Care Home: REACH Upton Court Road

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What the care home does well There are sufficient numbers of staff on duty at all times of the day and night to meet the needs of the residents. Staff are caring and kind, well trained and professional. The staff team have received the training they need to provide good quality care. Most have achieved professional qualifications to improve their skills and knowledge. It is evident that the staff team work well together to provide a happy home for residents From observation of practise it is clear that residents are treated with dignity and respect at all times by the staff. Personal care is provided in a discreet and sensitive manner. The manner of address used by staff to speak to residents is friendly, respectful and courteous. Residents enjoy a full and stimulating lifestyle. The activity programme is varied and interesting and includes trips out to local shops, holidays away and day trips to cinemas, pubs, restaurants and local beauty spots. Residents take an active part in the community and visits by friends and relatives are welcomed and encouraged. The food is varied and nutritious and offer residents choice. Meal times are considered an occasion each day and are relaxed and unhurried and taken in comfortable attractive surroundings. The home is comfortable, clean and satisfactorily decorated and furnished throughout. Residents are encouraged to personalise their own rooms and these are decorated and furnished to a good standard. The written care records are well kept and up-to-date and provide staff with the information they need to provide the right care to the residents. Residents are involved in planning their care and feel their views and opinions are valued and listened to. What has improved since the last inspection? Since the last inspection the service has continued to develop and improve the quality of its service. In the past year the home has been completely redecorated and new furnishings have been purchased for the communal areas. There is a new Manager in post who has recently registered with the Commission. What the care home could do better: There are new requirements or recommendations arising from this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: REACH Upton Court Road 2a Upton Court Road Slough Berkshire SL3 7LX     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: Julie Willis     Date: 2 1 0 1 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 30 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 30 Information about the care home Name of care home: Address: REACH Upton Court Road 2a Upton Court Road Slough Berkshire SL3 7LX 01753570222 01753579222 upton@reach-disabilitycare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): R.E.A.C.H. Ltd Name of registered manager (if applicable) Ms Sarah Davies Type of registration: Number of places registered: care home 8 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 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 2A Upton Court Road is a residential home offering a service to eight adult service users, of both sexes who have learning and associated behavioural difficulties. The house is owned and the care provided by Rehabilitation, Education and Community Homes Ltd. The home is a two storied, specially adapted house, offering accommodation on the ground and first floors. The home is located within a few minutes walk of Slough Town Centre, within easy reach of all amenities. There is a park nearby and public transport is easily accessible. The home has its own transport. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 Brief description of the care home The weekly fees range from 780 to 1700 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 30 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: This inspection of the service was an unannounced Key Inspection. The inspector arrived at the service at 10:00 am and was in the service for 5 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the services manager, and any information that the CQC has received about the service since the last inspection which was undertaken on 26th April 2007. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, relatives and visiting professionals such as doctors and nurses. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met all of the residents. The inspector also spent time talking to staff and observing how care was being delivered to the residents. Care Homes for Adults (18-65 years) Page 6 of 30 From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. The inspector gave feedback about her findings at the end of inspection. There were no legal requirements made as a result of this inspection. The Commission has received no information concerning complaints or safeguarding issues since the last inspection. Care Homes for Adults (18-65 years) Page 7 of 30 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. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 of 30 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 10 of 30 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. Prospective residents and their representatives have the information they need to choose a home which will effectively meet their needs. The home has a comprehensive admissions policy in place, which details the holistic assessment that will take place prior to a residents admission. It identifies the need to fully involve the person to be admitted, their family, advocates and a multi-disciplinary team of professionals. Evidence: The home has a highly detailed Statement of Purpose and Service User Guide which provides residents with information about the home and how it can meet their needs. The documents were updated in April 2009 and have been produced in a user-friendly widget format to help potential users of the service to understand there content. The complaint procedure, licence agreement and Person Centred Plan are produced in user-friendly format and incorporate a widget version of the complaints procedure and details of the Mental Capacity Act. All information about the home including pictures of the various services are available on the Organisations website. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Although there have been no new admissions to the home for a significant period and much of the paperwork has been archived it was evident from discussions with staff that people were fully assessed prior to their admission to the home. The home has a comprehensive admissions policy, which details the comprehensive and holistic assessment that will take place and the need to fully involve the person to be admitted, their families, advocates and a multi-disciplinary team of professionals. Individuals are encouraged and supported to be fully involved in the assessment process from the outset. Advocates are used to facilitate and enable the user when needed. Information is gathered from a variety of sources including other health and social care professionals and family members. During the transition process the new resident is supported to spend time at the home to meet other residents and staff. The transition is a gradual process which gives residents time to settle into their new environment. This period may take days or even months if the resident needs more time. The transition period focuses on achieving a positive outcome for the resident and includes ensuring that the cultural and diversity needs of the individual are fully met. Any aids or specialist input are provided by the home before admission. Care Homes for Adults (18-65 years) Page 12 of 30 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. Sufficient information is in place to enable staff to effectively meet the health & personal care needs of residents. Residents are encouraged to participate in the care planning and review process from the outset. The care plans were sufficiently detailed to enable staff to effectively meet service user need and activities that could be hazardous were underpinned by effective risk assessment and risk management strategies. Residents are encouraged and supported to make decisions in relation to their everyday lives and their individual goals appeared realistic and achievable. Evidence: The inspector examined three care plans and case tracked the residents from their pre-admission assessment to date. There was evidence that the written records were detailed, comprehensive and well documented. The records provided staff with sufficient information to enable them to offer the appropriate level of care to the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: residents. From discussion with staff it was clear that they are provided with sufficient time to over-see self care tasks in order that the resident may maintain a level of independence and learn new skills. The Person Centred Plans contain personal information, medical review, risk assessments, goals and lifestyle choices. They contain evidence of the residents involvement in the planning of their care. All residents have a review every six months to which family members and other social and health care professionals are invited. Residents are fully involved in their reviews. They help prepare them in advance and help to lead them. Their involvement has been facilitated by using photographs to capture residents taking part in activities and achieving their personal goals. A number of the current residents have complex needs, health needs and behaviours that may at times challenge the service. A number of the residents regularly attend appointments with behaviour specialists and psychiatric services. Individual support plans are in use at the home and it is clear that staff involve the residents in their production. All have agreed objectives, which have been agreed and signed by the resident. The objectives are reviewed regularly in a meeting between the resident and their allocated key-worker. The care plans encompassed residents personal and health care needs, social activities, specialist needs and behaviour management guidelines in an effective way. Staff were clear that they needed to adopt a uniform approach to respond to any challenges to the service in a planned and consistent way to avoid any confrontation or escalation in behaviours. It was clear from observation of care practise throughout the period of inspection that staff were attentive and caring. Staff have an excellent rapport with the residents based on mutual trust. Staff are responsible for keeping the records up-to-date and accurate. Weekly activity records and daily records were seen to fully validate the care plans. Individual support plans are in use at the home and it is clear that staff involve the residents in their production. All have agreed objectives, which have been agreed and signed by the resident. The objectives are reviewed regularly in a meeting between the resident and their allocated key-worker. All residents are provided with a key worker that takes a special interest in their welfare. From discussion with staff and residents it is clear that the key worker system works well in this home and clearly benefits the residents. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: The home reviews care plans monthly and any changes in the residents need was well documented and was responded to appropriately. The plan is working tool and staff are involved in writing the daily report and keeping the care plan up-to-date. Risk assessments had been routinely undertaken on a range of risks including manual handling, risk of falls and bathing. Where a risk had been identified there were effective risk reduction measures in place to reduce the likelihood of occurrence. The care plans gave clear instruction on how staff should reduce the risks identified. Staff were observed to be polite and courteous to the residents at all times. Staff routinely knocked and waited until they were invited in, before entering residents bedrooms. Observation of care practise concluded that staff were mindful of the need to encourage residents to remain as independent as possible by providing appropriate levels of support. Gentle encouragement and persuasion were used to encourage residents to take part in the activities of daily living. Several residents were tidying and cleaning the kitchen area after lunch. They said that they enjoyed taking part. It was evident that the residents right to privacy, dignity and autonomy were maintained at all times. Care Homes for Adults (18-65 years) Page 15 of 30 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 take part in activities that provide opportunity for personal, practical and emotional development. They are encouraged to be part of the local community and citizenship is encouraged and supported. Residents are provided with a menu that is nourishing, varied and meets their individual and cultural need. Evidence: It is clear that residents have the opportunity to develop life skills and to be an integral part of the community. Staff confirmed that visitors are made welcome at any time and are offered appropriate hospitality during their visits. A number of social events are held throughout the year which promotes community involvement and which provide residents families with the opportunity to engage with the staff and residents on an