Care Home: Oswald House

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What the care home does well People who move to the home have their needs assessed in detail by social or healthcare workers and the acting manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated care and lifestyle needs that require well-managed and agreed ways of supporting them. Staff help people to have interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. The staff work well as a team. Staff are trained so that they have the necessary skills to support the care and lifestyle needs of people living at the home and there are sufficient staff available so that these needs can always be met. The manager and staff have the experience and training to run the home effectively so that the in the best interests of the people who live there can be met. And people are asked about the way they wish to live so they have control over the way the home is run and are listened to if they have concerns. The manager has strong principles about how they support peoples` rights and empower them as valued citizens. She is enthusiastic about their work and gives good quality, person centered care and support. Care is provided to people with a different needs, varied ages, expectations and backgrounds. Both care practice and staff recruitment practices are governed by equal opportunity principles. Peoples` bedrooms are private and they can make them their own with furniture and possessions if they want to. The home is warm, and comfortable with a number of different areas for people to use during the day. What has improved since the last inspection? There has been improvements made to the decoration and facilities of the home which makes it a more comfortable place for people to live. The manager and staff have consulted with people who live at the home about how they want to live their lives and how they would like to be supported. This has been carried out in ways that have empowered people to be able to make up their own minds. What the care home could do better: Although there are no areas which fall below the National Minimum Standards, the manager should continue to improve medication administration to make it easier for staff to keep accurate records and improvements in the ways that some areas of care plans are recorded would show the good practices that staff are presently following at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Oswald House 31/33 St Oswalds Walk Newton Aycliffe Durham DL5 4BQ     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: Steve Tuck     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Oswald House 31/33 St Oswalds Walk Newton Aycliffe Durham DL5 4BQ 01325300296 01325314621 mail@oswaldhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Ian Thomas Patterson care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Oswald House is a care home which provides accommodation and personal care for eight people who have a learning disability The home is in a well-established residential area overlooking a park and a short walk from local shops and a bus or car ride from the town Centre. The house blends in with its neighbours, having a small garden to the front and rear yard. The facilities are those of a large family house and the furnishings are comfortable and domestic. Although the home has been fitted with adaptations to help people who difficulty getting around, the house is not designed to meet the needs of those people who have significant mobility problems Each person has a separate bedroom and there is a large shared lounge, kitchen and dining area. There is access to local transport at the end of the street and there are car parking spaces nearby. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 8 Brief description of the care home The home is owned and managed by Ian Patterson and is one of four other homes in the surrounding area. The weekly fees for living at this home is #421.50 The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people?s circumstances, further details can be found in the homes Service User Guide. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at Information we have received since the last Key Inspection. How the service dealt with any complaints and concerns since then. Any changes to how the home is run. The providers view of how well they care for people. We asked them to examine their own service and write to us with the results We sent surveys to people who use the home, people who arrange for residents to live there, those who visit the home to support people like doctors and therapists and the staff who work in the home, to ask what they think about services there. The Visit An unannounced visit was made on 30th June 2009. During the visit we Talked with the people who use the service the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the Care Homes for Adults (18-65 years) Page 6 of 29 people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Although there are no areas which fall below the National Minimum Standards, the manager should continue to improve medication administration to make it easier for staff to keep accurate records and improvements in the ways that some areas of care plans are recorded would show the good practices that staff are presently following at the home. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each persons needs are assessed before they move in which helps to make sure that these can be met at the home and inappropriate admissions are avoided. Evidence: The home has written information called the Service Users Guide which gives all of the important details that people need to know about what it is like to live there. This includes information about how to make a complaint and the most recent Inspection report. The Service User Guide for this home has been drawn up in ways which help people to understand what the information means and staff also help to explain it. This includes the amount of money the home presently charges so that people know how much their care costs. Each persons needs are assessed before they move to the home by a team of workers such a social worker, a community nurse, a psychologist, as well as the manager. This is to make sure that the home is suitable for meeting the needs of people who are going to live there. The manager has shown that he has a leading role to make sure that the home is able to successfully support people before they move there and has Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: demonstrated these skills. Records show that the manager, deputy and staff have found out about the cultural and lifestyle needs of people who wish to move to the home to make sure that these can be met. All peoples assessments information is detailed and has a lot of information in it which helps staff to plan and write down the ways that they are going to support them. This is important where people have complicated needs and large social networks which require a lot of insight and well-organised support. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has an individual plan of care, which sets out their preferences and how their assessed needs will be met. These plans describe the measures which staff use so that they can consistently meet peoples needs. Evidence: All people living at the home have a plan of care, which gives a description of how their physical, emotional and lifestyle needs are to be met. Some people at this home have needs which require the staff to respond to them in particular ways for example to give them support to feel confident and help them to manage their anxieties. People get support from staff which is individual and tailored to their specific needs so that they can live as valued citizens within their community. Care is carried out and arranged so that individuals are at the centre of a network of support and tailored so that people have individual lifestyles. Staff have an excellent understanding of peoples background, needs and preferences and they use this support people effectively. They also work closely with other community based health and social support staff to make Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: sure that peoples care is properly co-ordinated. The way that care plans are written down does show that peoples needs are clearly identified. Care plans are well organised, contain all of the relevant information that staff will need, in enough detail that helps them to support people consistently. The way that care plans are written down does show that peoples needs are clearly identified and the way that they are to be supported is written down in enough detail. There are also records to show where reviews have taken place to see if their needs have changed. There are examples of where a great deal of thought consideration and care has gone into this planning. For example how people whose behaviour may lead them to challenge staff or other people living at the home and how peoples relationships have been are supported. However care plans do not yet show all of the areas of good practice which are taking place in the home. For example where someone has a particular need, staff were all seen to support them in the same ways, using the same methods and language. Care plans demonstrate that people living at the home are supported by staff in ways that helps them to feel in control and confident and this work is clearly and carefully recorded. Care plans have developed since the last inspection and the manager is planning a further training programme for the staff team so that they can further develop the way that the home records their best practice. People living at the home are treated with respect by staff who know them well. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. Staff meet together at the start of each shift where they talk to each other about peoples needs so that they remain up to date, work well as a team and remain consistent. One person living at the home said,I like living here - staff listen to what i say. All people living at the home have access to someone outside of the home who can speak on their behalf and help to make decisions in their best interests. One of this homes strengths is how the manager and staff help people to be as independent as they can and to take measured risks if they wish. The manager and staff take actions to support people and reduce the risks which they take so that there is a balance between promoting peoples independence and rights, and making sure they are safe. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported by the staff to make choices about their lifestyle so that they can lead fulfilling and interesting lives and staff help people stay in touch with their circle of family and friends so that they can keep links with people outside of the home. Evidence: People who live at this home have active lifestyles, with their own routines and activities many of which occur outside of the home. The staff are very knowledgable and skilled at helping people to choose activities that they would like to take part in or to try out and to find out about things that people might be interested in and arrange them. Staff also encourage people to make decisions, and help them to organise the different opportunities they have each week. Examples of opportunities include gym,shopping, allotment, drop in centre, football matches, horse riding, dog walking, motor sport / go-karting, bowling, Onnovations (a social activities centre). People also Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: have the opportunity to continue their adult education including the Options programme and to gain work experience or voluntary or paid employment. One person who lives at the home said, I will be back out again tomorrow - Im going to work. Staff at the home were very busy planning how individual support for people is to take place so that all of their choices and event commitments could be met. Some people who live at thew home have had the opportunity to take part in activities and become more independent. Staff and the manager have supported them by making sure that the risks that people take have been reduced and where possible safeguards are put in place. Staff are good at finding out about opportunities or activities which are taking place in the local and wider community and making sure that support and transport is available for those people who want to take part. For example there were photographs