Care Home: Newbridge Hill

Similar services:

• 5 Seafield Road
• Honeybourne House
• Longrun House
• Bodley Community Care Support Centre
• Thomas Pocklington Trust
• Chantry Gardens
• 25-27a Alexandra Road

What the care home does well People living at the home who were spoken with and those who responded by survey said they were happy living in the home and that staff were very supportive and helpful. People living at the home were supported through person centred care planning and staff had been provided with comprehensive information in order to meet peoples assessed needs. People had been supported well in accessing individual opportunities to lead active and fulfilled lifestyles that were both appropriate and reflected their levels of independence. The home was very well run. The ethos of the service was clear, well communicated and remains focused on positive outcomes for each person. There was an open atmosphere in the home with staff supporting people to communicate their wishes and preferences. The staff team were friendly, professional, and very confident and maintained good relationships with the people living in the home. The administrative systems were effective and efficient and enabled quick and easy access to any documentation required. This ensured a safe and accountable system of support for the people using the service and staff. The people using the service had been provided with relevant information to in a format which was accessible to them. Newbridge Hill offers very attractive accommodation. This provided people with a homely environment, which had been maintained to a very high standard. What has improved since the last inspection? The manager has ensured all appropriate information regarding staff members is obtained and stored in the home. This promotes a robust recruitment process to ensure the welfare and safety of the people living at the home. . What the care home could do better: There are no requirements or recommendations. Key inspection report Care homes for adults (18-65 years) Name: Address: Newbridge Hill 51 Newbridge Hill Bath Bath & N E Somerset BA1 3PR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Webb     Date: 0 2 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Newbridge Hill 51 Newbridge Hill Bath Bath & N E Somerset BA1 3PR 01225443019 01225443019 ursula.forbush@rnid.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: RNID care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: May accommodate up to 6 persons aged 18 - 64 years Date of last inspection Brief description of the care home 51 Newbridge Hill is registered to provide accommodation with personal care for up to 6 people whose primary need arises from their sensory impairment. The home, one of the services operating as part of the Royal National Institute for the Deaf (RNID), describes its aim is `to promote independent living in the community. The property is a large Victorian building located in a suburb of Bath. It has car parking spaces to the front and a large mature garden to the rear of the property. It is within easy reach of the local shops and community facilities. There is a regular bus service to the city centre. The current range of fees for this service is from £1006.00 to £1271.00 per week, Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home depending on the support needs of each service user. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced Key Inspection. The pre inspection planning involved reviewing the report from the last Key Inspection completed in March 2007 and the Annual Service Review completed in June 2008. We also looked at the service history that details all other contact we have had with, or about the home. We looked at the Annual Quality Assurance Assessment (AQQA) completed by the Manager. This is a self assessment, which focuses on how well outcomes are being met for the people living at Newbridge Hill. We received five Have your say surveys from people living at the home. The findings have been included in the report. We spoke with two staff on duty during the visit, and with the Manager at a later date. We were supported by staff to communicate with the people living at home through Britsh Sign language (BSL). Interaction and communication between the people living at the home and staff was also observed Care Homes for Adults (18-65 years) Page 6 of 29 during the visit. We viewed all communal areas of the home and some bedrooms used by people living there. We gathered other information during this visit by looking at a number of records such as individuals care plans, risk assessments, daily records, incident and accident forms, complaints records, medication administration, staffing records and some health and safety procedures. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move to the home can be assured a full assessment of their needs is undertaken and that their needs will be met. People wishing to move to the home have the opportunity to visit the home and to be involved in various activities, before making a decision to move there. Evidence: There have been two new people admitted to the home since the last Key Inspection in March 2007. There are currently no vacanices. We looked in detail at one of these individuals assessment records and how they had decided to live at Newbridge Hill. We saw records that had comprehensive information about their assessed needs. They had been assessed by their social worker and we saw a copy of this. The manager had followed the referral up with a visit to the persons home and carried out their own assessment to confirm their needs could be met at Newbridge Hill. This was seen to cover all aspects of their needs with an assessment summary sheet linked into their core learning action plans. Staff spoken with showed how they had a good understanding of peoples support needs and that they were being met by a team who Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: had relevant skills and experience. We saw records that showed the individual had visited the home on several occassions before deciding to move in. They had been involved in a range of different activities including attending social activities with the other people living at the home. They had an overnight stay and had been involved in menu planning and accessing the local shops. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported and involved in the planning of their care through a person centred approach. Comprehensive and accessible care plans show how individuals needs and personal goals are met. People living at the home are involved in making decisions about all aspects of their lifestyles and how they want the home to be run. People are supported to take risks safely and independently in their daily lives. Evidence: We looked at two peoples care files in detail and at specific areas in the three other peoples files. We saw comprehensive information about how people should be supported with their individual needs. Care plans included health, communication, daily living skills, social aspects, and mobility. Core learning action plans set out current goals people had agreed to and how these had been actioned. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Records showed peoples care plans had been reviewed regularly. We saw yearly reviews had involved peoples families, and their social worker, and ongoing monitoring of how their individuals needs were being met. It was evident the individual communication needs of the people living at the home were understood by staff. Care plans were seen in a format which individuals could access and understand. They were written in plain English and with some that had picture symbols. Others incorporated both photographs and picture symbols to improve the accessibility of information. We observed how staff communicated with the people living at the home. It was evident the staff were able to communicate effectively through British Sign Language(BSL). People were seen to be comfortable and confident in their interaction with staff. It was evident people living at the home are empowered in making decisions about their life and how the home is run. Surveys received from people told us they always make decisions about what they want to do each day, and that they can do what they want to during the day, evening and at the weekend. This was also seen through individuals daily reports that showed all aspects of peoples lifestyle. Weekly house meetings chaired by the people living at the home gave people the opportunity to discuss all aspects of the general running of the home, activities they wanted to be involved with. We saw written pictorial records of these meetings and the agreed outcomes. A member of staff spoken with confirmed the aims of the service was providing as much choice as possible, but to get the people to decide. People living at the home had been supported and encouraged to live an independent and fulfilling life and take part in varying activities. Care and support was being provided through a risk assessment framework and if appropriate, issues relating to capacity, linked into the process. This showed how people were helped to take risks safely in their daily lives. Written risk assessments included known risks, factors contributing to risks and strategies to help reduce risks to make sure activites people were involved in were safe. It was evident healthy risk taking was encouraged and supported, as seen in the wide range of opportunities and activities people has been able to enjoy. Risk assessments were seen to have been regularly reviewed. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported to make choices about their lifestyle and in developing and maintaining all aspects of their personal development and independence. People living at the home are supported well by staff to use facilities provided by both the RNID and in the wider community for social and recreational activities. They are also supported to enjoy holidays, visits to family and friends. People living at the home are encouraged and promoted in making healthy and well balanced choices about their diet. Evidence: It was evident people living at the home had been encouraged towards taking personal responsibility in all areas of their lives. We saw clear and accessible Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: information about what was expected of people in working towards their individual levels of independence. Independence programmes showed how people had been supported with all aspects of their personal development. We saw records of when people had made progress in specific areas such as independent travel and managing their own finances. All records of evidence had been dated and signed. The timetables of the people living at the home were seen. These showed people had attended educational day services (known locally as EDS) provided by the RNID. These included art, ceramics and woodwork work shops. Some people worked in the coffee shop on the RNID site while another worked in a charity shop. One person was in paid employment with Bristol City Council one day a week. People had also attended local colleges, to access other courses. A great deal of importance was placed on individuals being able to participate in all aspects of home life and supported to enjoy a range of leisure activities, outings to places of interest, and to choose and attend holidays. This was seen through the activity file and how people had been asked to make choices about where they wanted to go so the activity could be planned. Staff had collected leaflets and brochures to provide information for people to help them decide. The activity file included visits to art exhibitions, Christmas lights switch on, Chinese State Circus, as well as frequent visits to various restaurants and cinemas. Feedback sheets were seen asking people for their views of their holidays, visits, and outings. We were told weekends were considered special and rotas seen showed staffing hours centred around the activities people had chosen to attend. People living at the home had been supported to write their own daily records, to explain how they had spent their day and whether they had enjoyed what they did. These records contained a mixture of words, symbols and drawings, with added comments by staff if needed. This is good practice. Records showed that the people living at the home had been supported to keep in contact with their families and we were told staff had good working relationships with families. An individual spoken with told us about contact with their family and showed us photograghs of when they had made visits. Records of house meetings showed discussion amongst the people living at the home about how the routines of the house such as the cleaning, and using the kitchen to cook, was managed. We saw that people shopped for their own food and cooked independently of the others. However there were occassions when people also cooked for eachother during the week and at weekends. A group meal was shared at weekends when people Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: decided whether to go out for a meal or have a take away at home. Records of individual menu planning were seen in care files, with consideration given to well balanced and nutritious meals. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the services are supported to lead healthy lifestyles with their healthcare and personal needs being monitored well. Staff show a good awareness of how to treat people with respect. People living at the home are safeguarded through safe medication practices. Evidence: The care plans seen of people living at the home showed they managed their own personal care independently. Staff provided support through discussion, explanation, pictorial aids and prompting. From discussion with staff, and observation of their interaction with people, it was evident that people were treated respectfully and listened to. Health care records showed people had been registered with the local General Practitioner (GP), optician, and dentist. A chiropodist visited every six weeks. Peoples health care was being monitored well and this was seen through records of appointments with the outcome of the visit and follow up. Health care records showed Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: that the physical and mental healthcare needs of the people living at the home were being met through regular reviews of medication and support from appropriate professionals. Referrals to specialist services had ben made if needed to help support people in different areas. These included health care professionals such as National Deaf Services. Psychiatry and Physiotherapy had also been accessed from Bridges, Community Learning Difficulties Team (known as CLDT) at St. Martins Hospital. These contacts with professionals were clearly recorded in individuals files and the outcomes acted upon. We were shown how the people living at the home had been supported with their medication needs. We saw a file that had medication profiles for each person and that included dosages, times, records of medication taken as and when required. Samples of the signatures of both people living at the home and staff had been recorded and and detailed notes of all medication administered. People had been encouraged to take responsibility for managing their own medication.. For one person we saw an accessible self medication programme to help them understand the process. The programme was set out over a phased period and how it was to be achieved. Clear guidelines were in place for each person and completed Risk Assessments had been kept up to date. Daily record sheets had been signed by both people and staff. Records showed peoples medication had been reviewed regularly by appropriate specialists with some peoples medication that had been reduced. Staff training records showed staff had attended medication awareness during their induction period. Further training had been provided through Protocol Training, that had been accredited by the City of Bath College and a new form of training was being provided through Boots Care of Medication Foundation module. 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 living at the home are enabled to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. People living at the home are protected from abuse, neglect and self-harm by a trained staff team. Evidence: The RNID had a complaints policy and procedure. We saw this in the home and a pictorial/symbolised version for the people living at the home. We saw in one persons care file a record of when they were shown the complaints policy and procedure, when they first moved to the home. This had been signed and dated to agree they understood the process. We saw there had been four recorded complaints since the last inspection. These showed how they had been monitored, when people had requested meetings to discuss concerns or complaints, and all but one had a record of the outcome of discussion and if the complaint had been resolved. All but two surveys received from people living at the home told us they knew how to make a complaint and knew who to speak to if unhappy. However, individual records showed that people had been asked how they felt on a regular basis. Pictorial information helped people convey their feelings through pictures. It was evident people were encouraged and supported Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: to speak to staff about any concerns and to helped to manage their own feelings. The RNID had an Adult Protection policy and procedure, which contained a step- bystep guide for staff to follow in the event of any allegation of abuse. All staff had received Safeguarding adults/Protection of Vulnerable Adults alerter training. Four staff had received refresher training with three staff booked for this in the future. Three senior members of staff had been trained to investigator level. We saw clear guidelines in place for supporting people living at the home who may become distressed or present behaviours which may be perceived as challenging the service. Each care plan had details of known trigger points and the appropriate defusing techniques. These were described as Methods of Approach. Staff had received regular training in responding to these through Managing Actual and Potential Aggression. We saw clear records had been maintained of both accidents and incidents which occured in the home. The reporting of these was clear with action taken. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a clean, homely, and safe environment that meets their needs. People living at the home are provided with bedrooms that meet their individual needs, and specialist equipment in to promote their independence and welfare. Evidence: Newbridge Hill was a large Victorian house with car parking to the front and a large mature garden to the rear. The people living at the home had ben provided with a comfortable and bright environment that had been maintained to a high standard. The house was tastefully decorated and furnishings and fittings were of a good quality. Photographs of the people living at the home were on display helping to personalise and give a homely feel to the environment. Three people showed us their bedrooms. These were decorated to colour schemes of their choice, well maintained and had photographs of friends and family displayed, Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: together with books, drawings and lots of other personal items. It was clear that they had been supported to personalise their room and that their privacy was respected. We saw in an individuals care file how they had been supported when first moving to the home with choosing their bedroom colour scheme, interior decoration, and buying bedroom items. The people living at the home had been provided with approprite equipment such as flashing fire alarm strobe light, flashing light doorbell and shake-awake pillow vibrators. Other aids included a digital television and a DVD player, which allowed films and programmes to use subtitling. Surveys received from people living at the home told us the home is always fresh and clean. One person answered the survey question What does the home do well with the comment makes me feel happy. