Care Home: Newton House

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well The home make sure that everyone is looked at very carefully before they are asked if they would like to move in so that everyone knows that staff can help them with all the things they need help with. People who are going to move in are helped to do so in a way that makes them feel as happy, as possible about leaving where they are living. This is so that people will have the best chance of settling down and enjoying their new home. The home write down all the ways that they are going to help people. They make sure that any special help they may need is also written down so that staff know exactly how to help people to live their day to day life, in a good way. The home help people to do lots of things so that they do not get bored and fed up, they are carrying on trying to find lots of interesting things for people to do. The home make sure that people have very nice, fresh food and that they can help to buy and make meals. The home make sure that people are helped, in ways that they like, to look after themselves. Staff help people to go to the Doctor or nurse, or other people that help you to look after yourself, if they need to, so that they can stay as healthy and happy, as possible. People who live in the home and their families are listened to and the manager changes things, if necessary, to make sure people are happy. The staff know what they are doing and know how to help the people who live in the home, so that people can get good care. There are lots of staff so that people can get all the help they need, when they need it. The home has lovely furniture and things, it is kept very clean and looks like a very comfortable place to live. The manager looks after the home properly and makes sure that the people who live there are always well looked after. The home has how they must keep people safe , written down, the staff do what this tells them, so that people are kept as safe as possible. What has improved since the last inspection? New Service. What the care home could do better: The home must look at, if it should write down how much it costs to live there and who pays for it. So that people know how much they are paying and what they get for their money. The home must make sure that people are helped to do as much for themselves as they can, as safely as they can. They must write down a bit more about how they are going to do this.The home must make sure that it writes down when they are given or spend peoples` money so that it can be counted and checked and everyone can see that it has been properly spent. The home could look at how it helps people to behave in a good way and see if it needs to write down more about how they will do this. This will make sure that people will be helped in the best and safest way. Key inspection report Care homes for adults (18-65 years) Name: Address: Newton House 404 London Road Benham Hill Berks RG18 3AA     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: Kerry Kingston     Date: 1 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Newton House 404 London Road Benham Hill Berks RG18 3AA 01635529818 0163542740 newton.house@chuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Aitch Care Homes (London) Ltd Name of registered manager (if applicable) Miss Anne Paulette Mayhew Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7. The registered person may provide the following category/ies of service only: care home only - (PC) to service users of the following gender: either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) Date of last inspection Brief description of the care home Newton House is a service, regsitered for seven people with learning disabilities who may have associated behavioural issues. The house is owned and the care is provided by Aitch Care Homes (London) Limited, who are providers of a number of care homes, acroos the South of England. The home is a large refdurbished building with two floors, most of the private Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 7 Brief description of the care home accomodation is on the first floor. There are spacious communal areas and everyone has en-suite shower facilities in their rooms, access to the first floor is by stairs, only. The home is situated on a main road, within a few miles of the towns of Newbury and Thatcham. It has its own transport and easy access to public transport. The fees are approximately£1,300 to £2,000 per week, depending on peoples assessed needs. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is a report for the first key inspection of a new service. It was registered in February 2009 with its first admission in August 2009. This took place between 10.30 and and 5.00 pm on the the 13th October 2009. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Care Quality Commission and completed by the service manager. Surveys returned to us by people who use the service, parents completed these on their behalf, and some surveys returned by staff of the service. Discussions with the manager and two other staff members took place. People who use the service have difficulty communicating with people who do not know them so observation of people and their interactions with staff took place during the visit to the home. Reviewing records of the people who use the service and other records and procedures Care Homes for Adults (18-65 years) Page 6 of 31 was also used to collect information on the day of the visit. All information received by the Commission since registration about this service was also taken into account when producing this inspection report. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: The home must look at, if it should write down how much it costs to live there and who pays for it. So that people know how much they are paying and what they get for their money. The home must make sure that people are helped to do as much for themselves as they can, as safely as they can. They must write down a bit more about how they are going to do this. Care Homes for Adults (18-65 years) Page 8 of 31 The home must make sure that it writes down when they are given or spend peoples money so that it can be counted and checked and everyone can see that it has been properly spent. The home could look at how it helps people to behave in a good way and see if it needs to write down more about how they will do this. This will make sure that people will be helped in the best and safest way. 