informal and regular basis. Residents are supported to stay in touch Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: with family and friends by phone calls, letters and supporting then on home visits. Several of the residents regularly spend weekends away with members of their family. The residents have the opportunity to take an annual holiday. Last summer five residents went to Disneyland Paris, one resident went on a coach tour in Ireland and one resident went to Torquay supported by the staff. The home has a house vehicle and residents are offered regular days out to places of interest, local shops and the seaside. In recent months days out to Madam Tussauds and Regents Park have been particularly enjoyed by the residents. Residents all have a bus pass and make use of taxis, trains and walk to the local town centre shops. Residents are frequent visitors to the cinema and use many local facilities including cafes, pubs and sports facilities. Residents have the opportunity to engage with other users at local clubs and societies. Evidence in activity schedules confirm that residents go to local day services, Men cap club, Thursday Club, Jazz & Morris dancing, WAMSAD, SADSAD, dance classes at Two Left Feet, wheelchair ice skating, trampolining and education courses at Langley College. One of the residents does voluntary work in horticulture. Although the home has no visiting clergy, several of the residents regularly attend a local church for services. The homes routines are flexible and can be adapted to meet the needs of individual residents. Meals tend to be at set times but alternative arrangements can be made if residents request it. Residents may rise and retire at a time of their choosing. The residents are encouraged to take meals in the dining rooms to aid socialisation. Lunch on the day of inspection was pizza and salad. The food was well received by residents and one resident confirmed that it was very tasty. Care Homes for Adults (18-65 years) Page 17 of 30 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. Peoples physical and personal support needs are well met at this home and welltrained and competent staff deals with medication safely and appropriately. Evidence: Examination of residents documentation and discussion with staff and residents indicated that all residents are registered with a local doctor. Regular health checks and routine screening and treatments are offered by the practise and several residents regularly see the practise nurse for blood tests and other advice and treatments. A number of the residents have regular contact with mental health services and have their medication reviewed at appropriate intervals by mental health specialists. Details of the outcome of these appointments and any changes in treatment or medication are well documented in the care plans and daily records. Several residents see clinical psychologists and behavioural specialists to manage behaviours that may at times challenge the service. Guidelines are in place to ensure all staff manage behaviours in a consistent way. Staff have received training in de-escalation techniques and non violent crisis intervention to support residents effectively. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: There was evidence that residents also have regular dentistry, podiatry and attention to their vision and hearing and their attendance is appropriately recorded in the care records. Several residents have support from speech and language therapy and attend outpatients appointments supported by the staff. The home has robust medication policy, procedure and practise guidance in place. Staff are aware of their responsibilities in relation to the safe administration of medication and have been properly trained. Several residents have seizures and staff have received training in the administration of rectal diazepam. Care Homes for Adults (18-65 years) Page 19 of 30 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 has a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by staff that can demonstrate knowledge of the homes abuse of vulnerable adults and whistle-blowing policies. Evidence: The complaint policy in the home meets the requirement of Regulation and Standard. Residents are provided with information on how to make a complaint and the stages and time scales for action. The complaint policy has been developed in a pictorial format to aid residents use and understanding. Examination of the complaint records indicated that there have been no complaints made to the home since 2005. The CQC have received no information about complaints or safeguarding matters about this home. Resident said that that they felt confident that any concerns or complaints would be taken seriously by the home and efforts would be made to remedy any problems in a timely fashion. There was evidence in staff files and from discussion with staff, that they receive training in safeguarding adults as part of their formal induction to the home. There Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: learning is later consolidated when undertaking NVQ training in which it forms a core module. Staff interviewed understood the importance of protecting residents from abuse and exploitation at all times and were conversant with local safeguarding procedures and the Organisations whistle-blowing policy. One resident said, I like it here, its lovely, staff are kind, its the only place I want to live. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standards of decor and furnishings in this home offer residents a comfortable and homely place to live. Standards of hygiene are good throughout. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: From a tour of the building it was evident that the residents live in warm clean and comfortable environment. All areas of the home were found to be clean and hygienic. The home is tastefully decorated and is furnished in a modern and comfortable style. Residents are encouraged to see it as their own home and to add their own personal touches to the environment. All areas have been decorated in the past year and new furniture has been purchased for the lounge. The home is well maintained and has the specialist equipment it needs to accommodate its residents. The home is fully accessible to people with physical disabilities. Adaptations and specialist equipment are designed to be as unobtrusive as possible and to fit in with the domestic homely surroundings. The communal lounges and dining area are pleasantly decorated and furnished in a homely manner. Lighting is domestic in character and bright enough to meet the Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: needs of