Care Home: Park Avenue

What the care home does well Some comments from the clients on what the home does well included, `the staff are friendly and always there to help, guide and listen, `the staff have a good temperament, and it is amazing how the house keeps clean and tidy,` `an excellent, homely atmosphere with staff that show genuine care,` and `the staff are compassionate, supportive and patient.` Clients are enabled to take positive risks as part of the promotion of an independent lifestyle, and they are enabled to take positive risks as part of the promotion of an independent lifestyle. Access to the community is promoted and the home provides transport to enable residents to take trips further afield. A robust recruitment procedure, good retention of staff, and the involvement of clients in the selection of staff, ensures that the clients are safely supported, by a loyal and committed staff team they like, and who provide them with consistency and continuity of support. What has improved since the last inspection? The care planning system had improved over the last twelve months to ensure a person-centred approach. Over the last twelve months a training schedule for the clients had been implemented, that has included safeguarding adults and how to make a complaint. Clients have been involved in reviewing polices and procedures and been more involved in the running of the home. Improvements had been made to the environment over the previous twelve months, including the redecoration of the hallways, bedrooms, lounge, dining room, conservatory and office and the refurbishment of the lounge with respect to fixtures and fittings, sofas, curtains and pictures for the enjoyment of the clients. What the care home could do better: The AQQA confirmed that the manager is aware of how to improve and develop the service, and plans are in place to show how this will be carried out in all outcome areas, for the benefit of the clients. Key inspection report Care homes for adults (18-65 years) Name: Address: Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD     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: Christine Bowman     Date: 2 9 0 4 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD 01252547882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): parkgroup.churchcircle@btopenworld.com Mr Lawrence Alexander,Mrs Diane Alexander Name of registered manager (if applicable) Sarah Mary Guilfoyle Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category 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 category; Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Park Avenue is privately owned and managed care home registered to provide care, support and accomodation for up to twelve clients with mental health disabilities and associated behavioural support needs between the ages of 18 to 65 years. The home is part of The Park Group that operates other residential homes and an outreach service mainly in the Farnborough area. The home is located in the North Hampshire Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 12 2 4 0 2 2 0 0 9 Brief description of the care home town of Farnborough with easy access to local shops,community ammenities amenities, public transport (both train and bus) and the M27 motorway as well as towns of Aldershot and Guilford. The building is a three-storey domestic detached house built in the late 1990s, comprising of twelve single bedrooms one with en-suite. One of the single rooms provides an independent flat facility on the second floor. The homes communal space comprises of one lounge and separate dining room and a conservatory. There is a mature garden laid mainly to lawn and parking is available at the rear of the premises. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection. Before we visited the home, we looked at the last key inspection report completed after the site visit on 24th February 2009, the Annual Service Review, and other information gathered about the service since that time. The manager sent us the Annual Quality Assurance Assessment (AQAA), when we asked for it. This document gives us up to date factual evidence about the running of the home, informs us of what they think they are doing well, how they have improved the service over the previous twelve months, and of their plans for further improvements. Nine people, who live at the home, and five staff members, completed surveys giving us their views on the service provided at the home. The site visit was carried out over six hours and we met four of the eleven people who currently live at the home, the interim manger, one of the providers, and five staff members. We looked at the service user guide, client care plans, medication records, staff files, maintenance and other records. We also looked at all the communal areas of the home. Care Homes for Adults (18-65 years) Page 6 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the home is available to prospective clients and their representatives to help them to decide if the home can meet their needs. Clients can be confident that the home can support them because their needs are assessed prior to admission. Evidence: The home had a Statement of Purpose and a Service User Guide to inform prospective clients and their representatives of what to expect from the home. The Service User Guide was under review to incorporate photographs and client comments, which included, the staff are friendly and always there to help, guide and listen, the staff have a good temperament, and it is amazing how the house keeps clean and tidy, an excellent, homely atmosphere with staff that show genuine care, and the staff are compassionate, supportive and patient. A pictorial complaints procedure was included in the Service User Guide, which was accessible to the clients. One new client had been admitted since the previous site visit and their assessment record, which was sampled, included information with respect to equality and Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: diversity, including religious and cultural needs. An interpreter had been involved to support the client, as English was their second language. The detailed assessment included health and social care needs, and had been completed by the manager, prior to admission. As part of the admissions process, information had been gathered from health and social care professionals. The client admission checklist recorded the procedure and confirmed that an introduction to the current clients and staff had been arranged, prior to admission, to enable everyone to be involved. Seven of the nine clients, who completed surveys, confirmed they had been asked if they wanted to move into this home. 