Care Home: Riverside Drive

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What the care home does well The home considers that: `Health needs of people who use the service are well met. There are good links with external professionals to support residents, for example, district nurses and the community learning disability team. All residents have a detailed health action plan.` We were able to evidence this during our site visit.People that live in the home told us in their surveys that they were happy with the way staff support them to live their lives independently. Riverside Drive has the potential to be an excellent service if it continues to build on current practices. What has improved since the last inspection? Requirements were made at the last inspection that related to medication handling, staff recruitment, information on handling challenging behaviour, regular checks of equipment and an accessible complaints procedure. All of the requirements are judged to have been met as a result of this inspection. What the care home could do better: No requirements have been made at this inspection. One comment on a survey stated that `more outings`, could improve outcomes for people that live in the home. The management of the home are aware of this and are planning to provide more diverse activities according to individual needs. We have made recommendations relatingto medication recording, routine cleaning and reviewing policies and procedures. Key inspection report Care homes for adults (18-65 years) Name: Address: Riverside Drive Mitcham 112 Riverside Drive Surrey CR4 4BW The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Pitt Date: 2 4 0 3 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 31 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 31 Information about the care home Name of care home: Address: Riverside Drive Mitcham 112 Riverside Drive Surrey CR4 4BW 02086408279 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : keniwenofu@merton.gov.uk www.merton.gov.uk/housingsupport London Borough of Merton care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only - Code 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 - Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home 112 Riverside Drive is a care home providing personal care and accommodation for eight adults with learning disabilities, up to two of whom may have physical disabilities. The home is staffed and managed by the London Borough of Merton social services department. The premises are owned by a housing association. The home was purpose built and is located on a site set back from a residential road in Mitcham. All residents are provided with their own single bedroom. One bedroom is furnished with en suite facilities and tracking for a hoist. A lift provides access to the first floor. An enclosed garden is provided to the rear of the premises. Parking is available to the front of the home. The home is close to bus and tram links. Information about the service is available in the Statement of Purpose and Service User Guide. Fees are not applicable to this service as it is an in-house service funded by the London Borough of Merton. However, residents are expected to pay towards holidays. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. One inspector undertook this unannounced inspection. A site visit was made that lasted four hours. During this time we were able to speak with individuals that live at Riverside Drive and members of staff. We received surveys from people that live in the home and staff members. We have used information from the surveys in this report. We received a completed Annual Quality Assurance Assessment (AQAA), that contained information which has been used in this report. What the care home does well The home considers that: Health needs of people who use the service are well met. There are good links with external professionals to support residents, for example, district nurses and the community learning disability team. All residents have a detailed health action plan. We were able to evidence this during our site visit. Care Homes for Adults (18-65 years) Page 7 of 31 People that live in the home told us in their surveys that they were happy with the way staff support them to live their lives independently. Riverside Drive has the potential to be an excellent service if it continues to build on current practices. What has got better from the last inspection What the care home could do better No requirements have been made at this inspection. One comment on a survey stated that more outings, could improve outcomes for people that live in the home. The management of the home are aware of this and are planning to provide more diverse activities according to individual needs. We have made recommendations relating Care Homes for Adults (18-65 years) Page 8 of 31 to medication recording, routine cleaning and reviewing policies and procedures. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janet Pitt 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 02072390330 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You 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 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make a choice about whether to live at Riverside Drive. They are given enough information to make a decision. Evidence: The home states in its AQAA that: Comprehensive service user guide and statement of purpose are in place.The statement of purpose and service users guide could benefit from modification to include pictorial descriptions that will help to make them service user friendly. The Home will need expert professional help to achieve this and this is being sought. We have noted from previous inspections that this has been ongoing and consider that this area of work needs to be finished. This will make sure that people have information in a format that they understand. A recommendation has been made to this effect. Riverside Drive has a key-worker system in place. People that live in the home have a member of staff who is responsible for promoting residents needs in the home and externally. We found evidence in care plans that confirmed key-worker involvement. Surveys we received from individuals indicated that they had had sufficient information to Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: make a choice about whether to move into the home. During our site visit we noted that people have been living at home for several years. Appropriate assessments were done at time of admission and since then regular reviews of needs have been carried out. Care Homes for Adults (18-65 years) Page 12 of 31 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. Peoples plans are routinely reviewed and updated as needed. Individuals are able to risks as part of their everyday lives and are supported by staff to do this. People that live in the home can make decisions about what they want to do. Evidence: The homes AQAA told us: Care Plans for service users are comprehensive and take account of individual needs and choices. This includes a life picture, strengths and needs, likes and dislikes and goals. The Care Plans are person centred. We hold six monthly and Annual Review of Care attended by service users, their family members, GPs, Psychiatrists and other professionals involved in their care. These reviews enable service users to be supported in making decisions about their lives and to participate in the assessment of their changing needs and personal goals which will then be reflected in their individual plan. Monthly meetings are held to make sure that individuals are able to participate in all aspects of life in the home. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: People that live in the home are supported to to take risks as part of an independent lifestyle. At the time of the site visit we saw one person going out to lunch and the cinema with their keyworker and relative. Other people that live in the home were at the day centre. Care plans showed that reviews are held and changes made if needed. One person has reduced the hours that they go to the day centre, as it was too tiring. One individual returned home for lunch and we observed staff offering choices around what food was available to eat. The person was offered a choice of hot or cold drinks. Care records evidenced people being involved in the care planning process and being present at reviews. The care plans were written from the persons viewpoint and words such as I prefer and I like had been used. Using more pictures and photographs would help to individualised plans more. The service plans to improve in the next twelve months by making sure that individuals are able to access independent advocates if they chose to. People that live in the home have appropriate risk assessments in place. We saw that these covered areas such as finances, being safe in the community and relationships. All people that live in the home that responded to surveys said that they were able to make their own decisions and plan what they want to do during the day and at weekends. Care Homes for Adults (18-65 years) Page 14 of 31 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. People who use the service have access to activities and leisure facilities to meet their social needs. People receive a varied diet to meet their health, religious and cultural needs. Evidence: The AQAA stated: Service users are offered opportunities to undertake various activities of their choosing within the Home and outside in the community. The Home supports the promotion of service users cultural and spiritual life and expectations. Service users are regularly supported to attend their place of worship and to celebrate their festivals as they wish. One care plan said : I am a white British citizen and belong to the Christian faith. I attend church on Sunday with staff support. I love Church music and the Church singing. Service users are supported and encouraged to keep in touch with family and friends and can invite friends and or family to their home as they wish. They can meet them in Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: private in their rooms. Personal and educational development is supported by attendance at clubs, colleges and day centres. Peoples plans detailed individual interests and hobbies and when the person attended these. Examples found in care plans of people being able to chose what they do are: discos, parities, TV, walks in park, drives out.and places to visit: museums, cinema, pubs and restaurants. Each person had a Life Picture that was arranged as a spider diagram and had information on the individuals keyworker, advocate, family and friends. Clubs the person belongs to eg keep fit, learning together, Gateway and Funky Feet had been recorded. Place to visit included museums, cinema, pubs, restaurants, shopping, club and church. The plans detailed an individuals preferred name, review dates and health professionals involved in meeting their care needs. We were told by staff that each person is supported to go on holiday at least once a year. On our site visit we saw that the menu was up to date. A member of staff told us that menu choices are decided at Residents Meetings. The menu had choices for main and pudding courses. Staff said that if people chose to eat something that was not on the menu for the day, then this would be arranged. People that live in the home have their main meal in the evening and a packed lunch, as the majority attend day centres. People have chosen to have a takeaway meal once a week. Visits to local places such as the Harvester are also arranged. We noted that fresh fruit and vegetables are available and the menu focused on health eating choices. At weekends brunch is offered on Saturdays along with toast and cereals that are offered daily. Barbecues are held in the summer. The kitchen provides enough space for staff to support people in meal preparation. there was an area for hot drink preparation, where individuals are able to help themselves. The Speech and Language Therapist has started working with staff to label cupboards so that people are able to find items easily. We were told that there are plans to develop a pictorial menu. Individuals food preferences are noted in their care plans: Do not have any particular favourites. I do not like hot spices in my food. I like both hot and cold drinks. I like wines generally. Information on whether support with eating was needed had been detailed. Page 16 of 31 Care Homes for Adults (18-65 years) Evidence: The AQAA told us that the home plans to improve in the next twelve months by: allocating a kitchen day when each [person] would actively participate during preparation of their meals. The home would like to have a car or people carrier for use by residents to maximise community participation. Care Homes for Adults (18-65 years) Page 17 of 31 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. Peoples health and personal needs are recorded with the involvement of the person. Medications are generally well handled and minor improvement is needed to make sure that records are accurate. Evidence: We were told in the AQAA that; All residents have detailed Health Action Plans and are registered with local general practitioners. Residents have access to other health support if required. There are good links with the community learning disability team and other professional groups