Care Home: Salisbury Terrace (12)

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What the care home does well The overall findings of the inspection were good. 12 Salisbury Terrace is a small home located in a residential area of Wavertree, Liverpool. The service is provided to meet the needs of people who have autism and as such routines and activities are planned with the specific needs of the people living in the home in mind. Each person who lives at the home has a care plan. These tell the staff what they need to do to support the person. Guidelines are in place which give staff information on how to support people with issues which they may find difficult. People are supported to use the local community and to go out for a meal, go to the pub, go shopping, attend local venues and follow interests they have. People living at the home are supported to use their independent skills and to learn new skills. People are supported to prepare their own snacks and meals when possible, do their own laundry, keep their room tidy, go to the shops.Staff support people living at the home to visit their doctor, dentist, nurse, optician and other important appointments on a regular basis. Staff are good at taking care of medication and support people well with their medication. The staff team is long standing and therefore staff have had the opportunity to build relationships with the people living at the home and to have gained a good understanding of their needs. Staff carry out regular safety checks so that people living at the home are provided with a safe place to live. The staff team are well trained and are confident that they can support people well. The home is well run and managed in the best interests of the people who live there. What has improved since the last inspection? People living at the home have more activities and staff support them with these.There has been further staff training since the last inspection visit.The manager has told us that the service has got better. People living at the home have more time with their key worker and care plans give staff clear information on how to support people and how to make sure they have more independence. What the care home could do better: A person from the organisation should visit the home once per month to check that the home is running as it should. But, there hasn`t been a visit for a couple of years so these need to be started again. Some parts of the home were not being kept as clean as they should be. This needs to be put right for the comfort, dignity and safety of the people living at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Salisbury Terrace (12) 12 Salisbury Terrace Wavertree Liverpool Merseyside L15 4HD 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: Debbie Corcoran Date: 3 0 0 7 2 0 0 9 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 32 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 32 Information about the care home Name of care home: Address: Salisbury Terrace (12) 12 Salisbury Terrace Wavertree Liverpool Merseyside L15 4HD 01517350283 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) : salisbury@autisminitiatives.org www.peterhouseschool.org Autism Initiatives care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: The registered person may provide the following category/ies 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 The maximum number of service users who can be accommodated is: 3 Date of last inspection A bit about the care home 12 Salisbury Terrace is a small home registered to provide care for up to three people with a learning disability. The service is provided by Autism Initiatives and the registered Landlord for the property is Liverpool Housing Trust. Care Homes for Adults (18-65 years) Page 4 of 32 Autism Initiatives was formerly called the Liverpool and Lancashire Autistic Society and it was established in 1971. The organisation provides a variety of services to adults and children who have autism. These include residential care, day care, supported tenancies, outreach, domiciliary care, respite and educational services. Autism Initiatives is a voluntary organisation with charitable status. 12 Salisbury Terrace is a four bedroom house which is located in a residential area in Wavertree, Merseyside. The home is a domestic property which promotes the principles of ordinary community living. The fees for residing at Salisbury Terrace are currently between £1,245 and £1,274 per week. Care Homes for Adults (18-65 years) Page 5 of 32 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 32 How we did our inspection: This is what the inspector did when they were at the care home The manager and staff did not know that we were going to visit the home before we arrived. During the visit everybody who lives at the home was met. Three members of the care staff team were spoken with during the visit. Care plans, staff records, health and safety records and other relevant records were looked at. A tour of the home was carried out and most areas were checked. The manager returned a self assessment of the service and we have used some of the information in this help us decide how the home is doing. We call this self assessment the AQAA. Surveys were sent to staff before the visit for them to make comments on the home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well The overall findings of the inspection were good. 12 Salisbury Terrace is a small home located in a residential area of Wavertree, Liverpool. The service is provided to meet the needs of people who have autism and as such routines and activities are planned with the specific needs of the people living in the home in mind. Each person who lives at the home has a care plan. These tell the staff what they need to do to support the person. Guidelines are in place which give staff information on how to support people with issues which they may find difficult. People are supported to use the local community and to go out for a meal, go to the pub, go shopping, attend local venues and follow interests they have. People living at the home are supported to use their independent skills and to learn new skills. People are supported to prepare their own snacks and meals when possible, do their own laundry, keep their room tidy, go to the shops. Care Homes for Adults (18-65 years) Page 8 of 32 Staff support people living at the home to visit their doctor, dentist, nurse, optician and other important appointments on a regular basis. Staff are good at taking care of medication and support people well with their medication. The staff team is long standing and therefore staff have had the opportunity to build relationships with the people living at the home and to have gained a good understanding of their needs. Staff carry out regular safety checks so that people living at the home are provided with a safe place to live. The staff team are well trained and are confident that they can support people well. The home is well run and managed in the best interests of the people who live there. What has got better from the last inspection People living at the home have more activities and staff support them with these. Care Homes for Adults (18-65 years) Page 9 of 32 There has been further staff training since the last inspection visit. The manager has told us that the service has got better. People living at the home have more time with their key worker and care plans give staff clear information on how to support people and how to make sure they have more independence. