Care Home: Rosemary Cottage

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What the care home does well It is evident through the inspector talking to members of staff that the emotional health of the residents at Rosemary Cottage is of a high priority to the home and that staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life. The home and its staff are committed to supporting the residents in accordance with their needs and goals. This was evidenced through the care plans, which detailed the areas of support that the resident needed and how this support is provided by the staff. There were guidelines in respect to routines and behaviour. The manager confirmed that these are reviewed on a regular basis and the families / friends are supported to be involved. All care plans viewed had short and long-term goals, which had been agreed with the individual. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from as there needs and capacity allows. The home has sought the views of the residents through their own methods of communication and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. Routines are very flexible and residents can make choices in major areas of their life. The routines, activities and plans are resident focused, regularly reviewed, and can be quickly changed to meet individual residents needs. What has improved since the last inspection? It was evident through the inspection process that the manager is taking appropriate steps to continually review and improves the standards of care within the home. What the care home could do better: It was evident through the inspection process that the manager is taking appropriate steps to continually review and improves the standards of care within the home. On standards inspected during this key unnnounced inspection some shortfalls were noted and recommendations made with regard to:Policies and procedure were in need of review and updating to ensure they follow current law and guidance. The area manager and home manager is aware of the shortfall in this area and the inspector is confident that this will be addressed. Therefore a statutory requirement has not been made at this time. The inspector observed that the home is set in generally well-maintained gardens. Paving slabs were however uneven and could be a health and safety risk for both residents and staff. Additionally the concrete ramp to one of the entrances has sunk, which now makes it an obstacle for wheelchair users. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rosemary Cottage Canterbury Oast Trust Highland Farm Woodchurch Ashford Kent TN26 3RJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Robert Pettiford     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Rosemary Cottage Highland Farm Canterbury Oast Trust Woodchurch Ashford Kent TN26 3RJ 01233861510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Emma K Stokes Type of registration: Number of places registered: Canterbury Oast Trust care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 6. 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) Physical disability (PD). Date of last inspection Brief description of the care home Rosemary Cottage is registered to provide accommodation for up to 6 adults who have a learning disability, 5 of which also have a physical disability. The home is owned by Canterbury Oast Trust (COT), a registered charity. The house is a modern purpose built property with all accommodation for residents on the ground floor. All bedrooms are single occupancy. The residents have the use of a fully assisted bathroom and Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 0 0 0 Brief description of the care home shower room (both with WC), and a separate WC. The kitchen is accessible to all residents with support and a large, comfortable lounge/diner has views into the garden, shared with other adjoining homes. Hallways are wide and have grab handrails where needed. The home is situated on the grounds of Highlands Farm, the home of the South of England Rare Breeds Centre, and a major tourist attraction in a rural area on the outskirts of the village of Woodchurch. A short drive will take you to the towns of Ashford and Tenterden, and approximately 3 miles away is Hamstreet train station. Within the village of Woodchurch there is the local GPs surgery, post office, church and two pubs, the home also has transport which can be used for residents if they wish and a local bus service passes the farm. The site itself offers many opportunities for community contact, an 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: 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 inspection took place at 9:00AM on 9th October 2008. The Inspector agreed and explained the inspection process with the manager. The area manager later joined the inspector. The focus of the inspection was to assess Rosemary Cottage in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Younger Adults. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. The Inspector used a varied method of gathering evidence to complete this inspection, Care Homes for Adults (18-65 years) Page 6 of 31 pre-inspection information such as the previous report and discussion and correspondence with the registered provider/manager was used in the planning process to support the inspector to explore any issues of concern and verify practice and service provision. The home has completed an annual quality assurance assessment questionnaire (AQAA), which was received on time. This provided the Inspector with information relating to What the home considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, training records and recruitment records. In addition an environmental tour took place. The Inspector identified three service users for case tracking. In addition the inspector had the opportunity to speak with several of the residents and a number of staff. Additional evidence was gained to inform judgements following the observation of many of the residents and their interactions with staff. Surveys were sent to Residents, Healthcare Professionals, Care Managers and Doctors. This provided additional information to enable the Inspector to make sound judgements on the quality of care within the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 31 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 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. Residents can be confident that their needs will be properly assessed prior to moving to the home. Prospective residents also have the benefit of a trial period at the home. Evidence: Records held showed that residents have an assessment, which identifies their individual needs prior to or on admission to the home. The residents, their families and health provide the information / social care professionals. This is then reflected into the care plans and these are developed in agreement with the individual where possible. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and specialist services provided by the home meet the needs of the individual. Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. The assessment process recognises cultural needs and the importance of promoting equality and diversity rather than just meeting needs in a reactive manner. The Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: inspector recommended that the home reviews it equalities and diversity policy and considers carrying out an equalities impact assessment. This is requested to ensure that all of the information and policies relating to residents are inclusive to all members of the community and comply with all current legislation and good practise. Additionally it was recommended that Equality and Diversity training for all staff including management be considered. Prospective Residents have the benefit of a trial period at Rosemary Cottage to assess whether the home can or cannot meet their needs. 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. Residents benefit from having clear individual plans that are comprehensive, identify their needs and are specific to the individual service user. However further evidence that residents are fully involved in the process and contribute towards setting their hopes aspirations and goals needs to be evidenced. Care plans showed that residents are enabled to make decisions and choices. Residents are enabled to take responsible risks through a thorough risk assessment process. Evidence: The key principles of the home for delivering a quality service are based on the belief that residents should be able to take control of their lives. The staff of the home are strongly committed to supporting all residents including those with limited communication or learning disabilities to make informed decisions, understand the range of options which are available to them and have the right to take responsible risks. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: The home and its staff are committed to supporting the residents in accordance with their needs and goals. This was evidenced through the care plans, which detailed the areas of support that the resident needed and how this support is provided by the staff. However behavioural management plans should be in place to support residents should their needs be more challenging. There were clear guidelines in respect to routines and supporting the residents with their needs. The manager confirmed that these are reviewed with health care professionals, relatives and residents where possible on a regular basis. The inspector viewed a sample of three care plans, which showed short and long-term goals. The plan focuses on current need. However development of skills, and future aspirations of the individual could be expanded upon. The plans of care follow the principles of person centred planning. Staff have the necessary training and skills to support and encourage the individual to be fully involved. A key worker system provides additional support enabling one to one involvement. Resident’s rights to make decisions are respected and the care plans reflected their ability to make an informed judgement where possible. Care plans included information concerning the preferred lifestyle and choices. The inspector visited the home at 9:00AM. During the inspection the Inspector noted that residents were seen making choices about their lives and were seen to be part of the decision process where possible. A relaxed atmosphere was noted with the residents interacting with staff. The inspector found that the home has a genuine commitment in evolving the resident in the day-to-day running of the home. Staff were responsive and receptive to the residents input. Examples of such included choosing activities and planning of the day ahead. There were guidelines in respect to routines and behaviour. The member of staff confirmed that these are reviewed with the residents on a regular basis and the families are supported to be involved. The inspector requested that care planning is reviewed to further evidence that residents are fully involved in the process and contribute towards setting their hopes aspirations and goals. It was the opinion of the inspector that more innovative methods could be considered to further enable residents to participate and communicate their views to the development of their care plan and the review process. The inspector recommended that a workbook be devised that explores with the resident area’s of their lives that they wish to influence and change. This could be completed by the resident as their capacity and understanding allows to further reinforce their own personal sense of ownership of their plan of care Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: and rights of citizenship. It was the opinion of the inspector that more innovative methods could be considered to further enable residents to participate and communicate their views to the development of their care plan and the review process. Daily records were not wholly comprentaneous in that they did not follow current guidance. It was strongly recommended that the home follow the Nursing and Midwifery Council guidance: Guidelines for records and record keeping. Residents rights to make decisions are respected and the care plans reflected their ability to make an informed judgement where possible. Care plans include a comprehensive risk assessment. Management of risk takes into account the specialist needs and age of people who use the service, balanced with their aspirations for independence, choice and normal living. Where there are limitations on choice or facilities, it is in the persons best interest. The resident understands and agrees the limitations where possible. Any limitations are fully documented and reviewed on a regular basis to ensure their ongoing relevance. Care Homes for Adults (18-65 years) Page 15 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 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 they are offered a wide range of opportunities for personal development and to learn new skills and feel part of the wider community. Residents engage in a higher than average level of activities which are appropriate to their needs and capabilities.Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered at the home. Evidence: Residents are enabled to participate and contribute to meeting their own self care needs and day to day chores around the house as their capacity allows. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Discussion with staff and residents confirmed that the level of activities were of a high level and that they enjoyed an excellent level of stimulation through leisure and recreational activities both inside and outside the home. The inspector joined residents at 9:00am while they were getting ready for the day ahead. The inspector had the opportunity to speak to several of the residents who expressed their opinion of the home and the activities they participated in and enjoyed. Other residents were observed participating and interacting with staff. Residents have been enabled to and encouraged to participate in hobbies and activities which they had an interest in, such as maintaining and building on personal collections and specific recreational activities. One resident spoke of his love for football and that he supported Millwall and enjoyed a ride in a professional rally car. The service actively encourages and provides imaginative and varied opportunities for Residents to develop and maintain social, emotional, communication and independent living skills at Rosemary Cottage. The staff have a strong ethos and focuses on involving Residents in all areas of their life, and actively promotes the rights of individuals to make informed choices, providing links to specialist support when needed. Evidence of this was observed from direct observation and comments made within the completed surveys received. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. Examples of such included provision for relatives and friends to visit the home and support being provided to enable services users to visit relatives or friends outside the home. Residents were consulted with regard to whom they saw and when and were under no compulsion to accept visitors should they not wish to do so. From observation, records viewed it was evident that residents were offered a choice of menus that meet their dietary needs and individual preferences. Meal times are flexible to suit the residents’ activities and schedules. Residents are able to choose where to eat, and also have facility to make drinks, meals and snacks for themselves and others with staff support should they wish. Residents on evidence seen have had been involved in planning and choosing what to eat where possible. One service user explained the menus how his choice and preferences influenced the menu. Residents are enabled to participate and contribute to meeting their own self care needs and day to day chores around the house as their capacity allows. Care Homes for Adults (18-65 years) Page 17 of 31 Care Homes for Adults (18-65 years) Page 18 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. Residents feel supported by the level of help given and that their healthcare needs are addressed.The service user can feel confident that their wellbeing will be protected by the home’s policy and procedures with regard to the handling and administration of medication. Evidence: The care plans fully documented the personal support required for individual Residents within Rosemary Cottage. They reflected their choices and preferences and staff were observed offering guidance where needed. Times of getting up / going to bed, having baths, eating meals and other activities are flexible to allow for different Residents daily routines. All Residents are allocated a key worker and the inspector observed excellent interaction between staff and Residents. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the Residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Attention is given to ensuring privacy and dignity when delivering personal Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: care and staff are sensitive to changing needs of Residents. When ever possible residents are able to have choice about who delivers their personal care. Where possible Residents are supported and helped to be independent and responsible for their own personal hygiene and personal care. All necessary equipment and aids are provided to support residents with any physical disabilities. The care plans fully documented all physical and emotional healthcare needs and where able residents filled in or were supported to fill in appropriate forms. Within the care plans records of health care provided by G.P, chiropodist, dentist, and opticians were evident. Residents physical and emotional health is monitored on a daily basis. Through their daily records and these correspond with support assessments held in the care plans. This system ensures that all Residents receive continuity of care and supports potential complications and problems at an early stage. It is evident through records that the emotional health support is of a high priority to this home and the staff are pro-active in maintaining and supporting residents with their emotional needs in order to maintain their quality of life. The inspector viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets, and the protocols for the administration of PRN/As Required Medication within the home. The manager confirmed that all staff who dispense medication have received the appropriate training. The inspection of the homes system for storage and the administration of medication brought no concerns. The MAR sheets (drug record sheets) were being completed properly. Doses were not missed and the MAR sheet were able to indicate a reason for missing the dose. The medication file / MAR sheets did have a signature list to evidence who gave the medication signed for on the MAR sheet. The home ensures that the temperature of the medication is monitored 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives know that their concerns and complaints are taken seriously. Residents can feel confident that they are protected from the risks of abuse. Evidence: A copy of Rosemary Cottage complaints procedures was reviewed. The procedure included details of how to complain, timescales for response and information for referring a complaint to the service provider. The complaints procedure is highly visible within the service and is more readily available in different formats. Surveys commented that complaints are managed and dealt with in a sensitive and proactive way. Residents within the service have an understanding of how to make a complaint as their capacity and understanding allows. It was also requested that the procedure makes clear that a complaint can be made to Social Services at any stage. The home’s Policy for the Protection of Residents and staff Whistle blowing procedure was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training however has been provided for staff. The home promotes an open culture where Residents feel safe and supported to share Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: any concerns in relation to their protection and safety. Policies and procedures regarding protection are in place. Criminal Record Bureau Checks (CRB) have been obtained for staff files sampled. The manager stated that all staff have such checks. 