Care Home: Northdown Residential Home

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What the care home does well Each person has a named key worker who knows them well and they work more closely with. Each person has a person centred plan. People`s current needs and goals have been identified and recorded using a person centred assessment tool. Individual plans are being further developed with people so staff know what support people want. People said they have a good lifestyle. Some people go to watch live footballmatches at the local pub. Some people have support to go to college and one person has a job. Each person has a health action plan and is helped to understand healthy living. There is a smaller separate kitchen that people can use to cook and prepare drinks. The people living in the home and their families are supported very well to keep in touch with each other. People can choose from a cordless telephone or a pay phone to make private calls. Some people have their own mobile telephone. People can arrange their bedrooms the way they like. What has improved since the last inspection? The manager has continued to develop the person centred plans and risk assessments. Each person has a talk time book and they have one to one meetings and house meetings to express their wishes. People said they feel listened to. There are guidelines for people who need support to communicate and to supportpeople`s behaviour. People are supported better with their physical and mental health needs. Staff training in health and safety and all the other training that is needed for the law has been provided. The manager and operations manager keep a check on what is happening in the home and continuously develop plans to make sure it is getting better. What the care home could do better: Continue with the person centred planning to make sure that all the people living in the home are able to participate with it as much as possible. Continue developing communication support depending on assessment for example develop a communication passport and also make sure all staff have updated Makaton training and use it. Give consideration to making the medication administration more person centred by making it individual and using the cabinets that have been fitted. The manager said she would look into this.For people to have a key to the front door instead of the number code key pads. The manager said thepads were beingremoved. Key inspection report Care homes for adults (18-65 years) Name: Address: Northdown Residential Home Canterbury Road Molash Canterbury Kent CT4 8EX 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: Julie Sumner Date: 2 5 1 1 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 30 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2010) 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 30 Information about the care home Name of care home: Address: Northdown Residential Home Canterbury Road Molash Canterbury Kent CT4 8EX 01233740882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): European Lifestyles (FL) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 15 0 learning disability Additional conditions: Date of last inspection 0 5 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Northdown is a large home in its own spacious gardens. Up to 14 people with learning disabilities can live here. At present 5 people with learning disabilities live here. The home is in a village called Molash which is near Ashford and Canterbury. There is a cottage in the grounds that is also registered and can be used for more independent living. There is no one living there at present. There are 12 bedrooms in the main home and 2 in the cottage. There are different rooms in the house for different activities including a lounge, dining room and arts and crafts room. There is a small kitchen next to the main kitchen for people to cook in. It costs £1000 to £2200 per week to live there. You can get CQC reports and information about the home from the providers. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home The manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The AQAA was clearly written giving us a good range of information. We talked to the manager about including more detail in the AQAA next time. We sent 6 surveys out to the people living in the home and 9 to the different people who are involved with them. We received 10 surveys back which was a good response. We visited the home without telling anyone we were coming so that we could see what they do on a usual day. We were in the home from 10.45 in the morning to around 4.30 in the afternoon. An expert by experience and their personal assistant also visited the home to assist us with the inspection visit and they were in the home from around 11.30 to just before 3 oclock. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Care Homes for Adults (18-65 years) Page 7 of 30 We talked to all the people living in the home. We talked to the manager and the staff who were working that day. We had a look around in the house and outside. We looked at plans and records for supporting the people living in the home. We also looked at staff records like what checks have been made before they started work and training they have been given. We looked at some of the policies and procedures. What the care home does well Each person has a named key worker who knows them well and they work more closely with. Each person has a person centred plan. Peoples current needs and goals have been identified and recorded using a person centred assessment tool. Individual plans are being further developed with people so staff know what support people want. People said they have a good lifestyle. Some people go to watch live football Care Homes for Adults (18-65 years) Page 8 of 30 matches at the local pub. Some people have support to go to college and one person has a job. Each person has a health action plan and is helped to understand healthy living. There is a smaller separate kitchen that people can use to cook and prepare drinks. The people living in the home and their families are supported very well to keep in touch with each other. People can choose from a cordless telephone or a pay phone to make private calls. Some people have their own mobile telephone. People can arrange their bedrooms the way they like. What has got better from the last inspection The manager has continued to develop the person centred plans and risk assessments. Each person has a talk time book and they have one to one meetings and house meetings to express their wishes. People said they feel listened to. There are guidelines for people who need support to communicate and to support Care Homes for Adults (18-65 years) Page 9 of 30 peoples behaviour. People are supported better with their physical and mental health needs. Staff training in health and safety and all the other training that is needed for the law has been provided. The manager and operations manager keep a check on what is happening in the home and continuously develop plans to make sure it is getting better. What the care home could do better Continue with the person centred planning to make sure that all the people living in the home are able to participate with it as much as possible. Continue developing communication support depending on assessment for example develop a communication passport and also make sure all staff have updated Makaton training and use it. Give consideration to making the medication administration more person centred by making it individual and using the cabinets that have been fitted. The manager said she would look into this. For people to have a key to the front door instead of the number code key pads. The manager said thepads were being Care Homes for Adults (18-65 years) Page 10 of 30 removed. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Julie Sumner The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 11 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good information for people who might want to move in. Everyone has an assessment before moving in and then when they are settling in to make sure their needs can be met. Evidence: The manager showed us the updated statement of purpose. The current service is changing so the statement of purpose will be changed along with this. The manager also has a computer programme so that pictures and symbols can be added to any of the documents. No one has moved in recently. One person has moved out. The people living in the home said that they really like living here. We looked at two assessments that are a part of the person centred planning and could see that the staff team monitor the needs of the people living in the home. Care Homes for Adults (18-65 years) Page 13 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service involves individuals in the planning of care which affects their lifestyle and quality of life. Individuals are encouraged to make their own decisions and choices. Evidence: Each person has a person centred plan which includes assessments for different areas of need. Then there are guidelines for staff to support the person to meet their needs in the way they prefer. The plans have goals that the person wants to achieve, information about who is important to them and a timetable of planned activities. There are also reviews and reports from other professionals who are supporting them. Each day the staff write in the plan to say what the person has done. People are helped to make decisions about their lives by having meetings with their key worker. They discuss what is important and any developments of changes to their plan. The key worker records the meeting discussions in the persons individual notebook. The people we spoke to in the home said they like the staff and the manager. People also told the expert by experience that they are happy here. The expert by experiences report said Two of them said they didnt want to live on their own. One said I cant do it Ive tried it Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: before, Im 70 years old now. The staff support people who cannot speak very much with their communication. One person can use Makaton signs, this is where people use learnt hand gestures to support what they are trying to say. We saw the manager use the signs when she spoke to the person but it did not look like the signs were used all the time in the home. Not all the staff have attended Makaton training. We discussed making the house a signing house so that everyone uses the signs routinely. This way the person may develop their sign language further and also it becomes a more natural process for everyone. We also discussed developing a communication passport, with the manager, so that people who do not know the person can look at it and understand the signs the person uses. This will help other people have a conversation with them and may assist developing their social life further. The manager said she would discuss this at a staff meeting and include this in the homes development plan. There are risk assessments in the person centred plan so that people can do different things and the staff have planned how to guide them to minimise unnecessary risk to safety. We looked at the risk assessments in the two person centred plans. There were risk assessments for various activities in and out of the home in a checklist format. The guidelines for staff to support the person were in the person centred plan. We saw that they were clear and that people are able to carry out the activities that they want to. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people in the home lead the lifestyles they like and staff are developing the activities further and to develop independent living skills. People are supported to keep in touch with their families. Good quality meals are served. Evidence: We talked to people when we first arrived. Some of the people living in the home were getting ready to go out. The expert by experience and his assistant talked to the people who stayed in about their lifestyle and what they have been doing recently. Each person has a timetable of activities in their person centred plan. The activities are organised around each persons interests and needs. One person is attending sessions at different day centres to continue to develop his independence skills. Another person goes for regular walks and attends the gym regularly. One of the people showed us the activities that were written up on the notice board. Staff write what each person has done in the daily records. The manager said they are focusing on developing peoples independence skills and encouraging them to try new experiences. We saw that people participate in the day to day running of the home and there is a rota for the jobs that need doing like Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: washing up and hoovering. People said they were out every day. Those that were not going out during the day said they were going out in the evening to the pub which they enjoy. They told us about the lovely walks in the surrounding area, the woods and the wild animals they see. One person said to the expert by experience, he goes on walks to the pub, and to RAF museums. He also said you are lucky you caught me in. I am usually out. I usually go walking in the forest theres deer there. Each person is supported to maintain contact with their family and friends. The names of people who are important to them are written in their support plan. Arrangements are made to help family members visit the home and also to take people to visit their families at their home. Visitors can come to the home at any reasonable time and do not have to give notice but may need to make sure that the person is in. People are also supported to stay in touch over the telephone. There are two cordless telephones and a pay phone that people can use for private calls. Some people also have their own mobile phone. One person said he rings his sister every day and is going to spend Christmas with her which he is really looking forward to. At present there is a front door key pad. This is going to be removed as the people who needed this restriction are no longer living in the home. We talked with the manager who said that the people living in the home can have their own front door key when the lock is changed. Parts of the home are locked when no one is in them but we saw that people were not restricted in the parts of the home they wanted to be in and were able to move from room to room freely. They went into the kitchen when they wanted to and were supported to make drinks and snacks when they wanted to. People have keys to their bedrooms and can lock them if they want to when they are out. The manager said she keeps the level of restriction under review. It is likely that some of the other areas that are locked do not need to be now and the manager said this would be taken into consideration at her next audit. The expert by experience and his assistant had lunch with the people living in the home. People said they like the food. They have their main meal in the evening usually. People take it in turns to participate in meal preparation and some people like cooking better than others. There is a menu which is flexible due to the small number of people. People also eat out regularly. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is responsive to the varied and individual needs and preferences of the people living in the home. Evidence: Each person has goals and guidelines written in their person centred plan that explain what is important to them and how they would like to be supported. This includes support with their personal care and their general day to day routine. The staff find out what people want by having one-to-one meetings with them. Each person also has a health action plan. This is kept in a folder with other information that is related to their health care, including specialist advice and letters. We looked at two health action plans and could see that people are supported to attend routine health check appointments like visiting the dentist, having their eyes tested and attending the GP for an annual health check. When a person needs support with their health and to understand what they need to do this is included in their person centred plan. We also saw that when someone is referred to a specialist that the appointments are followed up and the advice is incorporated into their person centred plan. People are being supported with healthy eating and regular exercise. If they have a medical condition that needs support, like diabetes, the staff make sure that they are able to access the services and keep themselves well. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Medication is administered using a monitored dosage system and also directly from the packets. We saw that these are stored securely and all medication is clearly labelled. Each person has their own medicine cabinet although these are not currently being used. We discussed with the manager about making medication administration individualised as part of their personal and health care day to day support. The manager said she would discuss this with the people living in the home and at the next staff meeting. We looked at the medication administration record sheets which were completed accurately. There is information for staff about the different medication prescribed and a list with what it is for in each persons health action plan. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are supported to voice their concerns and the procedures in the home protect people from abuse. Evidence: There is a complaints procedure that has pictures and symbols and is designed to make it easier for the people living in the home to understand. Each person has a key worker who sits down and has a one-to-one meeting with them each month to talk about what is going well for them and if there are any problems. The key worker writes in the persons book. If a change is needed to how they are supported, then this is included in the person centred plan. There is a complaints log that the manager writes in if there have been any complaints. There have been no complaints since the last inspection visit. The people living in the home said they feel safe here. People are supported by the home to manage their money. Their personal allowance is put into their own bank account and they are able to access it themselves. Each person has their money kept individually and securely. Any money that the person has been supported to spend when they are out is receipted and recorded with the staff and persons signature. When the expert by experience talked to the people living in the home about their money they said the staff look after their money. The manager is supporting the development of each persons independence through the person centred planning and understanding money is one of the areas that is included. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: All the staff have attended safeguarding training. We talked to one of the staff in the afternoon about safeguarding and they were confident about what to do should there be an incident. There have been no safeguarding alerts since the last inspection visit. We talked to the manager about how they support people who may display challenging or destructive behaviour. She explained that this has reduced as people have moved out of the home. We saw guidelines for staff in the person centred plans we looked at. These described what people may do and how to respond. Other guidelines were in the plan to prevent people displaying the behaviour if it is unhelpful or distressful for them. Behaviour is monitored by various charts so that the staff team can see if what they are doing is helping or not. People are referred to specialists like the community learning disability team if they need support. A psychotherapist visits the home every week. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is basically comfortable. It is clean, safe and spacious. Evidence: Northdown is a large detached house situated in a rural setting with large gardens another cottage in the grounds and a front parking area along from the drive. It is spacious inside and is designed to accommodate fourteen people. The people living in the home said it is beautiful and a lovely place to live in. They did say that it can be remote and they rely on cars to get out and about. There is a bus stop but it is quite a long way up the road. One of the people living in the home showed the expert by experience and his assistant around the home and the manager showed us around parts of the home. The home looked quite empty with only five people currently living there. There have been some attempts to make it more homely but overall many areas still need repairing and decorating and there are limited pictures and ornaments. The expert by experience said that they were shown two bedrooms which had been personalised and the people living there said they liked them. The manager said that they are going to continue to improve the look of the home and they are going to buy new sofas after Christmas. The gardens are large and well maintained. People said they like to sit outside for meals Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: in the warmer weather. There is a door from the dining room out to the garden so that people can get fresh air when they want to. There is a number pad fitted to the inside of the front door so only staff can open it from the inside. This is used to restrict access to the front of the property to keep people safe on the nearby road. The manager said this is no longer necessary for the people who currently live in the house and these will be removed. When this is done people can have their own front door key. The home was generally clean during the visit. The laundry room is kept locked so access is restricted unless people have staff with them. We saw people going in and out of the room doing their laundry. There is a separate smoking room for people to use. There is an extractor to the outside to help with the air flow. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have confidence in the staff who care for them. Evidence: The company has a thorough recruitment process to make sure the people applying for the job are who they say they are and will work in the right manner. The company asks for identification like a passport and 2 references from people who know the person including their previous employer. They request a Criminal records bureau (CRB) check and protection of vulnerable adults list (POVA) check to make sure they have not done anything in the past that will indicate that they are unsuitable or cannot be trusted. Staff work for a trial period of time in the company while everyone gets to know each other and the member of staff decides whether this is the right job for them. We looked at 2 staff files to check the recruitment information. All required information was in place. There have been no new staff but there are plans in place for the people who live in the home to participate with any future interviews. We talked to the manager about the staffing level and looked at the duty rota. We could see that there were enough staff to support the individually assessed needs of the people living in the home. Two people went out during the day and there were enough staff so that everyone could do different things. We talked about staff training with the manager and looked at the training matrix and Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: some certificates. The manager explained that since she has been in the home she has concentrated on making sure the staff have attended training to comply with the law like health and safety training. We saw that all the staff have attended this training with some odd courses that were missed now being booked. Training is being organised for their specific job roles and to support the individual needs of the people living in the home. Some of the staff team have already attended training in autism awareness, the mental capacity act, epilepsy and Makaton (signing for communication support). The manager is organising further training so that all the staff have the necessary training to meet the needs of the people living in the home. The staff team are also going to have training in the Deprivation of Liberty safeguards. The manager said she will provide further Makaton training and support for the staff so that they can support one of the people living in the home better. There is a national vocational qualification (NVQ) training programme in the company that the staff access. Four of the staff have achieved this to level 2 and 2 staff have achieved level 3. The manager holds one-to-one meetings with the staff and each person will have an annual appraisal. Staff said these meetings and the appraisal give them the opportunity to discuss any issues and to consider their knowledge and skill development which they find useful. Team meetings are also held every other month and more frequently if there are issues to discuss. We looked at the minutes of the last two meetings and could see that a variety of things are discussed to continue the improvement and development of the home. The staff said there is good communication in the team. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager gives the staff and people living in the home confidence and has a clear idea of the improvements needed. Evidence: The home has a temporary manager who has been managing the home for some time (and was in post at the last inspection visit). The manager has maintained the improvements made and has continued to develop the home. Person centred planning is underway and each person living in the home has opportunities to express themselves in one to one meetings and house meetings. The staff have attended training and this is ongoing so that they have the updated knowledge of health and safety in their work and meeting the needs of the people in the home. We made it a requirement at the last inspection visit that the home have a registered manager but there have been problems with the home being able to do this. The current manager has decided not to become the registered manager. We talked to the operations manager over the telephone to find out what is happening about the home having a registered manager. The operations manager said that she is going to make an application for registration herself. Since then, the manager said that the operations Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: manager is interviewing potential new managers this month. As improvements to the home have continued we will remove the requirement from the report and expect that the home will have a registered manager in post within the next few months. The managers said that they will keep us informed. We talked to the manager about quality monitoring in the home. The manager said that surveys are given to the people living in the home and are sent out to people who are involved in the service provided. New surveys have been designed with symbols and pictures which will be given out next time. The operations manager visits the home each month and checks records, talks to the people living in the home and staff and makes a report. The manager has given staff responsibility for various tasks like health and safety. This gives staff a role and means they are part of the running of the service. The manager carries out monthly audits which feed into the companys overall audit. An audit by the company was carried out and an action plan for improvement produced. The service has continued to send us updates to the action plan so that we can see what is happening in the home. People have the opportunity to express their views at house meetings that are held monthly and at their individual meetings with their key worker. The people we spoke to said that the staff listened to them. We looked at the minutes of the last 2 meetings and could see that a variety of things are discussed and that each person is encouraged to participate although they do not have to. The AQAA shows that health and safety checks of equipment and premises are carried out. The hot water temperatures in the bathrooms are thermostatically controlled and staff check the temperatures weekly and prior to people having a bath. The manager has made sure that the maintenance and checks to fire equipment have been carried out by companies employed to do so. This is also part of the managers audit of the home. The instructions displayed in the hallway about what to do in the event of fire have been updated into large text and have symbols and pictures to aid understanding. People we spoke to said they know what to do. The staff carry out fire drills every three months. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) 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. 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