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 10 of 32 If you want to speak to the inspector please contact Debbie Corcoran 3rd Floor Unit 1 Tustin Court Port Way Preston Lancashire PR2 2YQ 01772730100 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 11 of 32 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 12 of 32 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. Information about the service is available to assist people in deciding if the service is right for them. Evidence: A statement of purpose and service user guide are available to provide people with information on the service and facilities provided at the home. There have been no new people to the home for many years and since the introduction of the above standards. Therefore the assessment and referrals processes could not be practically assessed. Autism Initiatives do have assessment and referral policies and procedures to be used when a new service user is referred to the home. These detail that an assessment of the persons needs is carried out prior to the person moving in to the home. The assessment format is good and allows for the recording of information which is specific to the needs of people who have autism. Care Homes for Adults (18-65 years) Page 13 of 32 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 of the people using the service has an individual support plan which provides staff with guidance on what the persons needs are and how these should be met. People using the service are supported to take risks as part of living an independent lifestyle. Evidence: Each of the people living at the home has a plan of care. One part of this is a document entitled about me and this describes the support that the person needs in areas such as communicating, understanding, activities, meals, medication, keeping healthy and safe. Each person also has a support plan which describes goals for their personal development and guides staff in how to support the person to achieve these. An example of this being supporting a person to be self caring for personal care such as bathing or shaving. In addition to about me information and support plans there were guidelines describing how to support individuals with specific issues such as spending time with other people or how to deal with situations which they may find difficult. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: Care planning information was looked at for two of the people living at the home. The level of information was sufficient to guide staff in how to support people and ensure a good level of consistency in this. About me information describes the preferences and daily routines of the people living at the home and people are encouraged and supported to make their own decisions and to participate in the decision making in the home. People living at the home are supported to take risks as part of an independent lifestyle. Where a person is involved in activities which pose a risk to their safety then this is recorded in a risk assessment along with information on what steps need to be taken to prevent the risk from occurring. A risk assessment was looked at was found to be comprehensive and it had been reviewed regularly. All of the staff have worked at the home for a number of years. Staff are therefore aware of the needs of the people living at the home and of any risks to their safety and well being. All personal and confidential information is stored appropriately and staff are aware of their responsibilities in this area. Care Homes for Adults (18-65 years) Page 15 of 32 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 living at the home are supported to develop their independent living skills and to be involved in their local community. People choose their own meals and are supported to use and develop their skills as appropriate. Evidence: Each of the people living at the home has a number of support plans. These guide staff in supporting the person to learn and develop new skills. Each support plan outlines a specific new skill for example preparing a snack. The support plans ensure that staff work consistently in supporting people to achieve new skills. Staff make a daily record as to how they have supported the person in achieving their support plan and this is monitored on a monthly basis and this enables staff to monitor progress in achieving the new skill. Each of the people living at the home has an about me care plan and these include information on the social and recreational activities which the person likes to be involved Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: in. Discussions with staff indicated that people living at the home are supported to take part in a variety of activities on a regular basis. These include supporting people with horse riding, swimming, walking, personal shopping. The staff team are clearly aware of the activities and routines of the people living at the home and it is a priority to meet these. The manager has detailed in the self assessment of the service (AQAA) Service users participate in a number of activities throughout the week which include ten pin bowling, cookery, long walks, meals out, pub visits, weekly shopping at the supermarket, key client days take place for more 1 to 1 time with key workers annual holidays with 2 to 1 staff support, family links are maintained as much as possible, service users have a good rapour wth the local community. Staff have information on the contact details for people who are important to the people living at the home. Staff are reported to maintain good links with relatives of people living at the home. People living at the home are supported to build relationships through the use of community resources, the use of local facilities, leisure facilities and day services. In assessing the diet and meals available to people living at the home menu records were looked at. These indicated that the people living at the home have a good choice and variety of food and meals. People living at the home are encouraged to use and develop their skills in shopping, preparing and cooking food as appropriate to their