Care Home: Rushall Road (6)

Similar services:

• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road
• Radfords
• Honeybourne House
• 32 Beaumont Way

What the care home does well People`s assessed needs and personal goals were reflected in the individual plans so that these needs and goals could be met. People are supported to make decisions about how they choose to live their lives. Assessments are completed to ensure that any potential risks are minimised, whilst maintaining peoples` independence. People have access to various activities in both the local and wider community. Links with family and friends are supported and maintained, where appropriate. Records demonstrate that people have access to healthcare professionals, when required. Medication appears to be well managed. The home has not received any complaints since the last inspection. The staff team at Rushall Road has a good underpinning knowledge of the people they support. All staff members have worked at the home for many years, which provides consistency to the people living there. Staff are appropriately trained, with all staff having achieved a National Vocational Qualification (NVQ) level 2 or above. Policies and procedures are in place to ensure that the environment is safe for the people living at the home and staff members. What has improved since the last inspection? At the previous inspection, one requirement was made. We requested that a copy of the quality assurance survey be sent to CQC and a copy to be available for people living at the home. The general manager told us that although a copy has not yet been forwarded to CQC, there is a copy within the home. Good progress has been made to action a good practice recommendation set at our last visit. This related to the content and presentation of the care plans. These are also now dated and signed to show when they were developed and by whom. We also recommended that one bedroom was redecorated. This has now been completed and new carpet has been purchased. Risk assessments have been updated and reviewed. They relate to specific risks in addition to general health and safety risks. What the care home could do better: Some behavioral management plans and epilepsy profiles are in need of updating and reviewing. Support guidelines on specific care tasks must be kept within the care plans to ensure the needs of the people living at the home are fully met.To ensure that people are safeguarded individual building society accounts or bank accounts must be opened for each person living at the home. As mentioned previously some areas of the home are in need of redecorating and general maintenance to provide a homely environment for the people who live there. The radiator covers still need repainting and kitchen cupboards need to be replaced or repaired as mentioned in our previous report. Care must be taken to ensure that cleaning mops are hygienically stored. It is recommended that the home develop a fire evacuation plan, which is made available to staff and the people they support. Key inspection report Care homes for adults (18-65 years) Name: Address: Rushall Road (6) 6 Rushall Road North Newnton Pewsey Wiltshire SN9 6JY     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: Pauline Lintern     Date: 2 3 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Rushall Road (6) 6 Rushall Road North Newnton Pewsey Wiltshire SN9 6JY 01980630478 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Steven@StevenAbbott.wanadoo.co.uk Mrs Jane Abbott care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Valued Lives is a private organisation, which operates five care homes for adults with a learning disability. All are small establishments, intended to offer a normal domestic lifestyle. The main lead for the organisation is taken by one of the registered persons, Mrs Jane Abbott. She is supported by other senior colleagues, including family members. Each of the Valued Lives homes is situated in Pewsey, or nearby small villages. Pewsey itself offers a range of amenities. The market towns of Marlborough or Devizes are within 15 minutes drive. Or, slightly further afield, there are the larger centres of Salisbury and Swindon. The organisation has a number of vehicles used to transport service users, who contribute towards the costs of these. Most service users now cared for by the organisation have been with them for a number of years. Time may have been spent in more than one of the homes that Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 3 Brief description of the care home Valued Lives operates. Valued Lives also operates the Activity, Opportunity & Development centre (AOD). This is a day care facility which most of the organisations service users access, for at least part of each week. They pay a small weekly sum towards this. The unit is attached to the home in Ball Road, Pewsey but a new building is being converted for the service. 6 Rushall Road, in North Newnton, cares for up to three people. The present occupants are all male. All have single rooms, on the first floor. There is also a bathroom. There is a shared sitting room, dining room and kitchen downstairs. There is an enclosed garden area at the back of the house. The fees range from 650 pounds to 850 pounds per week. 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 peterchart Poor Adequate Good Excellent How we did our inspection: This home was last inspected on 11th and 12th July 2006. The unannounced key inspection took place on 23/06/2009. The manager Mr Steve Abbott was available throughout the day to assist us. The general manager also met with us and accessed various files and documentation for us to examine. At the time of our visit the three people using the service were at home. Due to lack of verbal communication we were unable to obtain their views on the service provision. However, we were able to observe interactions between themselves and staff members. As part of the inspection process, we sent surveys to the home for people to complete, if they wanted to. We also sent surveys; to be distributed by the home to people using Care Homes for Adults (18-65 years) Page 6 of 31 the service and staff members, care managers, GPs and other health care professionals. One staff member and one healthcare professional responded. The feedback received, is reported upon within this report. We sent Mr Abbott an Annual Quality Assurance Assessment (AQAA) to complete. This was the homes own assessment of how well they are performing and it gave us information about their future plans. We reviewed the information that we had received about the home since the last inspection. We looked around the home and read a number of records, including care plans, risk assessments, health and safety procedures, staff files and training records. The judgments contained in this report have been made from all the evidence gathered during the inspection; including the visit to the service and takes into account the views and experiences of people using the service. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: Some behavioral management plans and epilepsy profiles are in need of updating and reviewing. Support guidelines on specific care tasks must be kept within the care plans to ensure the needs of the people living at the home are fully met. Care Homes for Adults (18-65 years) Page 8 of 31 To ensure that people are safeguarded individual building society accounts or bank accounts must be opened for each person living at the home. As mentioned previously some areas of the home are in need of redecorating and general maintenance to provide a homely environment for the people who live there. The radiator covers still need repainting and kitchen cupboards need to be replaced or repaired as mentioned in our previous report. Care must be taken to ensure that cleaning mops are hygienically stored. It is recommended that the home develop a fire evacuation plan, which is made available to staff and the people they support. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 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. Each person using the service has an individual Service User Guide. The Statement of Purpose was not available as it is in the process of being updated. At the last key inspection, this outcome was judged as good. There has been no information to conflict with this view. Based on this, we have made a judgement, that the assessment process would ensure the service could meet the persons needs. This judgement has been made using available evidence including a visit to the service. Evidence: The manager reported that the Statement of Purpose was unavailable as it is currently being updated. We asked that when this is completed a copy be sent to CQC. We sampled individual service user guides. Each person kept their guide in their bedroom. Guides include a summary of the Statement of Purpose and provide text, pictures and photographs about the service provision. There is step by step guidance Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: on how to raise a concern or make a complaint. Since our last visit to the home there have been no new admissions. All of the people living at Rushall Road have done so for a number of years. The staff team remains consistent and the manager confirmed that all staff working at the home have a sound underpinning knowledge of individual needs. Due to there being no new admissions the key standard which relates to the assessment process could not be fully addressed. 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. Each person has an individual care plan, which reflects their assessed needs. People are supported to make decisions and choices about how they choose to live their lives. Strategies are in place to support people to take responsible risks. This judgement has been made using available evidence including a visit to the service. Evidence: Mr Abbott reported that the care plans were currently being updated and reviewed, as recommended at our last visit and therefore were not at the home. He arranged for the care plans to be brought to the home to enable us to sample them. They were brought to the home within the hour. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: We noted that the format of the care plans had been improved and were now dated and signed by the person who completed them. Care plans state that they are reviewed every six months or when changes are necessary. Each area of need is separated into sections and followed by an action plan, which all staff sign up to. The sections refer to accompanying support guidelines to provide further information on how a task should be carried out. However these were not found within the files. The general manager confirmed that the guidelines had been completed but must have been removed when the care plans were being updated. We asked Mr Abbott to ensure that the support guidelines be kept within the care plans to instruct and inform the reader. Within the care plans we noted that some management plans for behaviours were in need of being reviewed. The general manager confirmed that they have made referrals to the appropriate team; however they are waiting for an appointment to be made. The same applies to the person in need of an updated epilepsy profile. We asked Mr Abbott to chase up both appointments. Care plans explain how the people living at the home make day to day choices and decisions. Mr Abbott reported that people are given choices of items of clothing and are able to point towards the item they wish to wear. He added that some fast food outlets have pictures of meals on boards, which enables the people they support to identify the meal they would like. The manager explained how one person will indicate that he wishes to go to bed by walking around. Records demonstrate that staff receive training in Person Centred Planning. The home has developed communication dictionaries, to aid communication. Although in place, they have still to be completed by staff. Each person living at the home has a general health and safety risk assessment in place, which is kept under review. The general manager confirmed that they are currently completing assessments relating to more specific individual needs. These were made available to us by the end of our visit. 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 have access to various activities, within the local and wider community. Links with family and friends are encouraged and maintained if the person wishes to do so. People living at the home have routines, which are respected and recognised. Meals appear to be varied, well balanced and take into account personal preferences and needs. This judgement has been made using available evidence including a visit to the service. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Valued Lives have opened a local resource centre (Harlequins) and farm (the Secret Garden), which people living at the home can access regularly. This provides people with the opportunity to socialise with people from other Valued Lives homes and from other organisations. Each person living at the home has an activities programme. Activities include Bingo, swimming, walks, skittles, arts and crafts, singing, musical activity, puzzles, library , football and Jabadao. There is a guide in place, which explains what goes on at the farm and the various things and animals that people may have the opportunity to see. The manager reported that people have the opportunity to undertake gardening at the farm. The organisation has a static caravan near Bournemouth. This is available for all people being supported by Value Lives. The manager explained that this enables people to have a couple of holidays a year if they choose to do so. Valued Lives have good links with the local church. Special services are held for people from Valued Lives homes and dates of services are recorded in the parish magazine. Church services are also held at Harlequins day services. The manager reported that church volunteers come into the day centre once a month to sign hymns and support people with activities. Daily records showed that one person had been supported on a recent home trip. Another person using the service also went along for the ride. The manager explained that they are planning to take another person using the service home to see their relative. There are plans for them to all go out for a meal together. Within the AQAA it states at present there are no service users who have either the ability to remember a code or sequence of numbers for a lock, or a level of responsibility necessary to hold a key to their own room or to the house. Individuals are able to lock and unlock the outside doors with the homes key under supervision. The manager explained that they continue to use supermarket recipe cards to enable the people they support to make menu choices. Meals take account of any food intolerances. Generally people take a packed lunch when they attend day services. The main meal of the day is then served in the evening. On the day of our visit the main meal of the day was Beef burgers, mashed potatoes, gravy and vegetables. This was followed by cake and cream. As people were at home during our visit we were able to observe the mid day meal being taken. Everyone sat at the dining room table, including the manager, who supported everyone throughout the meal. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: 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. People have their personal care delivered in a way that they prefer. However, clear guidance needs to be available at all time within the persons care plan. People have access to health care professionals as required. The arrangements for managing medication are satisfactory. Evidence: As mentioned at the beginning of the report, although care plans provide information on each aspect of a persons needs, specific guidance on the support needed was not within the files. We asked Mr Abbott to ensure that care plans include sufficient information on how preferred routines should be carried out. Records and daily diaries show that people are supported to attend medical appointments, such as dentists, consultant psychiatrists, doctors and opticians. Our survey included a response from a healthcare professional, who commented positively about all aspects of health care provided by the home. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: People have a Health Action plan in place; however the plans sampled had yet to be completed. We asked the general manager who would be responsible for completing the plans and she reported that it would be either herself or another manager. We suggested that the learning disability nurses at CTPLD might be involved. The manager reported that one person they support sometimes displays behaviours, which may challenge. He described possible triggers and distraction techniques, which staff may use. As mentioned previously we asked that their behavioural management plan be reviewed and updated. We looked at the arrangements for managing medication and found them to be satisfactory. Care plans record peoples individual medication and there is a protocol in place for any as required medication. Appropriate records were kept of medication being administered and there is a booking in and out book for medication received into the home and returned to the pharmacist. All staff receive training about medication. The district nurse provided training on special methods of administration. All medication is reviewed annually by the doctor. Care Homes for Adults (18-65 years) Page 19 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. People are able to raise a concern or make a complaint if necessary. Policies and procedures are in place to safeguard the people using the service. However, consideration must be given to opening building society or bank accounts on behalf of the people living at the home. This judgement has been made using available evidence including a visit to the service. Evidence: We noted that there is a copy of the complaints procedure in the Service User guide, this includes a step by step flow chart to inform the reader. The complaints policy is in a pictorial format. One heath care professional reported in their survey that the home always respond appropriately if they or another person has raised any concerns. The manager told us that the home has not received any complaints since our last visit. The home does not have a complaints log in place. The general manager reported that Mrs Abbott (registered provider) keeps a log of any complaints received. Staff members sign to confirm that they have read and understood the local protocols for reporting suspected abuse. A copy of the local guidance No Secrets is available at the home. Training records show that all staff attend training in safeguarding people. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Video training is also available for refresher training. Staff are trained in the use of physical intervention. This is provided by an external trainer who is BILD accredited. As part of the inspection process we examined transaction records and cash held by the home on behalf of the people who live there. All records and cash balanced and appropriate receipts have been kept. We expressed concern that the home was holding large sums of cash on behalf of people. We asked the general manager to arrange for building society accounts or bank accounts to be opened for each individual to ensure their finances are safeguarded. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable, clean and safe environment. However some areas of the home are in need of attention. This judgement has been made using available evidence including a visit to the service. Evidence: 6 Rushall Road is situated in a row of houses on a main road through the Vale of Pewsey. There are views of the surrounding countryside. Amenities in the immediate local area are limited. The nearest large centre is the village of Pewsey itself. This is appropriately three miles away. At our last visit to the home a good practice recommendation was made. This related to one bedroom with peeling wallpaper and radiator covers, which needed painting. The bedroom has now been redecorated and new carpet has been fitted. The radiator covers still remain unpainted. We found the kitchen cupboards still to be in need of attention. The larder door was completely off the hinges and the plinth on the cupboard next to it was in need of redecoration. In the bathroom there was a tile missing and the wallpaper was beginning to come Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: away from the wall. The home is generally small but homely and meets the needs of the people who currently live there. There is a washing machine sited in the kitchen and a new drier in the garage. We noted that there was protective clothing such as gloves and aprons available. Mr Abbott was observed wearing an apron whilst he prepared the lunch. Outside the back door we saw a bucket with a mop in it. We asked Mr Abbott if this was the mop currently in use. He confirmed that it was. We asked him to ensure that it be hygienically stored in future as it was left in dirty water. Care Homes for Adults (18-65 years) Page 23 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 competent and effective staff team. People are properly recruited, inducted and trained. This judgement has been made using available evidence including a visit to the service. Evidence: The manager told us that there are two staff, who are fully designated to working at Rushall Road on a permanent basis. When cover is required for appointments, sickness or annual leave, extra staff support is available from other Valued Life services. The manager confirmed that this system works well. The people living at the home benefit from being supported by a staff team, who have known them for a number of years or from day services. The manager reported that there is always at least one person on duty. One staff member sleeps in during the night hours. Within our staff surveys one person commented that there is always enough staff to meet the individual needs of the people who use the service. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: We sampled the recruitment files of two staff members and found them to be in order. Files showed that safeguarding checks had been completed prior to the person commencing their employment. Satisfactory references have been sought and any gaps in employment history explored and documented. Since the previous inspection no new staff have been recruited. All new staff complete an induction period. During their three months probationary period they are expected to complete their induction work book. Within the AQAA it states that all staff have an NVQ level 2 or higher. Training records show that staff receive mandatory training in health and safety, fire awareness, food hygiene, manual handling, first aid and abuse awareness. Mandatory training is provided annually. Records show that staff also attend training in specific areas such as Autism, loss and bereavement and John OBriens five principles. The general manager explained that the organisation has now adopted work books for staff to complete in different subjects. These are then marked by a senior manager before being sent off for accreditation. Care Homes for Adults (18-65 years) Page 25 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. The manager is competent and qualified to run the home. Mechanisms are in place to review and aid the development of the service. Health and safety policies and procedures are in place to ensure peoples well being and safety. This judgement has been made using available evidence including a visit to the service. Evidence: Mr Abbott is the registered manager of 6 Rushall Road. He has a NVQ level 4. Mr Abbott has worked with the people living at the home for over 10 years so has a good knowledge of their needs and wishes. The quality assurance tool in place looks at various areas of the service. These include leadership, customer focus and access to records. The general manager confirmed Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: that quality assurance surveys are completed six monthly to ensure that peoples views are listened to. Surveys are sent out to all stakeholders including service users, relatives, visitors and staff. The home provides a regular newsletter, which is sent out to families and informs them of events which are planned or may have taken place. One relative had said in their satisfaction survey that they had particularly enjoyed receiving the newsletter. Records demonstrate that monthly health and safety audits are carried out. There is a staff signing sheet in place. The sheet states that staff should sign the sheet at the end of the shift. It states are you happy with all written work, being correct to fact and the events of the day. By signing you are stating that all service users care has been performed with dignity and in a respectful manner, and all clients needs have been met. Checks are completed by staff at the beginning and end of the shift. Staff keep a record of opening and closing checks when they have been completed. This includes tasks such as checking there is plenty of hand washing materials and that all opened food has been dated and signed. We noted that all toxic materials were securely locked way and had the accompanying data. Environmental risk assessments have been completed and are kept under review. Regular fire drills take place and there is a fire risk assessment in place. We suggested that the manager develop an evacuation plan to be included in the fire records. All rooms on the first floor have window restrictors fitted to them, most radiators are guarded and temperature regulators are fitted to hot water outlets. Hot water temperatures are checked and recorded regularly along with fridge and freezer temperatures. Care Homes for Adults (18-65 years) Page 27 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 28 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 1 1 4 A copy of the updated Statement of Purpose must be sent to CQC. To ensure it provides sufficent information about the service. 25/07/2009 2 6 12 Support guidelines should be 25/06/2009 kept within individual care plans. This will ensure that peoples needs are met. 3 23 16 You must make provision for 25/07/2009 a safe place where money may be deposited for safe keeping. This will ensure that peoples finances are safeguarded. Care Homes for Adults (18-65 years) Page 29 of 31 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 6 Behavioual management plans and epilepsy profiles should be reviewed regularly to ensure peoples needs are being met. The radiator covers should be repainted to make them look more homely. The kitchen cupboards should be repaired and repainted or replaced. The tiles and wallpaper in the bathroom should be repaired or replaced. The cleaning mops should be hygienically stored. The home should develop an evacuation plan. 2 24 3 4 30 42 Care Homes for Adults (18-65 years) Page 30 of 31 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!