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The roles and responsibilities of staff are clearly defined. These are understood by staff and promote an efficient and accountable service to all stakeholders. There are robust recruitment procedures to help to protect people. People living at the home benefit from a trained, competent and supervised staff team and with whom they have well established relationships. Evidence: The staff team was well established with staff having worked for many years at the home. Staff spoken with were clear about their roles and responsibilities and had a good understanding of the needs of the people living at the home. It was refreshing to see comments made through the AQAA including Another enjoyable year for the team. It was evident that staff enjoyed working at Newbridge Hill and staff spoken with confirmed the team respected each other and worked well together. Staff records showed that the retention of staff has been of value in ensuring a consistent approach in supporting the people living at the home with all Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: aspects of their personal development. Four of the thirteen staff (including bank staff) are profoudly Deaf BSL users. We were present at the staff handover session when information was given to the incoming staff on duty through signing. An individual living at the home spoken with told us they liked the staff. All five surveys returned from the people living at the home told us they felt the care staff and managers always treated them well and that they were always listened to with action taken on what they said. We saw personnel records that showed a robust recruitment procedure had been practiced. Appropriate documentation was in place including application forms, documents proving identity, induction checklists, at least two satisfactory references and Enhanced Criminal Record Bureau Disclosures. A requirement had been met for staff personnel files to contain all relevant information as required by the regulations. The AQQA told us a focus for the new year will be service user involvement in recruitment and selection. A new policy and guidelines had been developed and staff have further developed an in house process. The AQAA told us there are 90 of staff have a National Vocational Qualification(NVQ) level 3. The Deputy and Senior are working towards their NVQ level 4. One deaf member of staff is currently being mentored to prepare them for their Assessors certificate. Staff training matrix confirmed staff have completed their induction process and all mandatory training such as first aid, food hygeine, manual handling and fire. Where staff needed either training or a refresher a future date had been entered on the record. Although a member of staff spoken with had their first aid training cancelled, they demonstrated their knowledge and experience. They had carried out sleeping in duties and showed they knew how to deal with an emergency if it arose. Since the visit we have been informed they are booked to attend training in this area. Since the last inspection staff have completed training in Mental Health Awareness, deaf awareness, person centred planning, Mental Capacity Act and Deprivation of Liberty Safeguards. All staff have completed British Sign Language Stages(BSL) 1 while some staff are working towards BSL 2 and 3. Staff spoken with confirmed they had been provided with regular formal supervision meetings with either the Manager or a Senior member of the team. It was evident their personal development was valued and that this contributed to the smooth running of the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a home that is run in their best interests. Effective procedures in place provide the support they require to lead fulfilling lives. People who use the service benefit from an open management approach with systems in place that safeguard and promote their health, safety and welfare. The views of the people living at the home are central to the monitoring and review of the service provided. The rights and best interests of the people living at the home are promoted by the quality of the record keeping. Evidence: The Registered Manager, Ms.Forbush is qualified and competent to run Newbridge Hill, and meet its statement of purpose, aims and objectives. She has various qualifications including NVQ Level 4 in Care, the Registered Managers Award and is a qualified NVQ Assessor. She has attained BSL Levels 1, 2 and 3 and is in the process of completing Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: level 4. She also undertakes periodic training to maintain her knowledge and update her skills and level of competence. It was evident the management approach was one of an open and positive approach. We spoke with the Manager after the inspection and she showed a clear sense of direction and leadership. Staff spoken with said they enoyed working in the home and felt extremely well supported by the management team. They each felt they could contribute ideas and felt that they are always listened to. The views of the people living at the home remain central to the development of the service. Their views are sought through various methods such as reviews of their care, house meetings, feedback forms and complaints. People are consulted on every aspect of the running of the home and about their wishes and aspirations. We saw the most recent yearly Quality Assurance Questionnaires that had been given out to the people living at the home, their families, and healthcare specialists. The feedback seen in comments was positive. We received a completed AQAA in January 2010. It was evident an accurate reflection of the quality of the service had been reflected in the document. This was seen through the outcomes being consistent with the evidence gathered as part of our inspection process. The management systems and structures were efficient. The record keeping was of an excellent standard with files and documentation well-organised and easy to access. These had been well maintained and were stored safely and securely. We saw both weekly and monthly health and safety checks had been carried out. These included fire safety checks, checking equipment, hot water, refrigerator and freezer temperatures, first aid kits, lighting and vehicle checks. Records showed a fire risk assessment was in place and fire safety training had been provided for all staff on 27/10/2009 with fire awareness in the work place completed by staff in July 2009. Fire evacuation drills had been carried out for both the staff and the people living at the home . 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 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!