needs. Care Homes for Adults (18-65 years) Page 17 of 32 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 using the service are well supported with their personal, emotional, physical and health care needs and medication is well managed. Evidence: Each of the people living at the home has a care plan. These include information on the persons likes, dislikes and routines. They also include information on how to meet the persons personal care needs, physical care needs and health care needs. Information is available to guide staff on how to support people with their psychological / emotional well being. When appropriate records include guidelines for support with specific activities. For example there may be detailed guidelines for supporting a person when they are involved in particular activities which they may find stressful. Staff are provided with training in autism in order to assist them in understanding the emotional / psychological needs of the people they support. Records showed that people living at the home are supported to remain healthy. People are regularly supported to see their GP, district nurse, dentist, optician etc. People are also supported to see other health professionals as appropriate to their needs. Each person living at the home has a health action plan and care plans also include a good level of information on the persons needs with health care. A review of the support Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: provided to people takes place on a regular basis and this includes looking at the persons physical and mental health needs and ensuring these are being monitored and are being met . The manager has detailed in the self assessment of the service (AQAA) Staff team ensure that all service users attend doctors, dental, practice nurse and opticians appointments when required, chiropodist also carries out home visits every 6 weeks. Medication is administered and recorded in accordance with policy. Staff monitor service users closely and any health issues or concerns are acted on appropriately. Procedures for managing and administering medication were looked at. Medication storage and administration was checked for two of the people living at the home and was found to be appropriate and safe. Policies and procedures are in place for the receipt, storage, administration and disposal of medications. Information on the medication includes details of the medication, reason it is prescribed and any possible side effects. Staff have been provide with medication training. Care Homes for Adults (18-65 years) Page 19 of 32 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. Policies procedures and practices are in place for dealing with complaints and for aiming to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. Evidence: A complaints procedure is in place and this is time scaled appropriately. Information on how to make a complaint and an overview of how complaints are dealt with is provided in the homes statement of purpose and service user guide. There have been no complaints made since the last inspection visit and therefore how complaints are the managed could not be practically assessed. Staff have supported the people living at the home for a number of years and they therefore know the needs of the people well and can identify when a person is not happy or needs something to be changed and can then act on this. An Adult protection policy and procedure is in place. This includes information on responsibilities for contacting relevant authorities. Care staff have been provided with training in adult protection. A member of staff was asked how they would respond to a complaint or concern and they were able to provide an appropriate response to this question. The home has a whistle blowing policy. This is a policy which outlines that staff will be protected following the reporting of abuse. Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: The manager has detailed in the self assessment of the service (AQAA) Staff attend service user protection and safeguarding training within and outside our organisation, all staff are CRB checked, we have a named adult protection officer for Salisbury Terrace, service users are aware of complaints procedure and are asked if they have any concerns or complaints during house meetings. It was not possible to check on how people are being supported to manage their money on this occasion. It was reported by a member of staff that monies are audited periodically by a representative of Autism Initiatives and the manager has introduced a system for regularly auditing personal allowances since the previous inspection visit. Care Homes for Adults (18-65 years) Page 21 of 32 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 living at the home are not always provided with a clean and hygienic home environment. Evidence: Salisbury Terrace is a 3 storey terraced house located in the Wavertree area of Liverpool. The house is domestic in size and style. There is one small communal lounge and each of the people living at the home has their own bedroom which they have been supported to personalise with their own belongings. The home is satisfactory in terms of the general presentation. The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and free from hazards. However, on this occasion the cleanliness of the home environment was found not be have been maintained to an appropriate standard. The details of this were discussed with a member of staff on duty and with the manager following the inspection visit. In addition to this facilities for washing and drying hands should be available in all relevant areas around the home or at least signposted if not obvious when using the facilities at the home. This is to ensure appropriate infection control practices are in place to promote the health and safety of people living at the home and staff. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Care Homes for Adults (18-65 years) Page 23 of 32 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 living at the home are supported by well trained and well supported staff. Evidence: Staff within the home and across the organisation have clear roles and responsibilities. The manager records and plans staff training well and ensures that staff are provided with mandatory training. Staff training information indicated that staff are provided with training as appropriate to meet the needs of the people living at the home. All members of the staff team have had good training opportunities and the majority of staff have undertaken training in topics such as food hygiene, health and safety, infection control, moving and handling, fire awareness, risk assessment, support plans, positive intervention, adult protection, communication and autism, introduction into autistic spectrum disorder and medication. The percentage of staff who hold a relevant qualification in care is high as all but one members of staff have attained a National Vocational Qualification (N.V.Q) in care. The staff team is stable. There have been no new staff recruited since the last inspection visit. Therefore recruitment and selection procedures were not assessed on this occasion. Staff are recruited in line with the policies and procedures of Autism Initiatives and this Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: includes ensuring all appropriate pre employment checks are carried out prior to a new member of staff commencing employment. This aims to safeguard the people living at the home from potential abuse. During discussions with two members of the staff team they confirmed that they are being provided with the opportunity of supervision meetings and records showed that team meetings take place on a regular basis. These meetings provide an opportunity for staff to explore their practice, explore new ways of working and to make and communicate decisions as to how to develop the service. Staff turnover is low and therefore staff get to know the needs of the people they support well and have the opportunity to build relationships with them. We sent surveys to the home for staff to complete and a number of these were retuned to us. The feedback in these was good. The surveys include questions such as; Are you given up to date information about the needs of the people you support or care for ? Are you being given training which is relevant to your role ? Does your manager meet with you to give you support and discuss how you are working ? Do you know what to do if a service user, relative, advocate or friend has concerns about the home ? Do the ways you pass information about people who use services between staff work ? Are there enough staff to meet the individual needs of all the people who use the service ? Do you feel you have the right support experience and knowledge to meet the different needs of people who use services ?. The responses to all of these questions were positive and no concerns or negative feedback was received. Staff were also asked to comment on what the service does well and the following comments were amongst those received; Provides good support and care to service user, ensuring their individual needs are met Has a good staff team that work together well and support each other and the service users The home is very well run, there are 3 service users they all have support plans and activities to do every day the home is very well organised Has a competent and experienced staff team which promotes consistency. Surveys also gave staff the opportunity to tell us about how they think the service could be improved. Improvements to the service which were identified all centered around the provision of a better range of activities for people living at the home. The manager has detailed in the self assessment of the service (AQAA) Experienced and competent staff team, all staff CRB checked, staff attend training sessions provided by Autism Initiatives and other agencies. Recruitment and selection, equal opportunities policies are in place. Training matrix has been introduced for more effective monitoring and reviewing of staff training, more training has been attended by staff. Service users have contributed to the recruitment pack that is sent to prospective employees. Service user contributes to induction day at head office. Strive for staff to attend all training sessions provided to expand on knowledge and promote a higher standard of care and support towards the people that we support. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Care Homes for Adults (18-65 years) Page 26 of 32 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 home is well managed and is run in the best interests of the people living there. Practices are in place which protect the health, welfare and safety of people living at the home. Evidence: The manager of the home has worked for Autism Initiatives for approximately 11 years and has been managing this service for almost three years. The manager was not available at the time of the inspection visit and therefore a member of staff assisted with providing information about the service. The manager has detailed what is done well under these standards in the service self assessment (AQAA) as Maintain a consistent approach towards the service users we support by encouraging our service users to have as much opinion and contribution into the running of Salisbury Terrace as possible. Service users have an annual review to ensure all their needs are being met and to identify any areas that need addressing. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: In relation to promoting equality and diversity the manager detailed that the service has Equal opportunities policy, Statement of purpose file, Grievance, Complaints policies, Recruiting Foreign workers and Welsh Language policies also in place. The service appears to be run in the best interests of the people living at the home. However, there is currently no evidence of a quality assurance process which includes regular visits from a representative employed by Autism Initiatives. The last available report on a monthly visit to the service was dated November 2006. This means that Autism Initiatives are not monitoring the running of the service and not ensuring the aims and objectives of the service are being met. Regular monthly unannounced visits must be reinstated and a report of each of these must be made available. The home has numerous policies and procedures in relation to the health and safety and staff are provided with training in core health and safety related skills. A sample of records of fire and health and safety checks were looked at and found to be up to date. A safe working practice risk assessment is in place. Care Homes for Adults (18-65 years) Page 28 of 32 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 32 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 1 30 23 All areas of the home must 16/09/2009 be maintained to a clean and hygienic standard and infection control practices must be fully implemented. To ensure people living at the home are provided with a clean, hygienic environment and to protect their health and well being. 2 39 26 The home must be visited on 30/09/2009 a monthly basis in accordance with Regulation 26 and a written report on the conduct of the home must be prepared. To demonstrate that checks are in place to ensure that the service is run in the best interests of the people using it. Care Homes for Adults (18-65 years) Page 30 of 32 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 31 of 32 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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