Care Home: Queen Ann House

What the care home does well The home has consistently provided excellent outcomes for residents. The home make sure that new residents have information that helps them decide whether it is a place they would like to live. Perspective residents are given a detailed pre-admission assessment to make sure that the home can meet their needs. Residents who had recently come to live in the home told us they had been involved in this assessment process. Admission are not made to the home until a detailed needs assessment has been undertaken to make sure that residents get the care and support they need. Care plans and risk assessments provide detailed information about the needs of residents. Residents confirmed that they had been consulted about how their needs will be met. There was clear guidance on how to respond to residents mental health needs. Residents are involved in planning their care that affects their lifestyle quality of life. Staff are available to meet the needs of residents. The observed that they knew how to respond to residents mental health needs. Training records showed that they had all the relevant training they needed. This included training in mental health and how to respond to behaviours that might be challenging. Staff have the skills to meet the needs of residents. The home is managed is so that residents are involved and consulted about decisions that affect them. Staff and residents told us that they could talk to the registered manager about any issues. Detailed quality assurance is carried out to make sure that areas for improvement are identified. The home consults widely with residents, relatives and relevant professionals about the quality of the service. What has improved since the last inspection? There were no areas for improvement identified at the last key inspection. Over the last two years annual service reviews (ASR) have been carried out of the service. An ASR is a review of the service and how it is meeting the needs of residents. We found that Queen Anne House has consistently provided excellent outcomes for residents. What the care home could do better: There are no areas for improvement identified at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Queen Ann House 40-42 Old Park Road London N13 4RE     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: Tony Brennan     Date: 2 2 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Queen Ann House 40-42 Old Park Road London N13 4RE 02088822336 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs K B Kelly care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: It is recommended that accommodation in individual rooms (service user bedrooms) is now recognised as being provided in four double (shared) rooms and seven single rooms. Date of last inspection Brief description of the care home Queen Ann House is a privately run care home registered to provide personal care to fifteen service users who have experienced mental health problems. The home is located in an attractive residential area, a short walk from local shops and business premises in Palmers Green. It comprises of two inter-connecting houses with attractive rear gardens. The private accommodation for service users is provided in seven single and four shared rooms located on the ground and first floors. The communal sitting areas, dining room and kitchen are on the ground floor. The home is comfortable, homely and well maintained. The registered proprietor owns another care home, Queen Ann Lodge, for the same service user group, next door at number 38. Queen Anne House has traditionally provided a secure and supportive environment for people who have enduring mental health problems. Many of the present service users have lived at the home for several years. Care practice is targeted to supporting people in Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 15 Brief description of the care home their efforts to become independent and lead stable lifestyles. are available from the Commission?s Website. Copies of this report Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three star. This means that people who use this service experience excellent quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the home continues to provide excellent outcomes of the residents. Prices inspection the home and completed its annual quality assurance assessment. The annual quality assurance assessment provides us with information about the home and how it was seeking to provide the best outcomes for residents. We also looked at any other information we have received about the since the last key inspection. This included information regarding incidents that the home had told us about. The inspection took place over one day. We were assisted by members of staff and senior workers. As the registered manager was not available we discussed with her out Care Homes for Adults (18-65 years) Page 6 of 28 findings from the inspection. She was able to provide us with further information that enabled us to complete our inspection. We spoke with full residents and three members of staff. We observed care practice and interaction between staff and residents. We toured the building, and examines a number of records relating to do care, health and safety, and management of the home. At the end of the inspection feedback was given to the senior staff and later to the registered manager. We would like to thank the staff and residents were assisted us by answering questions about the running of the home. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The statement purpose provides residents with a clear description of the service. Residents needs are assessed prior to admission to the home to make sure they receive the care and support they need. Evidence: Residents told us that they had been given information about the home before deciding to come and live there. We found that the statement of purpose and the service user guide gave residents a clear picture of what the home was like. The statement of purpose clearly sets out the aims of the home. We found that the needs of the residents we case tracked were within a range of those specified within the statement of purpose. It identified the skills and staffing resources that are available to meet the needs of residents. People have information that gives them a clear picture of the home and how it will meet their needs. A residents who have recently come to live at the home told us, They came and spoke to me about how