Care Home: Paradise Lodge

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale
• Beau Sejour

What the care home does well Paradise Lodge provides people with good information about the home.The support plans are person centered and show staff exactly what support people want.The home makes sure that people get the right health care.People are looked after by staffs that have good training. What has improved since the last inspection? Information is now in pictures as well as words to help people to understand what the words mean.Paradise Lodge has new flooring, a new bathroom suite, a new boiler and a new fridge/freezer.There is a new office being made upstairs to allow staff to do the paperwork in private.Some rooms have been redecorated and the outside of the home has been painted and has new guttering. What the care home could do better: Two staff should sign the medication sheets when they are hand written to make sure filled in correctly. Staff should be supervised from time to time when they give out medication to make sure they are doing it right.The staff application form should ask for a full employment history so that the home can check that they are safe to work there. All staff should have papers on their file to confirm that they are fit enough to work at the home.All staff working at the home should have at least six supervision sessions each year. Key inspection report Care homes for adults (18-65 years) Name: Address: Paradise Lodge 28 Paradise Road Writtle Chelmsford Essex CM1 3HP 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: Pauline Marshall Date: 0 5 0 1 2 0 1 0 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 37 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 37 Information about the care home Name of care home: Address: Paradise Lodge 28 Paradise Road Writtle Chelmsford Essex CM1 3HP 01245422901 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): paradiselodge@hotmail.co.uk Paradise Lodge Care Home Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Paradise Lodge opened in 1995 and provides a home for five people who have learning disabilities. People may also have a physical disability and/or minor mental health problems. Paradise Lodge is a detached dormer bungalow that is in a nice road and is close to the centre of Writtle. Care Homes for Adults (18-65 years) Page 5 of 37 Everyone has their own room; this means that they do not have to share a room. There is a good sized lounge and a conservatory for people to use and there is a dining area is in the large kitchen. The conservatory leads out into the garden, which is well maintained and has a seating area. Care Homes for Adults (18-65 years) Page 6 of 37 There is enough space for several cars at the front of the home and there is also on street parking. You can get to Chelmsford town centre from the bus stop that is at the end of the road. The home has its own vehicle to help people to get around. The cost of living at Paradise Lodge is between £592.62 and £1398.00 each week and you may have to pay something towards this. Care Homes for Adults (18-65 years) Page 7 of 37 You will have to pay extra money for your holidays, hairdressing, personal toiletries and your personal spends. Care Homes for Adults (18-65 years) Page 8 of 37 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 Care Homes for Adults (18-65 years) Page 9 of 37 How we did our inspection: This is what the inspector did when they were at the care home We visited the home and looked at some of the files belonging to the people living in the home and the homes staff. We also looked at the policies that explain how the home does things. We looked around the home and spoke to the staff and to the manager. We read the information (AQAA) sent to us by the manager. The AQAA is a form required by law for the manager or provider to carry out a self-assessment of how well the outcomes of people using their services are being met. Care Homes for Adults (18-65 years) Page 10 of 37 We sent surveys to the five people that live at Paradise Lodge, to two professional people that visit the home and to five of the homes staff, to see what they think about it. All of the surveys that were sent back said that the service was good and we have added any comments to this report. The Last key inspection was done on 7th July 2007. What the care home does well Care Homes for Adults (18-65 years) Page 11 of 37 Paradise Lodge provides people with good information about the home. The support plans are person centered and show staff exactly what support people want. The home makes sure that people get the right health care. People are looked after by staffs that have good training. Care Homes for Adults (18-65 years) Page 12 of 37 What has got better from the last inspection Information is now in pictures as well as words to help people to understand what the words mean. Paradise Lodge has new flooring, a new bathroom suite, a new boiler and a new fridge/freezer. Care Homes for Adults (18-65 years) Page 13 of 37 There is a new office being made upstairs to allow staff to do the paperwork in private. Some rooms have been redecorated and the outside of the home has been painted and has new guttering. Care Homes for Adults (18-65 years) Page 14 of 37 What the care home could do better Two staff should sign the medication sheets when they are hand written to make sure filled in correctly. Staff should be supervised from time to time when they give out medication to make sure they are doing it right. The staff application form should ask for a full employment history so that the home can check that they are safe to work there. All staff should have papers on their file to confirm that they are fit enough to work at the home. Care Homes for Adults (18-65 years) Page 15 of 37 All staff working at the home should have at least six supervision sessions each year. 