residents with any visual impairment. All rooms are centrally heated and corridors and communal areas are sufficiently lit to provide sufficient light for reading and to provide a safe environment for residents. One resident said I like it here Ive got a lovely room and I chose this colour its my favourite. Another said Yes its nice. Care Homes for Adults (18-65 years) Page 23 of 30 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. The staff team were able to demonstrate that they have the necessary skills and experience to effectively meet the needs of residents in their care. Staff recruitment procedures are robust and transparent and protect residents from harm. Evidence: The inspector examined the recruitment records for two of the staff. The content of files evidenced that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. The content of the files met the National Minimum Standards and Regulations. The policies and procedures relating to selection and recruitment ensure resident safety and are robust, transparent and meet the requirements of current good practise guidance and legislation. Residents are involved in the recruitment process and meet all candidates. They can ask questions and have a say in who is recruited. From discussion with two permanent staff and examination of their training records it was clear that they have received structured induction training to Sector Skills Council specification. All staff receive core skills training in fire safety awareness, health & safety, infection control, safeguarding adults, food hygiene, first aid and manual handling. All staff are encouraged to attain National Vocational Qualifications at levels 2 & 3. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Additional training is offered to the staff of the home to enable them to effectively meet the needs of residents with a variety of complex needs. This training includes non violent crisis intervention, challenging behaviours, person-centred planning, equality & diversity and mental health needs. Future training will incorporate further information about the Mental Capacity Act and Deprivation of Liberty legislation and its effect on residents. All staff receive on-going support and are formally supervised at least six times a year. One of the meetings is an appraisal meeting. Staff have additional opportunities to air their views and to have a say in the way the home is run in the regular bimonthly team meetings. The minutes of these meetings were examined by the inspector and appeared to follow a shared agenda and were resident focused. Staff interviewed informally by the inspector seemed knowledgeable, motivated and caring and clearly knew the needs of individual residents well. Residents appeared relaxed and happy in the staffs care. The staff team were observed throughout the course of inspection to offer residents appropriate choices in relation to their everyday lives. One resident said staff are good here, they help me and are kind. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well managed home, where there is evidence that their health welfare and safety is of primary importance. The registered persons are qualified, competent and experienced to run the home for the benefit of residents. Evidence: The Homes Manager Sarah Davies has been in post since January 2009. She has attained an NVQ level 4 in care and is currently undertaking a Leadership & Management in Care to further her knowledge and skills. She also holds the A1 award to enable her to assess staff undertaking National Vocational Qualifications. The staff team confirm that the Homes Manager is a caring and effective leader and is always keen to support individual members of staffs personal and professional development. The staff team confirm that they have the opportunity to express their opinions openly and have regular staff meetings, which follow a shared agenda. These meetings, supervision sessions and staff handover times provide plenty of opportunity Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: for the staff to feel included and involved in the way the service is delivered. The whole team aspire to providing quality care to users in line with the aims and objectives of the home and are kept well informed and up-to-date. From examination of documentation, observation of practise and discussion with staff it was evident that although several of the residents are non-verbal, staff are skilled at interpreting the residents non-verbal signals and gestures. They are keen to support residents participation in all aspects of life at the home. The home has effective quality assurance system in operation. It is underpinned by an open and transparent ethos where staff and residents opinions are valued and acted upon. The home undertakes audits of its own services at regular intervals. A detailed action plan is drawn up to act on any deficits identified. The Organisations Senior Managers also carry out an annual service audit and produces a report. The most recent audit carried out in October was examined as part of the site visit and indicated very positive outcomes for the residents. In addition management visit the home monthly to carry out a Regulation 26 (Proprietors Representative) visit. Reports of these visits were examined during the inspection. The results of the most recent audits demonstrated excellent outcomes for residents at the home. Examination of residents cash accounts indicated that a safe procedure is followed for deposit or withdrawal of residents monies. Receipts are kept of all cash spent and there are double signatories to all transactions. Residents are regularly consulted about their care needs as part of the formal review process. They can ask to see their records at any time and will be given access. All records required by regulation were found to well maintained, secure and up to date. All staff were aware of the needs to treat information confidentially and to maintain records including computer held records securely in accordance with the Data Protection Act 1998 and other statutory requirements. A number of health and safety records relating to fire safety and the maintenance of the hot water system were sampled and found to be accurately documented and up to date. Routine serving and maintenance of equipment is carried out in accordance with the requirements of legislation and good practise guidance. Activities that pose a risk to users are fully assessed and procedures are put in place to reduce the risk of occurrence Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 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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