Adults, and is in the process of arranging for them to participate in Local Authority provision. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The house is maintained in good order and kept safe. However, it does not provide a choice of social spaces for the residents, and is short of accessible rooms suitable for private meetings. Evidence: New Redvers is a detached house, in convenient walking distance of Babbacombe and Torquay town centre. A handyman is employed to maintain good standards of decoration, and for prompt repairs as needed. The house is not suitable for its current purpose, as it does not provide a choice of social and quiet spaces for residents. There is one large lounge and one large dining room. The situation is mitigated to some extent as some residents are happy to sit in the lobby by the front door, and some use the small smoking room by the back door. The Manager considered they could make better use of their outdoors areas. The screened-off section of the dining room, where medication and care records are stored, is used as a care office, which is unsuitable, as there is no sound insulation to provide confidentiality, and no natural light. A lean-to by the back door has been partly liberated to provide a space where two or three people may hold a private meeting, but not with space or furnishing for care reviews. There is plenty of space on the top floor for staff meetings, but it is not accessible for service users. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: New sofas had been provided in the lounge, and new carpet in the dining area. The wooden dining tables had been given new surfaces, which was both attractive and serviceable. One bedroom is shared, by two men who may not have chosen to share in the first place but have now been together for many years. There is no evidence that either objects. All bedrooms have en suite toilets, and some have showers. We saw people had equipment of their choice in their rooms, such as televisions and DVDs, and in one case, karaoke equipment. Suitable locks were on peoples doors, for privacy, and people held their own key unless risk assessment showed this to be inadvisable. A person comes in two mornings per week, to clean the communal areas. The Manager told us that care staff have responsibility to clean toilets each morning, and care staff clean and tidy peoples private accommodation with participation from the occupant according to their ability and preference. Residents and staff clean the kitchen together at the end of the day, then close it for safety overnight. The laundry was in good order, with sound walls and flooring, a Belfast sink for hand washing, paper towels and liquid soap, and shelves for clean clothes which had been cleared. Residents each had a laundry bag for their belongings, and told me that staff supported them to do their laundry. A new laundry time table had been agreed. The owner and management team are in the process of consultation over the structure of the building, and how it might be redesigned to improve the service provided. Care Homes for Adults (18-65 years) Page 23 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. Service users are supported by good relationships with the people who support them. A sound system is in place to recruit suitable staff, and good training is provided. Efforts to provide cover for absent staff have not been entirely successful. Evidence: There is a written staff rota, which showed that on weekdays, as well as the Manager, there are four staff working through the day, but absences are not always covered. The administrator told us they are currently advertising for additional bank staff. On the day of our visit, an absence had not been covered. The staff on duty ensured that all service users still were able to enjoy their planned activities, one outing being moved to the afternoon. We saw that when more independent residents are out, and others are at their day opportunities, the staff/service user ratio was maintained at 1;3, which enabled a good level of attention for the more dependent service users. Either the Deputy Manager or the Senior Support Worker are on duty every day. At weekends they are supported by only two staff. However, all eight service users who returned surveys to us said they are able to do what they want at weekends. Some staff completing surveys said they found the long working shifts tiring, especially if they were also asked to work additional shifts to cover for absence. At night there is one awake Carer, and one asleep. A staff member who regularly does sleep-in duty told us they had only been called upon once by the awake colleague in the Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: past year, which suggests that this level of support is sufficient. Some residents had 1;1 staff time provided by the local authority, to meet their assessed needs. Records were kept both of the time spent and the activities that were enabled by this provision. Staff told us that the recruitment process started with any applicant visiting New Redvers and meeting service users. One new staff member confirmed they had been shown round the house by two service users. We examined the documents relating to new recruits, and found that all checks necessary to protect service users from potential harm had been carried out. A recently recruited staff member had completed the Skills for Care common induction, we saw the completed log book. This had included in-house fire safety and evacuation, and control of infection. Training in first aid, epilepsy food handling and Mental Capacity Act safeguarding had also been provided already. We met staff who told us there had been fantastic training over the past year. This had included Total Communication, Equality and Diversity, and Epilepsy, which they had found particularly interesting. Each had a Personal Development plan. The Manager was concerned that this training had not been available for all those who needed it, and she was continuing efforts to enable all the team to attend. Supervision sessions and appraisals have been provided to give staff feedback on their performance and check their knowledge of policies and of good practice. The Assistant Manager told us that she gives staff members a topic for discussion before their meeting is due. We found the staff team to be more settled and confident than at our last inspection. 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. New Redvers is well run in the best interests of the service users. Management are working to develop plans for reshaping the service to better meet their future needs. Evidence: Karen Barnes is Manager of New Redvers. Her registration with the Care Quality Commission was approved on 17th October 2009. She is a Qualified Nurse, has achieved NVQ4 in management, and is an NVQ assessor. She has demonstrated her competence and ability to raise standards in the home, and to effectively pursue change in the provision of care services. An Assistant Manager has been appointed and is contributing to good management within the home. She has achieved NVQ4 in Care and is working towards the Skills and Leadership level 4 qualification. A new Responsible Individual for the company, Mr Brian Armstrong, was notified to the CQC on 1st December 2010. He visits periodically and provides support for the Registered Manager. Monthly visits on behalf of the company are carried out by the Company Secretary. We saw some of their recent reports. He had noted concerns about the levels of sick leave, and the management strategies that were attempting to reduce the impact. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The company has recognised that the shape of this service, with residential care provided for a large group of people in one house, no longer meets the standards expected or the expectations of prospective service users or the placing authorities. The Registered Manager, Mrs Barnes, has set up a Development Board for the home, to consider how to move forward. She has met with residents, their families where appropriate, and local health and social care professionals. She has talked with service users about how they would be able to organise their finances, and has agreed to have weekly meetings to discuss plans. Each resident who is interested is being supported to gather information about the choices available to them. The Manager had introduced a practice of recording Improvement Reports if a problem was identified. For instance, when concern was aroused when a service user endangered themself by going upstairs, this was brought to staff attention, and a door alarm was provided to alert people to possible danger. We found the team had a positive approach to solving problems of daily life. Residents meetings had been held. We saw records from meetings in October and November when people had put forward their ideas for holidays, social events, and to discuss who would be their keyworker. The Manager has observed that service users now feel better able to speak up for themselves. We saw that policies and procedures were appropriate and had been updated by Diamond Cares administrator this year. The Manager took responsibility for ensuring they are implemented in the home. The Registered Manager has recently completed a two day course in Health and Safety, to ensure she was up to date with current requirements to ensure the safety of people who live and people who work at New Redvers. Accidents were recorded and analysed. This had shown up an increasing tendency to fall, by one service user, which was being followed up by medical assessment and review. The fire risk assessment had been reviewed by a professional company in July 2009, the same day as professional fire safety training was provided for staff. The alarm system was serviced and up-graded on 25/09/09. All other safety checks had been carried out and documented. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 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 Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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