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. Clients needs and goals are met, and they are enabled to make decisions about their lives. Their independence is promoted by positive risk-taking. Evidence: The files of three clients were sampled. Each contained a care plan, which included, managing mental health, self-care, daily living skills, social networks, relationships, behaviour, responsibiities, identity and self-esteem. Action plans included goals, and they had been signed by clients to confirm agreement. The AQAA recorded, care planning is person-centred and clients can choose their own key workers. They are suported to write their own care plans, if they wish. Plans with respect to behaviours were included and informed the staff of triggers, and early signs and symptoms to be aware of, and of actions to be taken to support the clients. Care plans viewed had been regularly updated to ensure the information was current and relevant. The AQAA recorded, we provide clients with the information, assistance and communication support they need to make decisions about their own lives, and they Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: are enabled to take positive risks as part of the promotion of an independent lifestyle. Seven of the nine clients, who completed surveys, confirmed that they always or usually make decisions about what they do each day. Records confirmed that risks had been assessed prior to admission, and care plans showed that positive risk taking was promoted to enable clients to develop independent lifestyles. Care plans recorded identified risks, risk factors, level of risk, liklihood of occurrence and control measures in place to minimise the risks to the clients. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clients are supported to follow their own interests, to maintain relationships and they are encouraged to be involved in the local community. Their independence is promoted, and they are provided with a well-balanced diet, which they have been involved in planning. Evidence: One of the clients spoken with on the day of the site visit, said they were looking forward to going home to visit their relatives at the weekend. They stated that, there was plenty to do at the home, and that they, also enjoyed visiting charity shops to look for vinyl records. The interim manager stated that activites were planned together in house meetings. The minutes of meetings for the previous two months, viewed, confirmed the involvement of the clients in decisions about menus, activities, the environment, and in the reviewing of policies and procedures. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: On a notice board for the clients to view, was a Park Newsletter, and photographs of a recent trip. Activity schedules confirmed that clients had the opportunity to be involved in a wide range of activites at the home, in the local community, and in trips further afield in the homes own transport. Baking cup cakes and scones, yoga, gardening, manicure and pedicure, board games, discos, scrabble, evening walk, pub trips, badminton, football, swimming, Spanish theme day, meal out, committee meetings, shopping trips and seaside trips were included in the schedule for the enjoyment of the clients. The AQAA recorded that the service has links with the community, and that clients access religious places of worship, colleges, the local recreation centre, shops, pubs and the library. The home also provides the clients with a guide to living in Farnborough so they know where to access different services. The majority of the clients, who completed surveys, confirmed that they always do what they want during the day, in the evening and at the weekend The policy of the home was to have open visiting hours, and private areas are available were clients can meet with relatives, friends and professionals and not be disturbed. Daily routines in the home promote the independence of the clients and care plans recorded how the home supports them to complete kitchen skills, shop independently, look after their own money, plan and prepare their own food safely, and prepare for work. The menu was displayed on a notice board and accessible to the clients. The interim manger stated that the new cook had met with the clients and staff and was in the process of compling a new menu based on the consultation. She confirmed there were always alternatives, if clients did not like the main meal provided, that fresh fruit and yoghourts were always available, and that there were two or three choices of vegetables with main meals. Plans were in place for the cook to meet with the clients on a monthly basis to review the menus. 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. Clients are supported to be self-sufficient in their personal and healthcare needs. Safe systems are in place to support clients with their medication needs. Evidence: Care plans sampled confirmed that clients were independent with respect to their personal care needs and required only prompts from the staff to support personal hygiene. Care plans recorded that clients made personal choices about such things as the clothes they wear, and that they received support to acquire daily living skills to promote independence. The AQAA recorded, we provide the clients with the information, assistance and communication support they need to make decisions about their own lives. The AQAA also confired that the care planning system had improved over the last twelve months to ensure a person-centred approach. A loyal and committed staff team provided consistency and continuity of support to the clients. The interim manager stated that, clients are supported to manage their own healthcare needs. The Care Programme Approach (CPA) was utilised, and the aim was to build the self-confidence and independence skills of individual clients to enable Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: them to achive eventual self-sufficiency. The organisation offers more independent accommodation for clients in the community, and one client, who had moved on to more independent living, had returned to the home for some extra support at the time of the site visit. The interim manager confirmed that the home provided transport and staff to accompany clients on health related appointments when required, and that the policy of the home was to accompany