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 Pauline Marshall 03000 61 61 61 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 Care Homes for Adults (18-65 years) Page 16 of 37 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 17 of 37 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 18 of 37 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. People know that their needs will be met within the home. Evidence: The Statement of Purpose and Service User Guide has recently been updated and both documents include good detailed information on the service that the home provides. The Service User Guide is in a written format that includes pictures to help people wishing to use the service to understand what the home can offer them. The guide included information on its person centred plans, risk taking and participation, health, activities, meals and the key worker role. We looked at three care files, two of these belonging to people that had lived in the home for some time and there was evidence of ongoing assessment. The acting manager said that old assessment documentation would have been archived as one of the people had moved into the home in 1996 and another in 2004. The third file contained a detailed pre-admission assessment that looked at the persons physical health, their mental health, their activities of daily living, their social needs and their medication. This assessment included information about the activities of daily living such as washing, Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: dressing, getting up and going to bed, the persons diet, their oral health their personal safety, their mood, their own perception of their mental health and at any social behaviours. The pre admission assessment that we looked at also included full details of family involvement, any special social interests and the persons religious and cultural needs. The acting manager said that this format is now in use and will be used for all future admissions. Each of the care files that we looked at contained a contract showing the persons terms and conditions with the home. Care Homes for Adults (18-65 years) Page 20 of 37 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive excellent individualised care based on their identified needs. Evidence: The care files contained person centred, informative and detailed support plans that are entitled How we support you. Each of the three support plans that we looked at included a personal profile, a character analysis, information on the persons likes and dislikes, their activity chart and full details of how they liked to be supported. Each of the support plans was signed and agreed by the person and or their advocate showing that the person has been fully involved in its creation. The daily notes were very detailed and provided good information on the activities of the day. Two of the three support plans that we looked at had not been reviewed since 27/06/2008, however, the acting manager said that all of the support plans were in the process of being reviewed and he supplied updated versions that were available on the homes computer system; staff spoken with were fully aware of the changes that had been made to the support plans. The third care file that we looked at was of a more recent admission and was not yet due for review. Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: People using the service have regular meetings and the notes of these showed that discussions have taken place around peoples like and dislikes, whether or not they were happy and any future activities they would like to do. Each person using the service has a named key worker and this role is discussed at every meeting to ensure that the people using the service understand their key workers role. People using the service appeared very comfortable whilst expressing their feelings and the meeting concluded with outcomes that people were happy with. The support plans that we looked at showed that people using the service contribute towards the running of the home and people spoken with confirmed this; one person said we have meetings and we decide what will happen all of the time. Documentation is in an easy to read format that includes pictures to assist people to understand the meaning of the words. Each of the three care files that we looked at contained very detailed risk assessments together with clear plans on how to manage any identified risks. The risks that were covered by these plans included behaviour and violent incidents, community environment, home environment, eating and drinking, leisure and sport, communication and personal care and hygiene. The management plans showed that people were supported to take everyday risks, so that they are able to live a full and active life of their choosing. Care Homes for Adults (18-65 years) Page 22 of 37 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 well supported to live a lifestyle that meets their identified needs and preferences. Evidence: The proprietor said in his AQAA we actively encourage people using the service in community participation and to develop their interests and hobbies and we provide them with information about community activities and facilities. The support plans confirmed this and they showed that people have the opportunity to access a wide range of activities in the local community and people spoken with said that they attend