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. Service users benefit from living in a good well maintained environment which provides a homely warm atmosphere with safe access to comfortable indoor and outdoor communal areas. However the garden could be improved To minimise risks. Evidence: The inspector observed that the home is set in generally well-maintained gardens. Paving slabs were however uneven and could be a health and safety risk for both residents and staff. Additionally the concrete ramp to one of the entrances has sunk, which now makes it an obstacle for wheelchair users. The manager stated that the home meets with the requirements of the Fire Officer. It was apparent that the individual and collective needs are being met in a comfortable environment. The standard of internal decoration and fixtures and fittings are well maintained and of a good quality. The home benefits from a wide selection of communal area’s thus affording residents space should they so wish desire. The premises are kept exceptionally clean, hygienic throughout and systems are in place to control the spread of infection, in accordance with relevant legislation, published professional guidance and the purpose of the home. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: The home is to be highly commended on the homely and well maintained environment internally it provides for residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care, social and emotional needs are promoted by the employment of caring and suitably trained staff in such numbers to support their needs who put the interests of the residents first. Residents are protected from potential abuse by the homes robust staff recruitment procedures. Evidence: From discussions with the Manager, observations and reviewing the staff rotas more than sufficient staff were on duty at the time of inspection to meet the residents needs. The inspector was informed that staffing numbers would be reviewed and staff increased should the needs of the service users change long term. discussion with staff confirmed that they have a positive attitude and are well trained and experienced. The staff training records indicated planned and undertaken training. The manager evidenced that individual and group staff training needs had been identified. A wide range of training has been identified for all staff. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: The manager confirmed that the home has a development programme for all new staff, which meets Sector Skills Councils workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users, and that all members of staff receive induction training to specification. However evidence was not readably available within the home. First Aid, Food Hygiene, Health and Safety and other core courses are undertaken by staff to maintain current qualifications and for protection of residents. Courses also include training in managing Challenging Behaviour. The service has a recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality carers is seen as integral to the delivery of an excellent service. The service is highly selective, with the recruitment of the right person for the job being more important to the filling of a vacancy. The Home undertakes a recruitment practise including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. All staff have a contract of employment and job description. The staff files were evidenced as meeting standards at the last inspection. Judgement of this was made by the inspector following discussions with the manager and staff. From documentary evidence seen with staff completing basic courses and over the required minimum 50 of the staff achieving a NVQ (National Vocational Qualification) Level 2 or above care qualification. 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 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 run and managed home. Residents and or their relatives can be fully confidant that their views and opinions effect how the home is run and that their best interest are safeguarded overall by appropriate policies and procedures.Residents can always feel assured that their health and safety/ welfare is protected by robust policies/ procedures and safety checks. Evidence: The manager is actively involved in the day-to-day management of the home and works with staff and residents. She is well supported by the area manager and will be shortly be applying to the Commission to be registered. From observation and staff feedback the manager and the provider offer a clear sense of direction and leadership, which staff and residents understand. Residents, their relatives and staff are encouraged to comment on the services the home offers and to voice any concerns they may have. There is strong evidence that the ethos of the Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: Home is open and transparent. The views of both residents and staff are listened to, and valued. Quality assurance was discussed and the views and opinions of many of the residents and stakeholders sought. The residents spoken with confirmed a great deal of satisfaction living within the home and felt confident that their views and opinions were valued by both staff and management. The manager confirmed that the home does undertake quality assurance by means of asking stakeholders to complete questionnaires. The home operates a key worker system to identify an individual staff member to directly to work with a service user on a one to one basis. The home has a quality assurance system. Spot checks and quality monitoring systems provide management evidence that practise reflects the homes policies and procedures. The registered provider of the home do regularly visit the home and complete what is known as a Regulation 26 visit. This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. However the quality of such Regulation 26 visits viewed could be improved and made more comprehensive. Policies and procedure were in need of review and updating to ensure they follow current law and guidance. The area manager and home manager is aware of the shortfall in this area and the inspector is confident that this will be addressed. Therefore a statutory requirement has not been made at this time. The home has a full range of policies and procedures to promote and protect Residents health and safety. There is full and clearly written recording of all safety checks and there is no evidence of a failure to comply with other legislation. There is a good understanding of risk assessment and this is taken into account in all aspects of the running of the home. The quality assurance system confirms that the findings from risk assessments have been actioned and the home continuously improves its systems. Care Homes for Adults (18-65 years) Page 28 of 31 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 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 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 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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