of the people horse riding, spectating at motorsport events, celebrations and visits to interesting places. At the time of the inspection a major social event was being planned involving all of the people who live at the home and the staff and manager. And people were talking about what sort of holiday they would like this year. Staff help people to keep in touch with friends and relatives and some people visit each others homes. Some people have taken college courses where they have an interest or skill and several certificates are displayed which show their success and commitment. Several choices of meals are offered at all times and people help to plan their meals. Attempts to offer a healthy balanced diet whilst still responding to peoples choices were noted. Although there is a menu, people living at the home are able to choose different meals depending on their preferences and the manager makes sure that there is sufficient stock of favourite foods. Mealtimes are pleasant sociable events at the home where people meet and share each others company. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are identified and arrangements are in place to help make sure that they can have a healthy lifestyle. Evidence: Records of peoples healthcare needs are kept by staff in their care plans. These show that staff look out for changes in their physical or emotional state which may need the involvement of specialist healthcare workers from outside the home. This has promoted joint working with healthcare staff and helped home staff make sure that people get the healthcare support that they are entitles to and also to put in place approaches for people whose needs are difficult to meet. People are registered with healthcare facilities for example their general practitioner or dentist and are supported to attend appointments if they wish. Any personal care is carried out in private with staff encouraging people to be discrete where this is required. Due to their levels of need, some people living at the home are not able to administer their own medicines, and designated staff therefore assist in this area. Staff at the Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: home have also worked with healthcare staff so that people at the home are supported to need less prescribed medication than they previously did. A number of people have also been able to safely take responsibility for their own medication which fits in better with their lifestyle. The home has weighed up the risks and taken steps to minimise the likelihood of harm. Overall Medication is securely stored and there are systems in place which should help to minimise mistakes. Medication is checked by the deputy managers to make sure that the home is supporting people sucessfully. However there were two errors where staff had miscounted the number of medication in stock and one other example where it was not clear if medication had been administered. The manager carried out an investigation which showed that everyone had been given their medication at the correct time and days, and that the amount of medication kept at the home was correct. The manager has since changed the way that medication administration is recorded to make it easier for staff to use and by reducing the amount of stock held at the home. The manager confirmed that staff at the home have been trained to help them to be able to administer medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. Evidence: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. By watching staffs day-to-day work we could see that they ask for the views of people living at the home all the time and help them to make real choices and decisions. People who live at this home assert their views and preferences and were clearly empowered to say what they thought. One person who lives at the home said, I would talk to staff, care manager, inspector if I was not happy. Although no one had decided to use the complaints procedure to resolve their grievances in the past 12 months. The manager showed that she knew how to record and take forward complaints if this was needed. Since the last inspection there have been no instances where abuse was suspected at the. The homes adult protection procedure is robust and complies with the Public Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Disclosure Act and the Department of Health Guidance. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed. All staff spoken to are knowledgeable of these practices and have had training. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The house is homely, well equipped and clean and provides people who live there with a comfortable environment in which to live. Evidence: People who live at the home are encouraged to keep their own rooms tidy and they are helped by staff when this is needed. The home is kept clean by staff who take effective steps make sure that it is well kept, comfortable and an attractive place to live. The house is in a quiet street of similar properties and has had adaptations made so that it is suitable for its present use. The home fits in well with those around it which helps people who live there to be accepted citizens within their community. The home has been designed so that the people who live there can have safe access to the house and garden / yard without restricting their rights, freedoms or independence. This includes a stair lift so that people who live there can have safe access to the house and garden / yard without restricting their rights, freedoms or ndependence. The bedrooms are pleasant attractive areas, which have a range of furniture, and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: fittings which people have chosen and are comfortable and useful to them. All of the people living at the home have decorated their rooms with their items, photographs and keepsakes and some have bought their own furniture and soft furnishings. And people are able to lock their bedroom doors so that they can have privacy. Two people have chosen to share a bedroom; everyone else has their own single room. The home is inspected by the Fire Prevention Service and overseen the local authority to make sure that risks from an accidental fire are lessened and a safe and healthy environment is promoted for the people who live and work there. There is evidence that repairs and maintenance has been carried out and the deputy manager has completed a refurbishment programme which has improved areas which were looking dated. The furniture and soft furnishings in the dining area are particularly attractive with leather seats, oak furniture and designer wallpaper. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff at the home to support the people who live there. And they have the skills, training and support from the managers so that they can meet the needs of people living at the home. Evidence: Information from the deputy manager shows that staff have received training relevant to their job roles and the specific needs of people living at the home. A training programme is in place which encourages staff to develop skills remain and motivated by the work they do and helps to improve the quality of the service. This covers National Vocational Qualifications (NVQ) as well as specialist courses which address the needs of the people who live at the home. At present over 75 of care staff have NVQ Level 2 or above and workers who have undertaken NVQ Level 2 training are being encouraged to continue their training to Level 3. New staff are given extra training which links with national training organisation standards so that they have sufficient skills to support people and work effectively with other team members. Some people living at the home have complex support needs and additional staff are available so that support can be successful and safe. Care workers are well organised Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: with shift patterns which reflect the demands of people living at the home and records show that sufficient staff have been working there. This work pattern reflects the times of the day when people need the most support, for example to carry out their daytime activities. Staff demonstrate that they have an in depth knowledge of peoples needs and the strategies and approaches they use to support them. By watching what staff do we could see that they are competent in their role as care practitioners and this is reflected in the good standard of practice when they support and interact with people living at the home. Staff have regular contact with the managers and senior staff who work alongside them on a day-to-day basis. The deputy manager has records which show that regular supervision takes place where staffs performance and the work they do with individuals is thoroughly discussed. Morale is good at the home and staff are motivated about the work they do. There is a good atmosphere and staff appear to enjoy their work. One staff said, Staff have the residents best interests at heart and they come first at all times. Another said, The home is ran to extreemly high standards. The deputy manager confirmed that all new staff have had checks carried out before starting work to make sure that they are suitable to work with vulnerable people and records are kept to verify this. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The managers make sure that people who live there are supported properly and give leadership and direction to staff so that the quality of the service they give is improved. Evidence: The manager, who is also the owner, is a qualified nurse. He is an NVQ assessor and has attended a wide range of training including clinical supervision, first aid, the Mental Capacity Act, food hygiene, dementia care and safeguarding adults. One deputy manager is also a qualified nurse and bothe deputies have completed the Registered Managers Award. Both manager and deputys have extensive experience and skills in supporting the needs of people with learning disabilities in a variety of hospital and community settings before working at this home. The manager and deputys have shown their capacity to organise the service on a day to day basis. This reassures people living at the home and their relatives that the service can continue to be provided in their best interests. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: One staff said, The manager is always there to support the staff when this is needed. People living at the home are empowered to give their views about all aspects of the support they get from staff. There are meetings held at the home and also other informal occasions (most evenings) where the manager and staff are able to check that people are satisfied with the service. The managers also collects the views of peoples families and friends, social work and healthcare staff who visit the home so that they can check to see if the service is meeting the needs and expectations of all parties. This helps the homes managers to monitor progress and to make improvements. For example the manager has recently consulted with everyone about the way that the home is run to see if they would prefer to make changes. This was a very detailed piece of work which was carried out carefully and fairly so that peoples views were properly represented and they were empowered to make decisions. Staff at the home help people who live there to manage their money. Detailed records are kept of peoples day-to-day finances and where staff have supported them to make purchases. Information is also available to people who live at the home and others who support them which shows the fees they have paid for their care. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living there and the staff who support them. There have been inspections by the Fire Prevention Authority and local authority environmental health officers to make sure that the home is safe. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The manager should review the way that care planning is recorded so that it includes staffs best practices by following person centered planning guidelines and recording tools. And staff should complete the planned training in these methods. The registered manager should review the way that medication is administered so that it is easier for staff to keep accurate records and mistakes to records are minimised. 2 20 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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