coming to live here might help me. We looked at the files of the three residents who had recently come to live at the home. These contained Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: detailed initial assessment of their needs. These outlines the past mental health histories, symptoms and behaviours. The homes initial assessment was backed up by information from relevant professionals (for example, psychiatrists, social workers and community mental health nurses). This provided a detailed picture of the needs of these residents prior to then coming to live at the home. A resident said, The staff are very helpful and understanding. Residents records showed that they had visited the home to see if it could meet their needs. People are not admitted to the home until a detailed initial assessment of their needs has been carried out. The initial assessment information had been used to plan the care of residents. Initial assessments were comprehensive in their coverage of the individuals needs. They showed that residents had been involved in the initial assessment process. The home had made sure that it could meet the needs of the three new residents. Training records and discussions with staff showed that they understood how to meet the needs of residents. The home makes sure that it has the resources to meet the needs of residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans reflect the individual needs and aspirations of residents. Residents are consulted about their preferences and how they wish to be supported. Risks are assessed to make sure that residents can live safely and as independently as possible. Evidence: The home has continued to improve the way in which it works with residents to identify and meet their needs. A resident told us, The staff spend time listening and talking to find out how you are. The annual quality assurance assessment stated that care plans were drawn up in partnership with residents, their families and professionals. Care plans of the residents Case tracked provided clear information about their mental health needs. The care plans also advised our on how to respond to residents mental health needs. Care plans were found to provide detailed information on the support provided to meet the needs of residents. Care plans were personalised and referred to the cultural needs of residents. This included whether or not they wish to take part in religious activities. The home involves residents in the planning of care that affects their lifestyles and quality of life. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Details of residents behaviour that might challenge the service were identified in their care plans and risk assessments. Actions to address and manage these behaviours were allied to detail. This included giving details on how to respond to specific behaviours. For example, residents who have hallucinations had clear guidance in their care plan on how this should be responded to our staff. Staff spoken to understood the specific needs of the residents Case tracked. Behaviours that might challenge the service are addressed sensitively to support and maintain residents well-being. Risk assessments were found to cover all areas affected residents daily life. Risk assessment to identify the specific risks facing residents. Risk assessments were detailed and based on the history of previous risk taking on the part of residents. This is reflected in their care plans. Risk assessments had been reviewed changes to the level of risk had been addressed. Staff were able to describe how they prevented risks to make sure that residents were safe and supported to exercise control over their lives. Risks relating to mental health needs were identified. We observe that staff engaged with residents in an appropriately adult way. Comprehensive risk assessments that are reviewed regularly are in place to ensure the safety and independence of residents. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to engage in a range of activities that meet their needs. Residents have community contacts, and are supported to maintain their personal relationships. Residents are supported and to have a nutritious diet that reflects their personal choice. Evidence: The annual quality assurance assessment told us that residents were encourage and supported to take part in activities. Records showed that residents were being supported to engage in activities both in the home and the local community. The home has a gym area for residents to use. Records showed that residents had been supported to access local facilities such as shops and a cinema. Residents told us that they had enjoyed a recent trip to the theatre. We observed that residents were engaged in board games and discussing the news. Residents are involved in meaningful activities of their own choice, according to their individual interests and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: capabilities. Residents told us that they were involved in doing a household tasks is such as shopping, washing and general cleaning. Residents told us that they were involved in cooking the main meal of the day. We observed residents in the kitchen doing this. Residents are involved in the domestic routines of the home to further develop their daily living skills. Residents told us that they were supported to maintain and develop contacts in the local community. Daily records show that residents were supported to maintain contacts with their families and friends. I resident told us, My sister visits every week. We can talk Private. Residentsare able to develop and maintain important personal and relationships. The menu is prepared at a weekly meeting of rule residents. Minutes of these meetings confirmed that residents suggestions for mills were recorded and put onto the menu. Residents spoken to confirm that they been involved in preparing the menu. We found that the menu was varied and reflected the cultural and dietary needs of residents. A resident told us, I like the food here. We observed that residents were able to enjoy them their meal together in a relaxed atmosphere. We saw that residents were able to have our hot drink when they wished. There is a separate small kitchen area for residents to prepare hot drinks. A variety of meals are offered that reflects the individual preferences of residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported with their personal-care needs in ways that maintains their dignity and independence. Residents