Care Home: Outlook House

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What the care home does well The relaxed, homely and welcoming atmosphere has evolved over many years and reflects the commitment and dedication of the Managing Director, the efforts of the management team and the close professional relationships that have developed between residents and the support staff. Staff are evidently valued and supported by the Care Manager and she is clearly held in high regard not only by members of staff but residents and their relatives as well. Effective systems are in place for the admission and ongoing care of residents. High quality individual care plans developed from comprehensive pre admission assessments ensure that the care and ongoing support needs of residents are met in a structured and consistent manner. Communication and consultation with residents` family members is effective with relatives having the opportunity to partake in individual assessment, care planning and reviewing processes. What has improved since the last inspection? There were no requirements or recommendations made following the previous inspection. What the care home could do better: There were no requirements made as a result of this inspection, however it is recommended that consideration be given to the current remote location of the Care Manager`s office. By her own admission, the manager feels slightly isolated in her office and could be perceived as being possibly `out of touch` with what is happening in the home. The staff rota should also be reviewed and amended to give details of the designatiion of individual members of staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Outlook House 74 Redhill Drive Brighton East Sussex BN1 5FL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nigel Thompson     Date: 2 7 1 1 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 28 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 28 Information about the care home Name of care home: Address: Outlook House 74 Redhill Drive Brighton East Sussex BN1 5FL 01273555252 01273558676 outlookhouse@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Outlook Foundation Name of registered manager (if applicable) Natasha Colburn Manager post vacant Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 15 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 disability - LD Date of last inspection Brief description of the care home Outlook House is registered for up to fifteen young adults between the age of eighteen and twenty-five years old who have a learning disability. The home offers a programme of further education and life and vocational skills over a maximum period of seven years. This is with the intention of residents developing sufficient skills and confidence to be able to live an independent life as is possible when Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 15 Brief description of the care home they leave. The Outlook Foundation, a registered charity, established the home in 1997. The Foundation has also developed properties into independent living flats for some residents to move into upon completion of the programme at Outlook House. In addition the foundation has opened a further residential unit in the Brighton area. Outlook House is a large detached Edwardian property located on the outskirts of Brighton. It is presented over four floors, basement, ground floor, first and second floors, with residents accommodation consisting of fourteen single bedrooms and one bed-sit. Communal space includes a large lounge and dining room, music room, conservatory, resident kitchen, home economics room, a learning centre and a large terraced rear garden. The home owns two mini buses and a car. The homes literatures states that the home is dedicated to quality living and training in preparation for independence, appropriate to individuals ability. The fees for residential care are currently £42,000 per annum. Additional costs include: Hairdressing; Chiropody; Toiletries and Magazines. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. This unannounced inspection took place over six hours, between 09.30 and 15.30, in November 2009. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was very good. On the day of the inspection there were fourteen residents living at the home. The inspection process involved observation of working practices, examination of the homes records and discussion with four residents, two residents relatives, two members of staff, the Registered Manager, the Training Manager and the Managing Director. Communal areas throughout the home were seen and all residents bedrooms Care Homes for Adults (18-65 years) Page 6 of 28 were viewed. The focus of the inspection was on the quality of life for people who live at the home. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are admitted only on the basis of a thorough needs assessment, undertaken by people competent to do so. Comprehensive and detailed information regarding the home ensures that prospective residents know that the service is able to meet their individual care and support needs. Evidence: Comprehensive and detailed information regarding the home has been produced and is made available to all prospective residents. The quality and accessibility of the Statement of Purpose and Residents Handbook is further enhanced by the effective use of photographs and diagrams. The Statement of Purpose provides an introduction and overview of Outlook House, including the organisational, management and staffing structure. It contains details of residents rights and responsibilities and information relating to the homes admission criteria, complaints procedure, facilities and activities available. The residents handbook is extremely well presented and comprehensive covering Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: most aspects of life in the home. It includes photographs of all the staff and answers many questions residents may have when moving to the home. These documents are reviewed periodically, they are accessible within the home and are made available to any interested parties. There is a clear admissions criteria in accordance with the homes aims and objectives. As well as being invited to visit the home