college, go shopping in the local town and regularly attend social clubs. The activities records showed that people have had trips out to London, been bowling, been to the pub and to church and one person spoken with said that they get out for drives and regularly go out with their key worker. The records also showed that sometimes people just want to relax in their rooms and people spoken with confirmed this and one person said I enjoy working on my computer Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: and I have a printer where I can print things out if I want to another person said I am hoping to get a computer and a printer soon but I really enjoy listening to my music in my room. Records of meetings held for the people living in the home showed that people are encouraged and supported to be as independent as possible by them sharing the responsibility for choosing their meals and doing the shopping. People using the service choose at least one meal each week and one person said that they have the opportunity to work together with staff preparing the meal that they had chosen. The support files that we looked at showed that people using the service are encouraged to maintain their links with family and friends and the proprietor said in his AQAA we respect peoples need to form relationships of their choosing. People spoken with confirmed that they were supported to maintain friendships by making regular visits to pubs and clubs. The dining area adjoins the kitchen and all of the people at the home eat at the large dining table. The menus showed that a range of meals is offered that have been chosen by the people living in the home and that these included plenty of fresh fruit and vegetables. Three of the people using the service commented on the meals being a little small for their liking when one particular staff member does the cooking. This was discussed and resolved at a small meeting with the proprietor and people using the service said that they were happy with his response to their concerns. Menus are devised weekly by the people living in the home together with the staff, and a shopping list is prepared for the foods that have been chosen. As stated earlier in this section of the report, each person chooses one main meal which is worked into the daily menu. Staff are working hard to advise people living in the home of the benefits of a healthy balanced diet but are meeting with some resistance as some people said that they enjoy fatty foods such as the skin of chicken and the crackling on pork and that they feel to throw this away is wrong. The home uses the Food Standards Agencys Safer Food Better Business for recording its catering activities; the last food hygiene inspection showed that the homes catering activities were satisfactory. One recommendation was made, this was to record the cooking temperatures and the inspector reminded staff that both sections of the Safer Food Better Business were to be completed. Care Homes for Adults (18-65 years) Page 24 of 37 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. People receive personal care in a way that suits them and their health care needs will be fully met. Whilst the homes medication practice is generally good, shortfalls on observing staff practice and transcribing medication on the medication administration sheets may put people at risk of medication errors. Evidence: People using the service said when spoken with that the staff supports them with their personal care needs in a way that they prefer. The proprietor said in his AQAA we work in partnership with all involved in the individuals care plan. One of the people living in the home confirmed this and said I do as much as I can for myself and the staff support me when I need it. Staff were observed entering peoples bedrooms and they knocked on the door and waited for a response from the occupant before entering the room. People appeared comfortable and relaxed in staffs presence. Each of the support plans that we looked at showed that peoples health care needs were met. We viewed health related letters and records that showed that each person had attended their health care appointments such as chiropody and dental. People spoken with said that their health care was taken care of and that staff come with me when I need to go to the doctors or to the hospital. People are encouraged to maintain as much Independence as possible and one person using the service told us that when they went Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: on holiday staff had arranged for them to carry on with their dialysis treatment at a hospital near their holiday destination. We spoke to a health and social care professional and they confirmed that the dialysis took place three times over the one week holiday period. The home uses a monitored dosage system for its administration of medication and has an up to date policy and procedure. The proprietor said in his AQAA medicines are always administered by designated and trained staff. The training records showed that all staff have had their medication training in December 2008 and that an update for this was due. The acting manager said that the newest member of staff had their training in October 2009 and that he was in the process of arranging an update for all other trained staff. There were PRN protocols in place for all as and when required medication and we carried out a random check of the medication administration records and their corresponding medication and this was all found to be correct. Staff spoken with had a good awareness of the homes medication procedures. There was no evidence to