are able to access the medical care they need. Residents are protected by the homes procedures for handling medication. Evidence: The home continues to improve the way in which it meets the personal-care and health care needs of residents.Care plans outlined the support that residents required to maintain their independence when being assisted with personal-care. We spoke of residents who explain that Staff provided support to help them maintain their personal care. Staff explained that they might encourage residents if they needed support with personal care. Care plans gave specific guidance on how the personal-care needs of residents should be met. This included if they wished to have the same gender care. Staff were able to explain how they would support residents with their personal care. Residents are supported with their personal-care in ways that reflect their varied individual needs and preferences. Medical needs had been identified as part of the initial assessments and were referred to in residents care plans and risk assessments. Residents notes recorded that they Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: had access to opticians, dentists and chiropodists.Residents confirmed that they had been able to see their general practitioner when they wished. Resident records showed that there mental-health needs were being reviewed regularly by the relevant mental health professionals. Residents are supported to access health care they need. Residents health care needs are address to promote their well-being. We found that the records from receipt, administration and disposal of medication were all complete. We checked the records of medication of the residents who we case tracked. These confirmed that they were receiving all the medicines they had been prescribed by their doctors. Residents care plans included a section on their agreement to staff administering medicines. All residents had a medication profile outlining the medicines they were currently taking. The residents case tracked had records of multidisciplinary meetings at which their psychiatric medication had been reviewed. Training records and discussions with staff confirmed that they had training on the safe administration of medicines. The home has developed an effective medication policy that makes sure that medication is administered safely. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their complaints will be listened to and acted upon. People are protected by the home is a safeguarding procedures from abuse and neglect. Evidence: The home continues to be developed the ways in which it listens to and responds to residents concerns. The complaints policy provided a clear explanation of how to make complaints. It showed how a complaint would be dealt with. The complaints policy was available around the home for residents. All residents we spoke to told us they knew how to make a complaint. They also told us they had regular meetings to discuss their views and resolve any issues. A residents said, They listern to you and are always helpful. Staff told us that they saw it as important that residents were encouraged to discuss their views of the home. A resident said, You can talk with staff about anything you like. The home maintains a record of any complaints. There had only been minor issues since the last key inspection. The home has an open culture that allows residents to express their views and concerns in a safe and understanding enviroment. Residents have access to information about safeguarding. It was available around the home. Staff were able to explain how they would respond to an allegation of abuse. Staff told us that they had read the homes policy on safeguarding. They understood Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: the need to report any incidents or concerns they might have about safeguarding issues. Training records showed that staff had received training on safeguarding and adult protection. There had been no adult protection issues since the last inspection. Residents feel safe and well supported by an organisation that has their protection and safety as a priority. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe and homely environment that is personalised to meet their needs. The home is clean and hygienic. Evidence: We walked round the home found that it was well decorated. Since the last inspection we saw that there had been a number of improvements to the home. This included redecoration number of bedrooms and the refurbishment of one of the bathrooms to provide a walk-in shower. A separates area for residents to make hot drinks and snacks had also been provided. The home provides a safe environment that is adapted to the needs of residents. We saw that residents were able to move around the home safely. Residents told us that the facilities provided by the home met their needs. The homes environment meets residents needs. Residents spoken were pleased with their bedrooms. We saw that each bedroom had been decorated and furnished in a way that reflected the residents preferences. We saw that bedrooms have been personalise with pictures and other items belonging to residents. Residents told us that they had been able to choose how they bedrooms were decorated. Residents bedrooms are personalise and reflect the individual needs. Appropriate measures are in place to prevent cross inspection. The home has detailed Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: policies on the prevention of cross infection. The annual quality assurance assessment and training records confirmed that staff had training on infection control. staff spoken to understood how to work to minimise the possibility of cross inspection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. A proactive infection control policy makes sure that the risks of cross infection to residents is minimised. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff, with the necessary skills and support are available to meet the needs of residents. Residents are fully protected by the homes recruitment procedures. Evidence: The home has consistently made sure that there are always enough staff available to meet the needs of residents. The annual quality assurance assessment told us that the home makes sure that sufficient staff are available to meet the changing needs of residents. We observed that staff were always available to spend time with residents. We found that the rota showed a consistent staffing level was always maintained. At times when specific activities or appointments are planned staffing is increased to cover these. Both staff and residents confirmed that there were enough staff available at all times. A resident said, There is always someone there to help. The home has plentiful staff available at all times to support the needs of residents. Residents told us that they felt staff understood their individual mental health needs. Staff with whom we spoke were able to explain how they responded to the mental health needs of individual residents. The home has a consistent record in providing a training programme that makes sure staff have the necessary skills. We saw that the homes training profile and other training records showed that staff had been provided with all the training necessary to meet the needs of residents. This included specific Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: training on mental health issues and addressing behaviours that might challenge the service. We observed that staff understood how to respond and communicate with residents. Training records confirmed that over 50 of staff had achieved the National vocational qualification in care. Staff who had recently commenced working at the home had been registered for this qualification. A number of staff have either completed or are working towards their National Vocational Qualifications in care at level 3 and level 4. The home has maintained its Investors in People Award for the quality of its training over the past two years. Staff training records showed that staff had completed all the training in essential areas, such as food hygiene health and safety, administration of medication, infection control and first aid. Staff had also completed training in areas such as the mental capacity act and the use of computers in their work. The home make sure that all staff have the necessary training that is focused on delivering improved outcomes for residents. Over the last three key inspections we have found that the home follows a comprehensive recruitment procedure. New staff spoken to confirmed that they had completed an application form and had an interview prior to being offered a job at the home. Residents spoken told us they had been involved in interviewing new staff. The annual quality assurance assessment highlighted that this was done so that residents were involved in choosing who would support them. After the inspection of the home and sent us information to confirm that all new staff had two references and a CRB check prior to starting work at the home. Residents said that they felt that staff could be trusted. Recruitment procedures to ensure the safety and well-being of residents. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective management systems are in place make sure that residents well-being and safety is promoted. Residents views of the home sought and used as the basis for improvement. Residents and staffs health and safety is always promoted. Evidence: We have found over a number of key inspections and annual service reviews that the home is managed in a way that consistently promotes the well being of residents. The registered manager has shown us that she understood how to develop a service so that it meets the needs of residents. The registered manager has shown us that she has the relevant skills and training to meet the needs of the residents. Both staff and residents told us that the registered manager was approachable. Feedback from professionals confirmed that the home was well managed. This has made sure that the mental health needs of residents are always addressed. Staff were clear about their roles and how this contributed to supporting residents. Staff meeting minutes showed that issues were addressed to improve how staff worked with residents. Effective management systems are in place to provide the best outcomes for residents. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home has made good progress in responding to the Mental Capacity Act. Staff are provided with information and training on how mental capacity issues might affect residents. We found that this is being reflected in care plans. Discussions with professionals prior to the inspection confirmed that the home demonstrated an awareness of these issues. Mental capacity is addressed as part of the care and support provided to residents. The home does not manage any residents money directly. The home invoices families or the relevant social service departments on their behalf for any expenditure. We found that a system is in place to record the money spent by individual residents. We checked these and found receipts were available to show how money had been spent. All expenditure was signed by two members of staff and the resident. This provided a clear audit trial of the money that had been spent. Residents can have confidence in the homes procedures for handling their money safely. We found a system is in place to monitor the quality of service provided by the home. There are records available of quality assurance surveys to show that this monitoring was taking place regularly. Residents, relatives and professionals views had been sought about how the home was being run. We found that the majority of comments and responses to questions were positive. There was one issue that had been raised in the survey and this had been addressed by the home. There were minutes of residents meetings. These meeting were used to discussed issues regarding the quality of the service (for example, the food provided and activities). This showed that residents are supported to provide regular feedback on how the home meets their needs. Actions to improve the home had been agreed with residents and their families. There is a strong emphasis on being open and transparent in all areas of the running of the home. Records show that the safety risks to residents and staff were identified, assessed and action taken to ensure their safety. Records showed that the fire equipment has been tested regularly. Fire drills were taking place regularly to make sure that residents and staff knew how to respond in the event of a fire. All health and safety policies were available. Certificates the gas testing were in date. COSHH guidance is in place, and chemicals were stored safely. Residents are aware of the safety arrangements and can have confidence in the safe working procedures of staff. 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. 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