clients in need of hospital treatment. The AQAA recorded, we have a guide providing local healthcare resources to help inform clients of services provided in the community. Records confirmed clients had received an annual health check, and appointments with General Practitioners, Community Psychiatric Nurses, chiropodists, opticians and dentists were recorded. Risk assessments with respect to self-medication were included in clients files sampled. Risk factors with respect to the ommission to take the medication or overdosing were considered, the liklihood of this occurrence and control measures in place for the protection of the clients. Clients assessed as safe to self-medicate were provided with appropriate lockable storage facilities. Medications held at the home were suitably stored in a secure metal cabinet attached to a wall. Records with respect to medication were double signed on receipt, and when distributed, and a returns book for unused medications was signed by the pharmacist to confirm receipt. The interim manager confirmed that all the staff had received training in the administration of medication and that regular audits were carried out to ensure safe practise. 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. Policies, procedures and training are in place to support people to raise issues if they have concerns about their care and the home has safeguards are in place to protect the clients from abuse, neglect and self-harm. Evidence: The complaints procedure was displayed on a notice board in the home and included in the Service User Guide to inform the clients. The document was easy to understand and included a response time of twenty eight days to let the complainant know the outcome of a formal complaint. The AQAA rcorded that one complaint had been received over the previous twelve months and that it had not been upheld. The complaint, which had been sent to the Care Quality Commission (CQC) in the first instance, had been responded to appropriately. Since the previous site visit, the CQC had received a complaint that the home had not recorded all the complaints received prior to the previous site visit, and that at least two complaints had not been resolved to the clients satisfaction. No evidence was available to support this statement. A number of anonymous complaints have been received by the CQC over the last six months, which had been referred to the Local Authority (LA) and investigated under Safeguarding Adults procedures. The outcome of the investigations concluded that the allegations were unfounded, and an action plan recommended staff training in the recording of information, which has been Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: carried out to their satisfaction. Since that time an anonymous complainant has expressed dissatifaction with the outcome of the investigation, but as they are not willing to be identified to the LA, this grievance cannot be resolved. The AQAA recorded that, over the last twelve months a training schedule for the clients had been implemented, that has included safeguarding adults and how to make a complaint. Plans for the next twelve months included reviewing the complaints log to include concerns. A copy of the local authority safeguarding adults policy and procedures were available at the home, and local policies, based on them, informed the staff of action to take, with respect to protecting the clients from abuse. The staff training and development logs sampled, recorded that safeguarding adults training had been updated regularly, to keep them informed. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people, who live at this home, benefit from a well-maintained, comfortable and homely environment, which meets their needs and is clean and hygienic. Evidence: The home is situated in a pleasant, residential area of Farnborough, close to public transport, shops and other public amenities. It is in keeping with other residential homes in the street, and next door to another of the Organisations homes, Parkway. A pleasant display of plants and flowers at the entrance gave a welcoming ambiance, and the exterior and interior of the home were well-maintained. Communal living areas of the home were homely, comfortable and clean and consisted of a large lounge, equipped with a widescreen television, a computor, DVDs, a music centre and shelves of books for the clients entertainment, a dining room, a conservatory area, laundry room and kitchen. Lighting was domestic and framed pictures and tasteful decor enhaced the environment for the comfort and enjoyment of the clients. The AQAA recorded that improvements had been made to the environment over the previous twelve months, including the redecoration of the hallways, bedrooms, lounge, dining room, conservatory and office and the refurbishment of the lounge with respect to fixtures and fittings, sofas, curtains and pictures. The AQAA Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: also confirmed that clients had been consulted with respect to the colour schemes for their bedrooms. Clients spoken with on the day of the site visit, stated that they were very happy with their bedrooms. To the rear of the home is a garden, which is shared by the home next door, because the carparking area is situated behind the other home. The garden had interesting features, including a terraced area with seating and potted plants, a fish pond and rockery, ornamental bushes and a barbecue, on which to prepare outdoor meal, when the weather allows. There was a greenhouse, which the interim manager stated, clients had grown vegetable in last year, and at the bottom og the garden was a small orchard. One of the homes three resident cats was sitting in the conservatory looking contented, and providing the added value of unconditional acceptance and appreciation to the clients. The laundry room contained a Control of Substances Hazardous to Health cupboard, a basin for handwashing, and a domestic scale washing machine and dryer, which the clients could acces to do their own laundry. The AQAA recorded that all the staff had received training in the prevention and control of infection. Seven of the nine clients, who returned surveys, thought the home was always fresh and clean, and two thought it usually was. 