show that staffs competence to administer medication had been checked, however, the acting manager confirmed that he is now observing staff when they are administering medication to ensure that they are competent to do so and that the first observation has been carried out. Care Homes for Adults (18-65 years) Page 26 of 37 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 know that their concerns will be dealt with and that they will be protected from harm and abuse. Evidence: The homes complaints procedure has recently been reviewed; it includes clear timescales and there is a pictorial copy for people that need it. There has been no complaints made to the home since the last inspection. People spoken with and surveyed said that they knew how to complain and one person said if I am not happy with anything I tell the staff and they sort it out for me. The home has a suggestion box in the hallway and people are encouraged to use this if they wish to do so. The proprietor said that this was not used as much as he would like it to be. The homes abuse policy has recently been reviewed to show that any suspicion of abuse must be reported to the Local Authority. The home has had two safeguarding issues in the past twelve months; one issue has been closed and the other is in progress. The first issue involved the registered manager and he was dismissed as a result of the investigations; the issue was dealt with appropriately by the proprietor and the second issue is also being dealt with appropriately. We looked at three staff files and they showed that safeguarding adults training had taken place and staff spoken with had a good awareness of the actions to take should they suspect abuse. Care Homes for Adults (18-65 years) Page 27 of 37 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. People live in a homely, comfortable safe environment. Evidence: There are five good sized bedrooms all with hand wash basins and there are sufficient bathing facilities for the people currently living in the home. The furniture and fittings are of good quality and in good condition. People using the service said in their surveys this is the best place to live and sometimes this home is too tidy. We looked around peoples rooms with their permission and they were very proud of their personal space and one person said I have all of my things around me and I tidy my room when it needs it another person said I like listening to my records and watching my new TV. All of the rooms were very personalised and included pictures and posters and many personal items. Since the last inspection new flooring has been fitted around the home, the main bathroom has been redecorated and the bathroom suite replaced. The home has had a new boiler fitted, purchased a new fridge/freezer, painted the outside of the house and had new guttering fitted. People using the service were keen to inform us that they had a Sky upgrade which gives them more channels to choose from on the television. The garden is of a reasonable size and has a table and chairs for people to use in warmer weather. Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: The maintenance records showed that repairs are reported to the proprietor and that he arranges for a contractor to carry out the work. The records showed that urgent work was carried out within a very short timescale. Staff ensure that the home is kept clean and tidy and there is a daily cleaning chart for recording all cleaning activities. One staff member said in their survey the home is always clean and tidy another said Paradise Lodge provides people with a good, clean place to live. People using the service said that the home was always nice and clean and people said in their surveys that the home was always clean and fresh. Care Homes for Adults (18-65 years) Page 29 of 37 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. Whilst people are generally cared for by a competent, well-trained staff team, who are safely recruited the lack of obtaining a full employment history may put people at risk. Evidence: We looked at the staff duty roster and this showed that there were adequate staff on duty to meet the needs of the people currently using the service. The acting manager said that the duty roster is prepared one month in advance to ensure that staff know the dates they are expected to work. The duty roster showed that at least two staff members work throughout the day and one staff member works each night with another staff member on-call and it showed who was in charge of the home, who was on annual leave and who was on staff training. The staff duty roster showed the workers first name only and was written in pencil; the acting manager has now reviewed the way that the staff duty roster is written and has told us that it is now printed and shows all of the staffs full names. We looked at three staff files and they all included copies of the workers first day induction to the home. The acting manager said that applicants are encouraged to visit the home prior to interview. We saw interview notes on the staff files that we looked at and these included questions from the management and from the people living in the home showing that people using the service are involved in the recruitment process. Each of the three files that we looked at included completed application forms, two written Care Homes for Adults (18-65 years) Page 30 of 37 Evidence: references, a criminal records bureau check (CRB) and a POVA 1st check where necessary. There was no evidence of fitness on the staff files that we looked at but the deputy manager has since told us that a signed document