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 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an up-to-date Statement of Purpose and a Service User Guide that has been provided in an easy to understand format. The cost of care and who is paying for it is not included on the statement of terms and conditions. The home makes sure that people are assessed thoroughly and that they are able to meet their identified needs, without compromising the comfort and safety of other people who live in the home. Evidence: The Statement of purpose, available in the home is, generally up-to-date and accurate, some information needs further up-dating. The Service User Guide called the Resident Guide has been produced in pictorial and symbolic formats to make sure that people have the opportunity to understand it. The resident guide includes a contract/statement of terms and conditions but does not include the costs of the service or who pays them. The manager advised that this information is held separately and there was discussion about whether it should be included in the Statement of terms and conditions. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: The home is registered for seven people, there are currently five people in residence with one imminent admission.The first admission to the home was in August of 2009. There is a robust assessment process, which is completed by specially employed staff of the organisation, called placement officers. They work with social services departments to find people who may be suitable to live in the services they provide. The placement officers do the initial, very detailed, assessments and the home is also provided with detailed assessments completed by the school (in most cases) or Social worker (care manager).(Four of the five people who live in the home have been admitted from residential schools.) The service then holds a transition planning meeting which ensures there is a detailed programme of how the individual will be admitted and settled into their new home, and what other specialist services may be necessary to support the placement both short and long term. For instance one person had a plan of exactly how and when the move was to be communicated to them, to ensure that even though they are on the autistic spectrum they were encouraged to feel it as a positive move.The plan also noted how they were to be supported through the actual moving in process and the involvement of previous carers. All five assessments are very detailed, identifying all areas of need including any diversity needs, such as cross gender care,religious, emotional and behavioural needs. The manager is very clear that the home should not only be able to meet the needs of individuals but that those individuals should also be compatible with the people who already live in the home. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home make sure that people know their assessed and changing needs, which are reflected in their plans of care. Plans of care are reviewed regularly so that people can be sure that staff know how to help them, appropriately, at all times. People are encouraged to make as many decisions as they are able about their life and risk assessments support people to as much independence as possible. Evidence: Five plans of care were seen, all are developed after the person has been admitted, beginning with a temporary one drawn up from school care plans and assessments,then changed and amended as the person settles into home and displays usual behaviour. The plans of care are amended and the placement itself is reviewed six weeks after admission. They ,including goals, are then reviewed again a minimum of six monthly, or more often if necessary. One person is having a further review after twelve weeks of residence as the family were not totally satisfied with some aspects of the care offered. Plans of care note any specialist care requirements and how the Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: home will meet them, everyone currently resident have limited communication skills,all have detailed communication guidelines such as one person who communicates by using the written word reading and talking on the computer, another has a list of words and what they sound like when they verbalise them. Religious needs are identified and how to meet them is detailed in plans of care, the home seek family help with any areas that they have no experience or knowledge of. How people make decisions and choices, and how they communicate them is noted in plans of care. People were observed, on the day of the visit,being offered different foods and activities. The day to day choices people make are often carefully noted in daily diaries. People who use the service are free to attend staff meetings that are held monthly. There have been resident meetings but they have not been very successful, the home is working on how to involve people and how to find out how they feel about the home and the care being offered to them. The manager is very aware of the balance between working closely with families and ensuring that the young peoples adulthood and choices are respected. Observations, on the day of inspection, showed that people appeared to be happy and settled and staff were interacting positively with them. Risk assessments are developed for all the necessary activities, they did not include very much detail of how the risk is to be minimised and they were not always cross referenced with the plans of care. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enable people to be involved in a variety of interesting activities that include being part of the community. Opportunities are increasing as staff get to know peoples likes and dislikes and everyone gets to know what is available in the local community. People, who use the service, are encouraged to keep in contact with family and friends and their rights and responsibilities are fully respected. The home provide a varied and interesting diet and people are encouraged to be as involved as possible in choosing, preparing and purchasing the food they eat. Evidence: People who live in the home, have been resident a maximum of two months. One staff and one family survey said they felt activity plans should have been in place prior to admission, the manager explained that they want to get to know people and what will fit in with their goals and aims both short and long term. Also as people have come Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: mainly from school, their adult life is going to be very different and it may be a difficult transition for them. All have an activity plan but they are not yet completed,the manager is working hard to establish relationships with local colleges and day care providers. The organisation provide a budget to pay for some activities. Residential staff,currently provide most of the day care activities, they make good use of the community and local facilities.On the day of visit people went walking/bowling and shopping and one person was on holiday with their parents. Good daily notes describe activities people participate in and if they like them or not. Other activities include swimming, bowling, trampolining, pub visits and attending an evening social club. Staff assist with attending visits to family and/or places of worship, as appropriate. Plans for holidays are being looked at for next year. For someone who is moving in, in the near future, plans are already being made to put their activity programme in place. The home has a sensory room (on site) and a trampoline with enclosure in the garden. The manager confirmed that risk assessments for all activities, both generic and individual, are completed as necessary. Rota hours are 7am -10pm and staff will stay later if any special activities have been arranged. The young people tend to go to bed early,currently, from choice but the manager can see this changing as people mature and are able to make more informed choices. The Manager has developed good relations with the local neighbours, who are helpful and supportive. Contact with family and friends is encouraged with staff supporting people to visit their families, as appropriate. Family influence and involvement is obvious as parents attend reviews, are involved in the admission process and are appointees for the people who use the service. The manager and staff very aware of the issues around people developing into adulthood and have worked hard to establish positive relationships with parents. The home is promoting independence, in stages and as appropriate for people, particularly for those who come from a residential school setting.For instance all rooms have door locks but they are currently risk assessed as not being provided with keys. Short and long term goals and aims including independence and development are included in plans of care and review notes. People do not have access to the grounds of home without staff present or observing them but the manger ensures that there are always enough staff to enable people to go outside if they want to. Menus are done on a four week rotating basis, people have two choices of main meal a day and also are able to choose whatever they would like for breakfast and lunch. The home use fresh vegetables from the local farm and people are encouraged to eat Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: as much fruit as they like.The manager reported that the home have a generous food budget. People are involved in choosing dishes to put on the menu for the four weeks, these four week menus change with the seasons, to make best use of seasonal produce and appropriate food for the time of year. Two people, in particular, enjoy working in the kitchen with staff and these activities are included on their daily activities plans. Everyone is encouraged to be as involved as possible in the purchasing and preparation of food. Any specific nutritional needs are identified and included in plans of care. Menus are presented in pictorial and symbol format so that people have a good opportunity to choose what they would like to eat, on a daily basis. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure that staff meet the needs of the people who use the service in the way they prefer. Staff treat people with respect and dignity, at all times. Peoples personal and physical needs are met effectively and medication is administered safely. Evidence: Respect and dignity are included in the induction process, staff were observed, on the day of the inspection visit, treating people very sensitively and respectfully. Two staff were able to describe how they preserve peoples dignity, at all times and how they show them respect. One staff member quoted being honest with people as a prerequisite to respecting them. Personal support plans also note how people like to be assisted, they include lists of preferences/likes and dislikes. Good communication guidelines ensure staff know how people express their choices and/or dissatisfaction aswell as if theyre happy and like what is going on. People have a health care plan, which is as detailed as necessary. Peoples health is noted in them, as is what is needed to keep them healthy, such as giving additional Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: fluids and keeping a chart to check that it is being done. All five people have visited the local G.P, to get to know her and she has reviewed all their medication. All have been registered with a dentist, who specialises in the care of people with communication difficulties and learning disabilities. The manager has sought specialist referrals,as necessary, such as a neurologist and a behavioural specialist. Specialist nurses from the local community hospital are going to be involved in peoples care and in staff training. Visits to medical professionals are recorded in peoples health care files. The home use a monitored dosage system provided by Lloyds chemist in the local village of Thatcham. Only staff who have been assessed as competent by a senior staff member are able to administer medication. Medication is always administered by two people, with one person signing the record sheet. One person has medication to assist them with controlling their behaviour but no-one has any medication that is prescribed to be used as required, for behaviour control. The home does not have guidelines, in place, for when to administer other medication prescribed to be taken as necessary such as for pain relief and constipation. The manager has just completed some generic ones and is to complete individual ones imminently. The home have no controlled drugs but have ordered a controlled drugs cabinet and book to prepare then for if they do have to administer them. The home has a comprehensive policy and procedure that instructs staff what to do in event of the death of someone who lives there. They also participate in end of life and bereavement training to prepare them for assisting residents , if it becomes necessary. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is developing ways to listen to peoples views and opinions. The manager and staff team, generally protect people from all forms of abuse. Behaviour guidelines, with particular regard to the use of restraint, and financial recording procedures are not robust enough. Evidence: The home has a robust complaints procedure, produced in pictorial, symbol (widget) and other forms that people may understand. It is unlikely that people would make a complaint without the help of staff or families. People were only admitted to the service in August 2009, no complaints have been received by them, since opening. Four compliments about the high standard of care offered have been received. A copy of the complaints procedure is sent to peoples families. The service have the West Berkshire Local Authority safeguarding procedures available in the office. Staff have safeguarding (POVA) awareness included in the induction process, this is followed by more detailed training supplied by an in house trainer or the Local Authority. Two staff spoken to, were clear about what they would do if they identified any abuse issues, they were clear about their responsibilities to keep the people in their care safe and were confident that the senior staff in the home would take appropriate action. They were not so clear about who to approach outside of their organisation, if it became necessary but advised that they would call the police if a criminal offence had been committed. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: People have behaviour plans, as necessary but some lack detail particularly with regard to any use of physical restraint. No physical restraint has been used, as yet but some people who have moved into the home have a history of behaviour that may require the use of some physical interventions. Staff have received challenging behaviour and breakaway techniques training, the home has not identified any individual who may require staff to use this training. The manager explained that peoples behaviour appears to be improving and they are not seeing incidents of some of the reported historical behaviour. One incident of aggressive behaviour was noted on an incident form ,which was not reflected in a review of risk assessments and amendment of behavioural guidelines for the individual. The home only deals with peoples personal allowances as provided by families, families act as appointees for all the people who use the service. The families leave money for people and the staff of the home spend it and send receipts to the family.There is no ongoing record of money received and spent,in the home. This system is not robust enough to protect either the people who use the service or the staff team who are dealing with their money. Peoples access to their own personal allowances is being considered on their development plans, so that they may be able to take more control, of their own finances, in time. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well kept, well equipped and homely, providing a very pleasant environment for people to live in. It is well adpated to meet the needs of individuals and the group, as a whole. Evidence: The home is registered for seven people, it is spacious with large communal facilities and good sized bedrooms. It has seven bedrooms, all with en-suite shower facilities. There is a further bathroom with a large bath so that people can have a bath if they choose to. One bedroom, currently used as the sleeping in room by staff, is on the ground floor, the other six are on the first floor, accessed by a staircase. There are two different levels on the ground floor making it unlikely that the home would be able to accommodate anyone with severe physical disabilities. All areas of the house were spotlessly clean and very good quality furniture and fittings, were in place, in all rooms. The laundry is situated in a lean-to structure, to the side of the property the manager advised that this is soon to be replaced. The washing machine has sluice facilities and washes up to 95 degrees. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: All areas are adapted to individual and group needs, bedrooms are very individualised reflecting peoples choices and tastes. Their are many family pictures/photo boards and communication boards, around the home. People were seen making good use of their private space. The home has its own people carrier vehicle and has easy access to public transport. The small garden is well used with a patio area, garden furniture, pots of flowers, a trampoline and sensory room. One person was seen enjoying being in the garden with pieces of equipment that he enjoys handling, this activity calmed him. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home have a competent staff team who are undertaking training with realistic timescales. The manager ensures that the staff team is able to meet the complex and diverse needs of the people who live there. The home has a robust recruitment policy to ensure that staff are safe to work with the people who use the service Evidence: The home,currently, has 12 staff, recruited over a period of months as more people come to live in home. There are now five people resident (registered for seven), the home is recruiting to fill more staff vacancies, including a senior care worker. There are, currently, a minimum of four staff on duty between 7.30 am and 10pm. They work in 2 shifts 7.30 -3 and 2.30 to 10 with a half an hour handover period between 2.30pm and 3.00pm. Night staff start work at 9.45 and work with the member of staff who is sleeping in. The manager is constantly reviewing the skill mix and numbers of staff, as the numbers of people and dynamics of the resident group change. Residential staff are providing daily activities for the five people who live there. One survey from a parent and one from a staff member suggested staffing ratios were not high enough. The manager explained that she has staff numbers under continual review, because of fluctuations in the numbers and needs of people being Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: admitted. All staff have detailed Job descriptions and are provided with the General Social Care Council and the providers codes of conduct, the three day induction includes attitudes, respect and dignity.This induction is not always available until someone has been in post for several months but the basic in house induction completed by the manager and assistant manager cover all the necessary areas. Three of the 12 staff have an NVQ 2 or above qualification and several are waiting to begin training after they have completed their probationary period. Some of the staff team are relatively inexperienced, the manager manages this by ensuring there is always a senior /experienced staff member on duty. Training courses in specific areas are planned, some are completed such as, seven staff have completed autism training. Five staff are still awaiting specialist training and the three day induction. Training records and training plans showed that people are participating in training in realistic timescales. Staff confirmed that they have good opportunities to train and know when their training is to take place. The home has staff meetings monthly, people who use the service are invited to attend but tend not to stay for long. Good quality minutes are kept and appropriate topics discussed. Recruitment files were seen for three staff members, all the necessary paperwork is on file. Notes from interviews are kept and set questions are used by the manager, to ensure equal opportunities for all applicants. The manager supervises all staff monthly and keeps good quality notes, supervisions inform the staff training and development plans. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run, the manager is committed to running the home in the best interests of the people who live there. People are kept as safe as possible by adherence to Health and Safety Policy and procedures. Evidence: The registered manager has been in post since July 2009, she is a Registered General nurse and has had several years experience in a managerial position in the care field. She has partially completed the Registered Managers Award and is seeking to find a provider so that she is able to complete it as soon as possible. Staff were very positive about her management style which they described as open and supportive. They also said that her prime concern is the needs of the people who live their and that she ensures their best interests are always at the forefront of the work of the staff team. The providers support the registered manager with a identified management structure, so she knows who to approach for advice and support. The regional manager visits monthly and completes regulation 26 forms, at the last visit she identified one of the issues noted in this report. The provider has a quality assurance Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: system that the manager intends to launch within the next few weeks to enable her to get feedback on what people feel about the home and make any appropriate changes. She views quality assurance and listening to people who use the service or others who are speaking on their behalf as very positive. She discussed the evolving of the service to suit the needs of individuals and the group who use it. The manager confirmed that all policies and procedures were available and up-to-date as described in the AQAA. The home has everything in place to ensure that regular and timely health and safety checks are completed, the home had a visit from the fire officer on the 12th October and he made no major requirements, those requirements and recommendations that were made are being attended to. All radiators are covered or are cool wall and windows have safety closures attached. Risk assessments are in place for individuals for their en-suite facilities and generic risk assessments are in place to ensure staff adhere to safe working practises (as advised by registered manager). The home do not lift or give physical assistance, to any of the people who live there, at this time. Water temperature controls were seen on all hot water outlets and the manager reported that any full immersion points were tested prior to people getting into them. The home has a locked COSHH cupboard, policies and procedures and data sheets. The manager very clear that she will only admit people who are able to fully use the home, that is, it would not be unlikely to be able to meet the needs of anyone who has physical disabilities because of various levels of floors on the ground floor and to the garden. The home has incident and accident forms but although these were detailed and recorded the events, they lacked detail of what the manager was going to do to minimise the risk of any recurrence. From other records it was clear that action had been taken but this was not cross referenced or noted on the accident/incident forms. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 5 5 To review whether the cost of care and who pays for it, should be included in the statement of terms and conditions within the service user guide. So that people have the opportunity to see how much their care is costing and who is paying the fees. 18/01/2010 2 9 12 To review the detail noted on individuals risk assessments relating to how the home minimise the risk and how this is related to the plans of care. So that people can be assured that everyone knows how to keep them as safe as possible whilst allowing them as many experiences and as much independence, as possible. 01/12/2009 Care Homes for Adults (18-65 years) Page 29 of 31 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 3 23 13 To develop a robust system for recording receipts and expenditures of peoples personal monies. So that people can be assured that their money is kept safe, spent appropriately and there is no possibility of financial abuse. 01/12/2009 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 23 To develop detailed behaviour guidelines, to include what, if any, physical interventions can be used to help people to control their behaviour. So that people know what will happen if certain behaviours occur and staff and other people who use the service are kept as safe as possible, from peoples physically aggressive behaviour. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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 31 of 31 - 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!