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. The people living at the home benefit from being supported by a safely recruited staff team, who provide consistency and continuity of support, and are well inducted, trained and suported to meet their needs. Evidence: The AQAA recorded that no staff had left the homes employment over the previous twelve months, resulting in consistency and continuity of support for the clients. The interim manager stated that there were always two staff members on duty in addition to management, and rotas viewed confirmed this. The AQAA recorded that clients needs resulted from mental health issues, and personal care support was not required, except as prompts to clients to complete their self-care independently. The interim manager stated that two staff on duty during the day and in the evenings were usually sufficent, but that numbers could be increased if situations arose which required more staff. Three staff were also employed to provide domestic and maintenance support. Staff files inspected, contained all the necessary information with respect to their recruitment, such as references, Criminal Record Bureau (CRB) and POVA First (Protection of Vulnerable Adults). Reasons for leaving past employment were recorded on the application form, and all gaps in employment had been accounted for, with Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: respect to the staff files sampled, for the protection of the clients. The AQAA recorded that, clients are supported to be involved in the recruitment process, thus enabling them to receive support from people they like. The five staff, who completed surveys, confirmed that recruitment checks had been carried out before they started work. Records confirmed that the staff received an induction in line with the Skills for Care Common Induction Standards, in addition to the house induction. All the staff, who completed surveys, recorded that their induction covered everything they needed to know to do the job when they started work, very well. Staff training and development files sampled, included up-to-date certificates for mandatory training including health and safety, risk assessment, moving and handling, first aid, infection control, fire training safeguarding adults, the safe handling of medication and food hygiene. A training schedule posted on a notice board, showed that training was updated throughout the year and available at times to suit day and night staff. The Mental Capacity Act and managing challenging behaviour training were included in the schedule. The AQAA recorded that ninety percent of the staff had either achived a National Vocational Qualification at level 2 or above, or were working towards one, to support them in their role. The staff spoken with on the day of the site visit, confirmed that the training was very good, and the five staff, who completed surveys all recorded that they were being given training that is relevant to their role, helps them to understand and meet the individual needs of the clients and keeps them up-to-date with new ways of working. One staff member spoken with stated they had just completed equality and diversity training and that staff meetings included awareness training with respect to individual clients needs, such as diabetes, eating disorders and self-harm. Another staff member stated, the training is excellent, and there is lots of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people, who live at the home, can have confidence in the management to protect their best interests and take into consideration their views in the running of the home. The environment is safe for the clients and the staff because health and safety practices are carried out. Evidence: On the day of the site visit , the registered manager was on a training course and therefore was not available to be interviewed. The registered manager of the the home next door was managing the home in her absence, and provided support for the inspection process. The registered manager holds a National Vocational Qualification (NVQ) at level 4 in management, a Community Mental Health Qualification, has worked for the organisation for more than ten years and has four years of management experience. She keeps herself up-to-date by attending training courses, including those provided by the local authority (Train the Trainer) designed for cascading to the staff team. Most of the staff spoken with were very complimentary with respect to the manager. One staff member commented, she is a very good manager, and another that, the manager provides excellent training. Two staff Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: members commented, the proprietors are very supportive and offer good opportunities to both the clients and the staff. One staff member, however, stated that, the manger is not empathic or approachable, that, the clients have been much happier with the interim manager in charge, and that, the registered manager does not promote an open culture. They gave an example of meetings conducted to expose people who may have spoken out. The home sends out an annual quality control questionaire to be completed by clients, relatives, staff and professional involved with the home, to monitor the quality of the service. The AQAA recorded that the findings are used for the improvement of the service. Samples of house meeting minutes confirmed the involvement of the clients in all aspects of the running of the home. Regular monthly visits are undertaken by the proprietors and reports sampled confirmed client and staff satifaction wit the support received from the management. Staff comments included, I really do enjoy my job, and the clients are respected and valued. A client commented, I like my room, it has a nice view. The staff are supportive and I have a say in what goes on in the home. The AQAA recorded that Health and Safety checks with respect to the maintenance and servicing of equipment had been completed in a timely manner, and samples of certificates viewed on the day of the site visit confirmed this. Certificates held in the staff training and development files showed that training with respect to health and safety, risk assessment, moving and handling, first aid, infection control and fire training had been completed to ensure the staff were being kept up-to-date in order to protect the clients. Risk assessments included in clients care plans promote safe practice and protect them from hazards. Appropriate systems were in place for the recording of accidents and incidents. 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 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). 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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