confirming staff fitness for each employee is now in place. It was not possible to identify if there was any gaps in each employees employment history as the application form asked for the last ten years only. The training matrix showed that the home employs two qualified nurses and that all of the staff either have or are working towards an NVQ level 2 in care or above. Three staff have recently begun their Learning Disability Qualification and a further two staff are due to start it in February 2010. The training records showed that staff had received training which included safeguarding adults, medication, the Deprivation of Liberties, the Mental Capacity Act, food safety, first aid, health and safety, fire, infection control and manual handling. We saw the training matrix and there were copies of certificates on staff files; staff also confirmed that this training had taken place both when spoken to and in their completed surveys. We also saw certificates of training for the administration of ear and eye drops and death, dying and bereavement and epilepsy awareness. Two of the three staff files that we looked at contained evidence that staff supervision had taken place. The acting manager said that since the registered manager left, the management of the home has been unsettled and that supervision has not taken place as often as it should have done. The supervision notes that we looked at were very detailed and included observations of staff whilst carrying out their duties. Staff spoken with said that they felt well supported by the management and that they had many informal supervisions and communicated well through the use of staff meetings and their communication book. Care Homes for Adults (18-65 years) Page 31 of 37 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home that is run in their best interests. Evidence: Paradise Lodge has been through a very unsettling time since the last inspection and there has been major changes to the management team. The home was being managed by the proprietor after the registered manager left; it is now being managed by the acting manager with the support of the proprietor. The acting manager has told us that he is in the process of applying to be registered as the manager of Paradise Lodge. The acting manager has an NVQ level 4 in care and is due to commence the Leadership and Management award in April 2010, he regularly updates his practice and has recently attended training in food safety, first aid, health and safety, safeguarding adults, medication, fire awareness, manual handling and infection control. The proprietor has a degree in business management and has had training in the past year that includes safeguarding adults, first aid, food hygiene, health and safety, medication, manual handling and infection control. The staff duty roster showed that the proprietor is either on duty at the home or on call throughout the week. Staff spoken with said that they felt well supported by the management team. Care Homes for Adults (18-65 years) Page 32 of 37 Evidence: The proprietor said in his AQAA our ambition is to continually research, develop, innovate and practice good care and we carry out an annual quality assurance survey to ensure that we are maintaining this. The home is currently in the process of surveying the people using the service to obtain their views on what it is like to live at Paradise Lodge; the last quality assurance survey took place in December 2008 and any actions required had been carried out. The records showed that there had been regular monthly visits when the proprietor was not in the home on a day to day basis. People using the service said that they were consulted on all matters and that they regularly met to discuss all areas of the running of the home. We checked a random sample of the cash and cash transaction records belonging to people living in the home and we found them to be accurate and up to date. We viewed a random sample of the homes safety certificates and they were all in place and up to date. The fire risk assessment was last reviewed in April 2007 and the fire alarms and equipment had been tested regularly. The fire drill records showed that there had been four fire drills carried out in the past six months and staff spoken with confirmed that these take place on a regular basis. Care Homes for Adults (18-65 years) Page 33 of 37 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 34 of 37 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 1 20 13 The registered person must ensure the recording, handling, safekeeping and safe administration of medication. This refers to the need for two staff members to sign for hand written entries on the medication administration sheets and to ensure that staff are competent to administer medication. 28/02/2010 To ensure that people are protected from the risk of any medication errors. 2 34 19 The proprietor must ensure 28/02/2010 that he holds full and satisfactory information about every employee. This refers to not being able to check a workers employment history as the application form only requests the last Page 35 of 37 Care Homes for Adults (18-65 years) 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 ten years. To ensure that people using the service are protected. 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 36 It is recommended that all staff receives at least six supervisions every year to ensure that they are fully supported to carry out their work. Care Homes for Adults (18-65 years) Page 36 of 37 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 37 of 37 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!