Care Home: Peppard House

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Pinta
• Kestrel House, St Anne`s Opportunity Centre,

What the care home does well The home has very good written plans to make sure that staff know what people need, before they come to the home. People are helped to have a good look at the home and decide if they want to live there. People have things to do so that they don`t get bored and can enjoy their lives. People are helped to see Dr`s and other people who can make them feel better and happier, if they need it so that they stay as happy and healthy as possible. The home is good at helping people to behave in a way that makes them, and the people they share their home with happier. The staff are taught things so that they can give good care to people. The home makes sure that people are kept safe from accidents and from anyone who might try to teat them badly. What has improved since the last inspection? The home try to get better at making sure that the people who live there are helped to enjoy their lives. What the care home could do better: The home could make sure it is easy to count how many pills are in the cupboard and to know when people might need them. They could make sure that it is easy for all staff to know when people might need some help to behave properly and safely. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Peppard House 45 Woodcote Road Caversham Reading Berkshire RG4 7BB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kerry Kingston     Date: 1 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Peppard House 45 Woodcote Road Caversham Reading Berkshire RG4 7BB 01189472067 01189464014 jenny.thwaite@choiceltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Choice Ltd Name of registered manager (if applicable) Mrs Jennifer Mary Thwaite Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 7 The registered person may provide care to service users in the following category 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: Learning disability (LD) Date of last inspection Brief description of the care home Peppard House provides residential care to seven adults, of both sexes who have learning and associated behavioural disabilities. The house is owned by and the care provided by C.H.O.I.C.E Limited. It is situated in a residential suburb approximately two miles from the town centre. It has its own transport and is on a public transport route. The house is a large three storied building, with bedrooms on the first floor, there is ample communal space and an adequate, well-used rear garden. Care Homes for Adults (18-65 years) Page 4 of 29 care home 7 Over 65 0 7 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection of this service was completed on the 18th January 2007. The current fees are 1,712.00 Pounds to 2,074.00 Pounds per week,depending on the assessed needs of the people who are using the service. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 10:30 and and 6.30 pm on the the 15th January 2009. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the service manager. Surveys were sent to the people who are supported by the service and other interested parties. Care Homes for Adults (18-65 years) Page 6 of 29 Discussions with the acting manager, the operations manager and three members of staff took place. Some people who use the service have difficulty communicating with people who do not know them so observation of people and their interactions with staff took place during the visit to the home, one person who uses the service was also spoken to. Any information collected by the Commission for Social care Inspection, since the last inspection has also been included in this report. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that it properly assesses people, that they are involved in the assessment and it is able to meet their identified needs. It ensures that people have opportunities to see what it is like to live in the home and that they want to live there before they move in. Evidence: One person has left and one person has been admitted to the service since the last inspection. There is a very robust referral and assessment process. The provider has a dedicated referral team who look at the assessment completed by the referring authority,they decide if the organisation can meet the identified needs and which service might be the most suitable. If there is a vacancy the manager of the service and an assistant psychologist go to meet the prospective resident, if all are in agreement (including the person who may move to the home) a meeting of all the relevant parties draws up a comprehensive transition programme , individually tailored to the needs of the resident. This includes a very comprehensive assessment with all the necessary information and a detailed transition plan developed from the Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: assessment. The transition programme includes a series of visits and overnight stays, depending on the needs and preferences of the individual. The visits provide opportunities for those already in residence to make their opinions of the prospective person known and for staff to observe interactions between them to ensure no issues are evident. Families are included, as is appropriate and the home use them to provide useful information to help them meet the needs of people. The person who was most recently admitted to the home has an excellent, detailed and thorough assessment and a comprehensive transition plan and paperwork. After admission the placement is reviewed regularly at six weeks and 12 weeks. The person admitted said that they liked it much better here (than where they lived before.) There are currently, six people living in the home, which is registered for seven. The acting manager explained that there had been several referrals that had been assessed as unsuitable and that the service could not meet their needs, one person was not accepted because he did not want to move from his current home although others wanted him to, it was, not felt to be appropriate to accept the referral under these circumstances. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home make sure that people know their assessed and changing needs, which are included in their care plans. People are helped to make as many decisions for themselves as possible and comprehensive risk assessments assist staff to enable people to be as independent as is practicable. Evidence: Care plans for four people were seen, all had comprehensive individual care plans, which recognise and identify any equality and diversity issues. Some people had the new Person Centred Plan completed others have the Essential Lifestyle Plan, both plans contain detailed information to make them robust working documents. They include daily living, history (if relevant), what people prefer and enjoy, How I tell you things, peoples cultural religious needs,any gender or sexuality issues, what is important to them and health plans. Monthly key worker meetings are held, these monitor the action plans drawn up at the six monthly reviews and give people an Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: opportunity to talk about any issues on a one to one basis. The home does not hold resident meetings at this time as the monthly individual meetings with key workers are judged to be a more effective way of getting peoples opinions and views. There was evidence of people making decisions on a day -to- day basis with regard to activities, food and holidays. Risk assessments are detailed and support people to maintain and develop independence in areas such as community presence and inclusion for example some people have 2:1 staffing to enable them to go into the community. There are Risk Assessments with regard to behaviour so that peoples equality and diversity needs are not compromised because of some difficult behaviours. There are also comprehensive and up-to-date risk assessments with regard to peoples involvement in household chores and personal care. Any limitations of choice or freedoms in the home are risk assessed and people are asked , as far as possible, to agree to them. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enable people to be involved in a variety of activities that include being part of the community and they are supported to keep in contact with family and friends. The home provide a well balanced and healthy diet. Evidence: Individuals have a weekly activities plan displayed on the notice board in the activity room, it is presented in symbols/pictures and simple words so that people have an opportunity to understand them. The plan can be changed according to peoples choices/moods and availabilities. There are a mixture of community based and inhouse activities which are organised by the activity co-ordinator who works weekdays and every other weekend, she ensures activities are organised before she leaves work the previous day. One or two (including the day care organisor) additional staff assist residential staff with the provision of daytime activities. Activities include horse riding, Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: college attendance, computer, trampolining,music, visiting churches, shopping and drumming. Records showed that if people refused to do one activity another that they particularly like is offered. One person has been introduced as a volunteer to work in a garden centre with a view to further employment, if it is successful. The home is working with an employment company to look at opportunities for other people to do some voluntary work. One person who uses the service commented (via a survey ) that they felt there were not not enough activities at weekends and after hours, three staff supported this view. Records, however showed that the individual has a great number of activities during the week with occasional outings in the evenings and at weekends. There are some restrictions on after hours activities as some people need 2:1 staffing and some people are unable to use public transport, activities are then reliant on there being enough drivers available. One person told me that they had plenty to do. The acting manager and operations manager felt that the focus was on ensuring people had good quality day time activities, understood that there were some limitations on out of hours activities but felt that generally people are content with the level of activities. According to records people officially go out once a week in the evening to a special social club. Daily recordings noted that other outings occur especially at weekends but not many during the week. All residents have an annual holiday but as it suits their choices and behaviours, most have two long weekends a year and day outings rather than a week away. The home encourages people to stay involved with families and maintain any relationships. Families are particularly involved if it is felt to be beneficial when someone first moves into the home. One person was observed being assisted to make a phone call to a family member. Contact with families and Friends, how people contact them and when are noted,in detail, on individuals care plans. Menus operate on a four weekly cycle and once a week one person is encouraged to choose the meal,shop for the ingredients and help to prepare it.This practice has not been happening recently but the acting manager is to reinstate it. Meals well balanced and nutritious. Breakfast is not noted on the menus and choices are not always clearly recorded. The meal time observed was not well used by staff as a communication venue but he inspector and operations manager being in the home may have effected the way staff were interacting with people. The Acting manager and operations manager had a good rapport with people and were adamant that the rest of the staff team , generally, interact positively with people who use the service. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the needs of people in the way they they prefer. Peoples emotional and physical needs are effectively met and medication is administered safely. Evidence: Four care plans were seen, they are comprehensive and include goal status with action plans, contact and input from any specialist services, religious and social needs and day services. There is also an action plan monitoring form to be used at annual reviews, capacity assessment and risk assessments. Peoples equality and diversity needs,preferences and choices are clearly described in care plans. Individual lifestyles reflect peoples age, likes and dislikes and any other special needs. Paperwork called my care plan includes, personal care, daily living skills, sexuality,religion,sleep patterns, restrictions, cognitive abilities and eating and drinking. All care plans seen had very comprehensive, extremely detailed information, the home is currently transferring from one care planning system to another but either system contains detailed and good quality information that staff can use as a working tool when supporting the people in their care. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Good health care records are kept for all residents, care plans include health and medication (health passports), how I show I am in pain and how I tolerate medical intervention. They also detail the help received from any specialist services and include psychiatrists and psychologists. The provider supplies a psychiatrist who visits the home on a regular basis and provides in depth support for any individual who may require it, on a short term basis. They also provide a psychology service and an assistant psychologist visits the home regularly and is involved in the assessment and admission process. People who need support to control some behaviours have behaviour guidelines that are provided by psychology and people are aware of what the guidelines say, signing their agreement to their use, if they are able. It was observed that guidelines were not always followed by staff, on the day of visit. There were references to this in staff meeting minutes, an issue that the home is dealing with. Some staff confirmed that they felt that guidelines are not always consistently followed. Overall people appeared happy and content, there are few incidents of out of control behaviour. One persons behaviour has improved considerably over the period of a year. The home has very good behaviour monitoring charts and work very closely with the psychiatrist, the G.P and the pyschologist, to ensure the emotional and mental health of the people who use the service. A Survey from a G.P (received by the Commission) was all positive and commented this is a very good service which looks after service users well. The home use the BOOTS Monitored Dosage System (M.D.S). All the people who use the service take medication, but none are able to self administer. There is a list of staff who are able to give medication, these are staff who have been trained and judged as competent by senior staff to be able to adminsiter medications. Staff competency is checked every six months. The medication records seen on the day of the inspection visit were accurate and no errors were noted. The home administer some medication prescribed by the G.P, to be taken as necessary to assist people to control their behaviour. They are rarely used but there are specific guidelines to follow if they are necessary. It was discussed that some of these guidelines could be more detailed, an easily accessible stock control record of when necessary medications could be kept and the use of them could be reviewed if they have not been used for some time. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that peoples views are listened to and acted upon. People who use the service are protected from all forms of abuse by policies and procedures and staffs knowledge and understanding of them. Evidence: The home has a robust complaints policy and procedure, produced in pictures and symbols for people who use the service. One person said that they would know who to talk to if they were not happy. There have been three complaints since the last inspection in October 2007. A staff issue was dealt with appropriately and action was taken to ensure there was no repetition of the incident. There were two complaints in January 2008 which were quickly resolved, detailed records are available of the complaints and the action taken. The Acting manager confirmed that there had been no further safeguarding issues since the last inspection, all staff have received safeguarding (POVA) training and three staff were able to explain what they would do in the event of a safeguarding issue arising. All were clear about their moral and professional safeguarding responsibilities. Two peoples cash and expenditure records were seen and were accurate, on the day of the visit. A new, very detailed and comprehensive policy, with regard to peoples Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: finances has been developed by the organisation during 2008. The Appointee for individuals is the financial director from head office, benefits and the mobility element of the Disability Living Allowance is paid directly into peoples bank accounts, staff support them to access this. It was noted that all the people who live in the house had bought their own towels, which cost over 80 pounds, there was a discussion with the acting and operational managers that the provider is responsible for supplying basic necessities such as linen. The acting manager was not aware of this but the operations manager said that it was the organisations policy to supply these items and that he would arrange for a refund. Individuals have behavioural guidelines so staff can help them to control their behaviour, some of these include the use of physical interventions. Staff are trained in the use of physical interventions and their training is updated annually, the most severe hold used is a two person escort. Physical Intervention is rarely used in the home if it is, it is recorded in a physical intervention book which cross references with an incident form and behavioural observational chart. There has been only one recorded recorded during the last 12 months. There was a discussion with the acting and operational managers that individuals physical restraint guidelines could contain more detail, to further ensure the safety of the person who uses the service and the staff member. The Commission has received no information with regard to complaints or safeguarding issues about this service. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensure that they provide a comfortable environment that meets the needs of individuals and the group. It is kept clean and hygienic. Evidence: Some parts of the building are looking tired, such as the upstairs toilet, but the service has an annual maintenance plan which is generally adhered to.Some areas are due for redecoration and re-furbishment this year. The people who live in he home are quite demanding of their environment but the home ensures maintenance and repairs are effected as soon as is possible. The organisation has its own in-house maintenance team who are able to respond quickly any important or emergency repairs that are requested. Grab rails have been fitted in one bathroom to ensure that people are safe and will have no difficulty in getting out of the bath, as they age. Non-slip mats are used in all showers and baths for safety, after an incident that resulted in risk assessments. Staff are trained in infection control procedures but some staff felt that some of the hygiene equipment such as gloves were not to a high enough standard to complete Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: their tasks safely, they have requested better quality protective clothing. The home has an industrial washing machine with sluice facilities, any pads are disposed of in a yellow bin collected by a contractor. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home have a competent and well trained staff team who are able to meet the complex and diverse needs of the people who live there. The home has a robust recruitment policy to ensure that staff are safe to work with the people who use the service. Evidence: There are a minimum of three staff per shift , the manager is not on the care rota so is additional during the usual working day in the week. A day care organisor is also available for four working days per week and every other weekend. The usual staff ratio is 4:7 but as there are only six people resident in the home it is 3:6. Some people have 2:1 ratios in the community so they generally use the community during usual daytime hours. Staff felt there were not always enough staff, this comment related to opportunities to access activities after hours and at weekends. The Provider places high value on training and qualifications, 64 of the staff team have an N.V.Q 2 or above and 17.5 are working towards NVQ 3 (as detailed on the AQAA). There is a robust induction programme, which includes staff completing the L.earning Disability Qualification which is equivalent to the Learning Disability Award Framework. Training records showed that people have good opportunities to access Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: training courses, both those leading to qualification and those provided to enable staff to do their job better such as epilepsy, effective communication and autism awareness. Staff spoken to and surveys received by the Commission from staff, confirmed that there are plenty of opportunities for training. Two staff recruitment files for were seen, all the necessary information is on file in the home. Staff do not begin work until they have received a satisfactory police check. The home keeps records of interview questions and responses made. The people who live in the home show candidates around and other staff observe interactions between them, this information is included when considering candidates suitability for the post. The staff are disappointed that the registered manager is not returning from maternity leave as she is highly respected and valued by the team. The acting manager has been in post since the manager went on leave , approximately nine months. Some staff felt that they were not supported as well as they could be but all agreed that they are supervised regularly and can approach the acting manager as necessary. All staff spoken to felt that the care they give is good, and the staff team are committed to ensure standards remain high. There were several comments about there not being as many staff as there used to be, that is there are now only three staff per shift when there used to be four. The operations manager explained that there are only six people in residence, when there are seven they will revert to a minimum of four people on duty. The interactions between staff and residents observed over the lunch time period were brief and some of the interactions with a resident in the morning did not entirely follow the guidelines. The acting manager and operations manager felt it was because there were two people in the house who werent usually there and this had caused staff to be less confident. They were adamant that staff, generally, ave very positive interactions and relationships with those in their care. People appeared to be very confident and comfortable to approach any member of staff and access the office if they chose to. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run, it focuses on the needs of the people who live there. People are kept as safe as possible by adherence to Health and Safety Policy and procedures. Evidence: The operations manager advised that the registered manager has been on maternity leave for approximately nine months, she has recently resigned her post. The acting manager has been managing the service for that time so there will be no immediate change. The staff team are disappointed because they were expecting her back shortly and she is a very popular manager. The operations manager advised that the provider would be advertising the post imminently so that they are able to organise the long term management of the home, as soon as possible. The acting manager has achieved an N.V.Q.3 and is currently completing her Registered Managers Award, she has 12 years experience in care work. The Quality Assurance system includes the operations manager completing monthly Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: regulation 26 visits, on two occasions he has used an observational approach to try to gain information about the standard of care received by those people unable to clearly communicate their feelings. The report written from his observation has been developed into an action plan and the provider has begun a programme of intensive interaction training for staff to enable them to interact more positively with those people who cannot or choose not to communicate by the usual means. People who use the service and other interested parties are sent questionnaires on an annual basis and an annual development plan is written as a result of the feedback received. This was not seen on the day of the visit. Some policies and procedures were not included on the A.Q.A.A. but the Acting manager confirmed that all policies and procedures are in place, most having been reviewed fairly recently. The operations and the acting managers confirmed that all the usual Health and Safety maintenance checks are carried out at the correct regularity. Staff are trained in Health and Safety topics, which are up-dated as required, this was confirmed by training records. A staff member completes a monthly Health and Safety Audit and the in-house maintenance team address any issues which impact on safety, immediately. The home report, in detail, any accidents or incidents and the senior staff complete them to say what action is being taken to minimise the risk of recurrence. It was discussed that consideration should be given to creating new risk assessments for people as accidents occur, judgment should be used if it should be done after the first incident such as someone falling downstairs. The operations manager looks at accidents and incidents and any other safety matters as part of his monthly, regulation 26 visits, which he completes on behalf of the provider. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 To produce more detailed guidelines for when to give medication prescribed to be taken as necessary, to review any such medication that has not been used for some time and to develop an easily accessible stock control system for it. This will ensure that all such medication is necessary and administration of it, is as safe as it can be. To produce more detailed guidelines for the use of Physical Intervention to assist people who use the service to control their behaviour. This will ensure complete safety for service users and the staff team. 2 23 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!