to look around and meet with existing residents and staff, prospective residents have the opportunity to stop overnight or occasionally for a weekend stay before moving in. A thorough assessment process ensures that prospective residents are suitable to undertake the programme. This involves interviews and visits, which can range from an overnight stay to weeklong assessments. During this time an individual assessment programme is developed, which covers standard skills and current range of abilities. In addition to establishing whether the individuals care and support needs can be met within the home, the manager also stressed the importance of ensuring compatibility with existing residents. The Managing Director confirmed that new residents undergo a flexible trial period at the home, followed by a thorough placement review, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and support needs are able to be met. Care Homes for Adults (18-65 years) Page 11 of 28 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. Comprehensive, high quality care plans enable staff to meet the assessed support needs of residents in a structured and consistent manner. Systems for consultation and participation are effective. Residents are treated with respect and encouraged and enabled to make decisions about their day to day living. Evidence: High quality care plans, including a life skills plan, are in place for each resident. Individual plans include basic details and health care needs. Life skill plans identify individual goals and associated targets, including maintaining personal hygiene for people involved in independent cooking. As previously documented, the effective use of pictures, photographs and diagrams in the plans ensures that the assessment and ongoing care planning process is more clearly focused on and accessible to the individual resident. The manager confirmed that residents and, where appropriate, a relative or representative continue to be directly involved in annual care plan reviews. It was Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: evident from plans that were examined that reviews are appropriately recorded and plans, including risk assessments, are amended to reflect changing needs or circumstances. Information recorded includes who was present at the review and details of issues discussed and agreed goals. Individuals are clearly enabled and supported to make decisions about many aspects of their life and are made aware of and understand the reasons for specific action being taken. Residents continue, as much as is practicable to be enabled and supported to participate in all aspects of life in the home. They are encouraged to help with meal preparation, make their own hot and cold drinks, go shopping, attend to the laundry. Certain residents continue to play a significant part in the selection process for new staff. There was documentary evidence of detailed risk assessments and management plans to enable residents to undertake a wide range of activities in the home and in the community. All of those seen had been recently reviewed and updated as necessary. Independence and individuality continue to be encouraged and promoted within the home and are clearly reflected in the personalising of residents rooms, the choice of bedclothes and colour schemes and individual preferences for menus and activities. Care Homes for Adults (18-65 years) Page 13 of 28 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. The ethos of the homes promotes the right of residents to make choices in all aspects of their lives. Residents lead fulfilling lives and are supported and enabled to take part in a wide range of educational and recreational activities, reflecting their needs and interests and promoting their personal development. Residents benefit from nutritious, varied and balanced meals and they are supported to maintain positive relationships with family and friends. Evidence: Community participation remains a focus of life at Outlook House and residents are evidently encouraged and supported to attend local colleges and visit restaurants, cinemas, theatres, shops and other amenities in the area. Various college courses held at local further education centres include a wide range of topics from film studies to home economics. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The home is an approved satellite centre by Sussex Downs College, which enables courses to be held at the homes development centre, run by approved tutors. These in house courses are tailored towards the individual needs of residents and include literacy, numeracy, information techchnology and home economics. Some courses provided at the home lead to formal qualifications. The Training Manager confirmed that on days when residents do not attend college they may also undertake life skills training, which evidently promotes independence and includes cooking, laundry, money management and road skills and traffic awareness. In addition to this, the recreational and leisure interests of residents are identified and recorded in their individual care plan. They continue to be supported to access activities and facilities, including bowling and swimming, reflecting their individual needs, preferences and abilities. Activities at the weekend include going out for walks, football in the park or going out for a coffee. Staff confirmed that there is sufficient staff on duty to be able to undertake the range of individual leisure activities that residents pursue. The home has its own transport enabling residents to access a wider range of leisure amenities. The manager confirmed that, where appropriate, residents family links continue to be supported, with several residents going home at the weekend or during college holidays. Visiting to the home is unrestricted and residents relatives and friends are made welcome at any reasonable time. As part of the inspection process, two residents relatives were spoken with and both expressed a high level of satisfaction with the home and the care and support provided: He does so much and is so happy there and that is obviously very important to me. The staff are so kind and cant do enough to help. Im always made very welcome. He has done very well and come on so much since he has been at Outlook House. Its a great comfort to know that he is happy there and doing so well. Im desperate for him to stay within the Foundation if at all possible. The varied, balanced and nutritious menu reflects seasonal variations and is based on residents identified likes and preferences. An alternative to the main meal is always available. Care Homes for Adults (18-65 years) Page 15 of 28 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. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: As previously documented and in accordance with their personal care plan, residents are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, residents were observed being supported in a sensitive, professional and respectful manner by members of staff. Each resident continues to enjoy a varied and personalised daily programme, which involves considerable organisation to ensure that everyone receives the necessary support to meet their identified needs and aspirations. Comprehensive needs assessments and details of staff intervention and action to be taken, ensures a structured and consistent approach to individual care and support. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The manager confirmed that close and effective working relationships between residents and their key worker ensured that any subtle change in an individuals mood or behaviour can be identified and addressed at an early stage. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. Care plans provide clear guidance to staff on the health needs of residents. Records showed that there is regular input from health care professionals where needed. Individual care plans that were examined were found to contain detailed information, clearly developed through close consultation with and direct involvement of residents and their relatives. All residents are registered with local GPs and have access to other health care professionals, including psychologists and occupational therapists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The manager confirmed that all staff responsible for administering medication have received appropriate training and are individually assessed and authorised to do so. This was confirmed through discussions with staff and supported by training records examined. Care Homes for Adults (18-65 years) Page 17 of 28 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 open and inclusive atmosphere within the home enables residents, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. Residents are safeguarded from abuse through relevant staff training and robust policies and procedures. Evidence: A clear, concise and accessible complaints procedure has been developed for the benefit of residents, their relatives and other visitors to the home. All complaints are recorded appropriately and include actions taken and outcomes achieved. Close working relationships and effective communication and consultation between residents and staff provides adequate opportunities for any concerns to be raised and discussed before they become complaints. Residents, relatives and members of staff confirmed that they would have no hesitation in speaking to the manager or Managing Director, or making a complaint if necessary, and each person was confident that they would be listened to. There have evidently been two complaints received by the home since the last inspection. It was noted that both were being investigated and recorded appropriaetely. In another recent initiative, a Comments Box has been introduced. It is situated in a Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: communal area and enbles residents to make a note of any concerns that they might have. The Managing Director has a key to the box and ensures that any issues raised are followed up. The home has produced detailed policies and procedures, relating to safeguarding adults, including a whistle blowing policy. These documents have evidently been drawn up in accordance with the multi agency guidelines. The Managing Director confirmed that all care staff have also undertaken appropriate training regarding abuse awareness and procedures relating to Safeguarding Adults. This was supported through discussions with members of staff and the Training Manager, during the inspection, and evidenced through individual training records. Care Homes for Adults (18-65 years) Page 19 of 28 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 service is accessible, safe and clean and remains clearly suitable for its stated purpose. Residents benefit from pleasant accommodation that is comfortable, homely, well maintained and decorated to a satisfactory standard. Evidence: Outlook House is situated in a residential area on the outskirts of Brighton and within walking distance of local amenities and public transport. The well maintained decor, including some original 1930s features, and good quality furniture and furnishings continues to provide a comfortable, pleasant and very homely environment for residents. The domestic feel of the home is enhanced by examples of residents artwork displayed throughout. The manager confirmed that independence and individuality continue to be promoted within the home, as far as is practicable, and this is evident from the personalising of residents rooms, which clearly reflects individual tastes, preferences and interests. All rooms were found to be exceptionally well decorated and contain personal furniture and belongings, typically including a TV, DVD player and audio equipment. Bedroom doors are fitted with locks with the majority of residents having their own key and choosing to lock their rooms when it was not occupied. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The home provides spacious communal facilities including a lounge, dining room, music room, and conservatory. There is a large well maintained, terraced garden, which has several patios and seating areas, as well as a lawned area, flower beds and a green house. The learning centre is located in the grounds. This building is used in the main as a learning room but also as an additional meeting and leisure area. The home is not designated to offer services to people with physical disabilities and the stairs and other access arrangements would make it unsuitable for residents with permanent restricted mobility. Staff are very mindful of the restrictions the building poses and residents mobility forms part of the assessment criteria of the home. Therefore the use of individual aids and adaptations remains limited. Suitable laundry facilities are located on site with many residents being responsible for their own laundry. Residents are also largely responsible for cleaning their bedrooms and evidently this often forms part of their identified goals. Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Care Homes for Adults (18-65 years) Page 21 of 28 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. Residents are protected by the homes thorough recruitment policy and procedures and benefit from sufficient trained, competent and dedicated staff on duty at all times to meet their assessed care and support needs. Evidence: To ensure the protection of residents, the home continues to operate thorough and robust recruitment procedures. The Managing Director confirmed that residents are actively involved in the recruitment process including the interviewing of candidates. Individual recruitment files, relating to recently appointed staff, were exaimined and found to contain all relevant details and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. The Managing Director clearly recognises the importance of a skilled and competent workforce. All new staff receive comprehensive induction and foundation training. In addition to these programmes, appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and the Training Manager and Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: supported by training records examined: There is always plenty of training going on here. Ive had masses of training since I started. Training here is flexible and as well as reflecting organisational requirements, it is very much geared to an individuals identified training needs. Staffing levels within the home continue to reflect residentsassessed support needs, their individual programmes and college term times. In accordance with company policy, the manager confirmed that formal supervision is provided for all suppport staff on a regular basis. Staff and residents are assigned to a pod of which there are two. This makes clear the line management chain for each member of staff and the named staff for each resident. Each pod has an appointed care officer who undertakes the supervision and performance review of staff within their pod. They are in turn supervised and appraised by the care manager. Through direct observation and discussions, it is evident that staff feel confident to approach the manager and able to discuss any issues or concerns at anytime. Staff morale is reasonably high within the home and individual members of staff, spoken with during the inspection, clearly feel valued and supported by the manager. Shes a good manager and is always ready to listen or help if you need it. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the dedication, experience and close involvement of the Managing Director and the commitment of a skilled and motivated Care Manager, providing clear direction and support to project workers. The views and rights of residents underpin the ethos and development within the home. Evidence: The Registered (Care) Manager is evidently competent and experienced and holds the Registered Managers Award (RMA). From direct observation and through discussions with residents, relatives, and members of staff, it is evident that the manager is conscientious, motivated and approachable and helps to creates an open and inclusive atmosphere within the home. Natasha is wonderful. She has always been very kind and is so helpful at reviews. This place wouldnt be the same without her. The Managing Director, who is also the founder of the organisation, continues to Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: provide clear direction and strong leadership. The Head Office for the Foundation is situated on the ground floor at Outlook House. It is clearly a hub of activity, where the administration staff work and also where the Managing Director is based. However, of some concern is the location of the managers office, high up on the second floor. By her own admission, the manager feels slightly isolated and sometimes detached from whats happening downstairs. Although by no means spending all of her time in her office, an unhelpful consequence of this arrangement is that the manager could be perceived as being possibly out of touch with what is happening in the home. With the Managing Director on the premises for so much of the time, there is also the risk of roles and responsibilities becoming blurred and some confusion, for residents, staff and visitors, as to who is actually managing the home. The home continues to operate effective quality monitoring systems, including satisfaction questionnaires for residents, their relatives and other visitors to the home. A formal Quality Assurance audit has recently been completed by an external party on a range of policies and procedures. Regular residents meetings are held, the most recent being 24 November, where residents write their own agenda and run the meetings themselves, with the support of staff. There is also a structured programme of staff meetings, including meetings of the whole team and separate meetings for specifics roles. The manager confirmed that the health, safety and welfare of residents and staff remains of paramount importance within the home.The general manager has responsibility for the premises, and much good practice is evident in relation to the management of health and safety matters. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents. All accidents, incidents and injuries are recorded and reported, as required. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 37 It is recommended that consideration be given to the current remote location of the Care Managers office. The staff rota should also be reviewed and amended to give details of the designatiion of individual members of staff. Care Homes for Adults (18-65 years) Page 27 of 28 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). 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