including psychiatrists, psychologists, community nurses and speech and language therapists. When we looked at peoples care plans were found evidence of this. For example health plans covered areas such as hearing, dental and chiropractic care. Individuals had moving and handling assessments that were tailored to their needs. For example one person had specific information on how they were to be positioned for various activities throughout the day. As the individual was at risk of choking when eating and drinking the guidance covered how they should be sat, what types of food were appropriate and how assistance should be given. Peoples specific health needs had been detailed. One individual has epileptic seizures. Their plan included details of how seizures Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: should be handled to keep them safe, possible triggers or warning signs and how long the recovery period was. Emergency actions detailing what to do when the person had a specific number of seizures was present. The AQAA told us that: Care Plans include information on the likes and dislikes of people who use the service which gives staff a clearer idea of what choices to offer them. Staff allow service users to make choices and decisions about how they preferred to live. We found evidence of this in the care plans inspected: privacy when using toilet. When I am Feeling Ill. generally slow in doing things or reacting to events around me. Not talk as much, appetite down and withdrawn. I like praises and good compliments when I achieve a good outcome. I am able to understand and speak English very well but due to my condition I only talk when I want to. I can understand when someone is talking to me if the message is expressed clearly using short sentences. I like to be given time to respond to what is being said to me. I have a communication passport that I carry with me most of the time. There was information on how to deal with challenging behaviours, such as: When someone has upset me or when I am angry, I will usually bite my finger, wag my finger or swear. I could also hit out at the person. During such moments I depend on staff to calm the situation by talking to me calmly, firmly and by taking me out of the situation to find my own space. Plans had information on individuals reading, writing and number skills and what assistance they needed. Improvements have been made in medication management in the home. The AQAA told us that: Medication profiles are in place for service users and these include the photograph of the service user. We saw that medication profiles for people had a recent photograph of the person, details of any allergies, prescribed medicines, along with the reasons they were being taken and what form the medications came in e.g. cream or tablet. When medications are received into the home two people count the amount and sign the record sheet. Care is needed to make sure that when part of a prescription is received this is noted on the record sheet. Some peoples charts showed that a large number of tablets had been dispensed, but smaller amounts were received weekly. This needs to be clearly documented so the number of medications actually held in the home is correct and it is clear when the other medications will be sent to the home. Medications were seen to be stored securely and at the correct temperature. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Care Homes for Adults (18-65 years) Page 20 of 31 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. There is an accessible complaints procedure displayed at Riverside Drive. People can be confident that any concerns they have will be listened to and action taken if needed. People are protected from harm by safeguarding procedures and staff receiving specific training. Evidence: The home said in its AQAA that: Policies and procedures regarding complaints are in place and the procedure for making complaints has been made user friendly allowing easier accessibility to service users. During our site visit we noted that the home had received two complaints in the past twelve months. One of these was upheld. The records were well completed and included what actions and outcomes had been done. A copy of the complaints procedure was displayed on a notice board by the office. The policy included pictures to help people know what to do. All people who answered our survey said that they knew who speak to if they were not happy. Individuals knew how to make a complaint. The AQAA stated that all senior members of staff have had training on complaints handling. This training is to be given to all of the staff team. A compliments book is kept at the home. Comments included: [Their] hair, nails looked very nice. The cuisine is always excellent too so the staff should be congratulated. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: [They are] very happy and settled there and it is a lovely family atmosphere. The home considers that an area in which it does well is Safeguarding:Staff protect all residents from abuse, neglect and self harm by following the robust policies and procedures in place regarding the protection of vulnerable adults (POVA). Staff are to receive Safeguarding Adults training in the next twelve months and Deprivation of Liberty training. We have not received any concerns or complaints about the home and there have been no Safeguarding alerts in the past twelve months. Care Homes for Adults (18-65 years) Page 22 of 31 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. Poeple live in a homely place that they are able to personalise if they chose to. Individuals are involved in helping to make sure the home is clean and tidy. People are supported to carry out domestic tasks in their rooms. Evidence: Riverside Drive states in its AQAA: The Home is clean, hygienic, comfortable and homely at all times.Service users have freedom to choose the furnishings for their bedrooms to suit their different tastes, choices and lifestyles.and Adaptations in the Home support residents with physical disabilities. A large well kept garden at the rear of the building that provides a useful place of relaxation for service users, friends and family during the summer months. We were able to confirm this during our site visit. One of the people that lives in the home showed us around the building. We saw that peoples rooms were decorated and furnished to their individual taste, and they had their own personal possessions, such as disco balls, double beds and televisions. All surveys respondents said that the home was clean and tidy. However, we did find one extractor fan that was full of dust. This was cleaned at the time of the visit. It is recommended that this is done regularly, to minimise the risk of fire. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Suitable adaptations such as hoists, special chairs and shower tables are at the home if people need to use them to have their needs met. We are concerned that the first floor bathroom is not able to be used, as this restricts choice for individuals. The manager told us that the landlord was aware, but had been slow to respond. The home were continuing to follow up the necessary repairs in order that the bathroom could be used again. People are able to use a large lounge on the ground floor, that leads into the dining room and kitchen. Partitions are available if someone wishes to have more privacy. There is a quiet lounge on the first floor that has comfortable sofas. A television and music system are available in this room for people to use. A member of staff told us that this lounge is used for individuals reviews and meetings. The laundry, was clean and well organised. People have colour tags on clothes to show what items are theirs. This is more dignified than having name tags and respects peoples privacy. Care Homes for Adults (18-65 years) Page 24 of 31 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. People are supported by a trained and competent staff team. Regular supervision is carried out and training relevant to individuals roles is provided. Care is taken to make sure that staff are recruited safely so that people are protected from harm. Evidence: Information from the AQAA tells us that Riverside Drive consider they have a good recruitment process in place. They make sure all necessary checks are carried out prior to a person starting employment. Training is given to make sure that people are supported by a staff team that have the necessary skills to care for them. The AQAA stated that: All staff receive regular supervision and appraisal to support them in their work. and Staff receive regular training in various areas of care including the mandatory subject areas such as Health and Safety, Fire Safety, Food Hygiene, First Aid,Medication Administration, Manual Handling and the protection of vulnerable adults. Staff who completed surveys were able to confirm this. the majority of respondents said they had enough support, experience, knowledge to meet peoples needs. Staff members also said that they received regular training and supervision. The home plans to improve in the next twelve months by making sure staff receive Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: regular training relevant to their job role and include service users in the recruitment of new staff into the Home. When we spoke with the manager during our site visit they told us that all recruitment is done by the borough and the home keep evidence of Criminal Records Bureau checks. The manager said that they are involved in the interview process and people who want to work at Riverside drive undertake a literacy and numeracy test when they apply for a job. Surveys we had from people that live in the home told us that they were always treated well by staff and management and staff listened to them. No issues were raised about staff numbers. We observed on the site visit that there were sufficient numbers of staff available to meet individuals needs. Riverside Drives staff team are aware of meeting cultural needs and are planning to further changes to promote equality and diversity: [By seeking] ways to attract staff from the White ethnic group that are under represented in the Care Assistant ranks as a way of promoting culture relevant and appropriate lifestyles for service users of white ethnic origin who form the majority of service users in this Home. Care Homes for Adults (18-65 years) Page 26 of 31 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. People are encouraged to make their views known through meetings and sessions with their keyworkers. Staff are inclusive and are focused on meeting the needs of the people that live at Riverside Drive. Health and safety checks are up to date. Evidence: Information from the AQAA informed us that the home no longer uses agency staff and most staff have an NVQ qualification. Regular staff meetings are held to discuss issues relating to the efficient running of the home and provision of high quality services. Residents meetings provide a formal channel to make their [peoples] views count in the running of the Home and service provision. Review of care for each service user is held six-monthly and annually and is attended by service users, their family members, relatives, psychiatrists, social workers and other professionals involved in their care. We were able to evidence this during our site visit. We noted that the home has comprehensive policies and procedures in place. However, these had not been reviewed every two years in line with good practice. The manager Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: reported that the polices are corporate and the local borough who run the home have responsibility for reviewing and updating. It is recommended that all policies and procedures are reviewed at least every two years to make sure practice remains current. The home plans to improve in the next twelve months by: Support[ing] service users to have access to advocacy in pursuit of empowerment in all aspects of their daily life. We hope to diversify and increase service users access to regular communal facilities. When we looked around the home we found that hazardous substances were stored safely and no major issues relating to health and safety were identified. One recommendation relating to cleaning of extractor fans has been made in the section on the environment. Checks on electrical equipment and fire extinguishers had been carried out recently. The manager and staff team were welcoming on the day of the site visit and were able to find information requested easily. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 1 It is recommended that work is completed on producing the Statement of Purpose and Service User Guide in pictorial format. This will make sure that individuals are able to access information independently. It is recommended that there are clear records of how many medications are held in the home to evidence safe practice. It is recommended that extractor fans are cleaned regularly to reduce the risk of fire. It is recommended that all policies and procedures are reviewed at least every two years. To make sure that practice in the home is current. 2 20 3 4 30 40 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. Care Homes for Adults (18-65 years) Page 31 of 31 - 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. 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