Care Home: Sandy Lodge

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What the care home does well People living at Sandy Lodge were relaxed and happy. Families told us that they are very happy with the care that people receive.Everyone has very good care plans in place so that staff now how people like things done and what they like to do. Most staff at the home have worked there for some time. They know the people living there very well, and can look after them in the ways that they are familiar with and prefer.Staff at the home help people to lead interesting lives. People can go to day care, take part in different activities and go out and about in the local community.People can stay in touch with their families and have visitors whenever they wish.The home is very well equipped so that people are cared for safely and comfortably.Staff at the home make sure that people`s health is looked after. They support people in seeing doctors or other professionals needed to help them.The manager is very experienced, so makes sure that the home is run safely and well. What has improved since the last inspection? Most parts of the home have been redecorated so that it stays nice for people. To help people know about the home before they go and stay there, information has been put on to a DVD for people to view to make it easier for people to understand. People living at Sandy Lodge and their families have been involved in making new care plans about themselves. These are easy to understand, and tell people everything they need to know in order to give them good individual care. People living at Sandy Lodge all have communication difficulties so now have talking picture books to tell people about themselves.Staff working at Sandy Lodge have been on training courses to keep them up to date. What the care home could do better: Although the home has a core team of staff that have worked there for a long time, not enough staff employed at Sandy Lodge. This means that a lot of agency staff are used. This will not help in providing people with consistent care from people that they know well. So that people living at Sandy Lodge are cared for safely, staff need to know how to manage and report any safeguarding issues. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sandy Lodge Southchurch Avenue Shoeburyness Essex SS3 9BA The quality rating for this care home is: Two star good 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: Vicky Dutton Date: 0 2 0 9 2 0 0 9 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. 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 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 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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.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: Sandy Lodge Southchurch Avenue Shoeburyness Essex SS3 9BA 01702298064 01702298064 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) : Estuary Housing Association Ltd care home 9 Number of places (if applicable): Under 65 Over 65 9 0 learning disability Additional conditions: Excluding any person who is liable to be detained under the provisions of the Mental Health Act 1983 Date of last inspection 3 0 0 8 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Sandy Lodge is owned and managed by Estuary Housing. Up to nine people can live at the home. People living there have a learning disability. Sandy Lodge is a purpose built care home that has plenty of room for people. There is a large lounge and separate large dining room. The home is on two floors but there is no lift. There are bedrooms on both floors. Most people who live at the home have their own room. There is only one shared room. The home is very well equipped to meet peoples needs. There is outside space for people to enjoy with a nice patio and seating area. There is a small car parking area at the front of the building, and visitors can also park in the street nearby. Sandy Lodge is near to the local shops and a beach in Shoeburyness. Other facilities and the main town of Southend are not far away. A railway station and bus links are also very close by. The home has their own minibus to help people to get out and about Information about the home is made available to people in the Statement of Purpose and Service Users Guide. The current weekly cost of a place at the home is £1179.94. Residents pay a contribution toward this of £69.90 per week. People pay for their own chiropody treatment, hairdressing, toiletries and transport. 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 When we went to Sandy Lodge, we did not tell people that we were coming. This was so we could see the home as it usually is. Before we went we sent surveys to people living at the home, their families and staff so that they could tell us about what it is like there. Some people sent surveys back to us and this gave us good information. Also before we went, we asked the manager to tell us about the home. We asked them to fill in a form to tell us how the home make sure that they keep up good standards in looking after people, and make sure that the home is safe. When we went to Sandy Lodge we spent time with people living at the home. They were not able to tell us what it was like to live there, but we were able to see if people were relaxed and happy and got on well with staff. We also spoke to some staff at the home and a relative. We looked around the building to see if it was nice for people to live in. We spent some time in the office looking at different paperwork that would let us see how peoples care is arranged and how the home is managed. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well People living at Sandy Lodge were relaxed and happy. Families told us that they are very happy with the care that people receive. Everyone has very good care plans in place so that staff now how people like things done and what they like to do. Most staff at the home have worked there for some time. They know the people living there very well, and can look after them in the ways that they are familiar with and prefer. Staff at the home help people to lead interesting lives. People can go to day care, take part in different activities and go out and about in the local community. People can stay in touch with their families and have visitors whenever they wish. Care Homes for Adults (18-65 years) Page 8 of 32 The home is very well equipped so that people are cared for safely and comfortably. Staff at the home make sure that peoples health is looked after. They support people in seeing doctors or other professionals needed to help them. The manager is very experienced, so makes sure that the home is run safely and well. Care Homes for Adults (18-65 years) Page 9 of 32 What has got better from the last inspection Most parts of the home have been redecorated so that it stays nice for people. To help people know about the home before they go and stay there, information has been put on to a DVD for people to view to make it easier for people to understand. People living at Sandy Lodge and their families have been involved in making new care plans about themselves. These are easy to understand, and tell people everything they need to know in order to give them good individual care. People living at Sandy Lodge all have communication difficulties so now have talking picture books to tell people about themselves. Staff working at Sandy Lodge have been on training courses to keep them up to date. Care Homes for Adults (18-65 years) Page 10 of 32 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 If you want to speak to the inspector please contact Vicky Dutton CQC Eastern Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel: 0300 616161 Care Homes for Adults (18-65 years) Page 11 of 32 Email: enquiries.eastern@cqc.org.uk 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 12 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 13 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. People considering moving into Sandy Lodge will be assisted in ensuring that it is the right place for them to live. Evidence: We saw that there was a Statement of Purpose and Service Users Guide in place. Staff said, and information on files indicated, that the service has also developed a Service Users Guide on DVD. This was not viewed but would help information to be accessible to people with a range of abilities. Everyone living at Sandy Lodge has lived there for a long time, and there have been no permanent admissions since the previous inspection. Staff said that they have procedures in place and are aware of appropriate admissions processes. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that the home will be responsive to their changing needs and respect their choices. Evidence: Each person had a file in place containing profiles, care plans, risk assessments, ongoing care information, and other documentation. Care plans were clear, easy to understand and covered all aspects of peoples complex care needs. The files provide staff with good information to enable them to care for people in a way that meets their individual needs and preferences. Where care needs necessitate a particular technique, such as using the stairs, we saw that photographs were in place for further guide staff in maintaining a good and consistent approach. Each person also has a Lifestyle Plan available in their rooms. These folders have been developed as far as possible involving the resident and their families. They provide a colorful and detailed picture of the person, important people in their lives, their skills, likes, dislikes, preferences and routines. The files would enable any staff to deliver good person centered and individualised care. Also available in peoples rooms are talking picture books, or Communication Passports. These also express peoples needs and preferences. The home uses a number of agency staff to cover shifts. We saw that colourful information sheets were available for each resident to give agency staff an overview of their Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: individual care needs and preferences. Care plans are kept under review and good daily records of care and monitoring are maintained. People living at Sandy Lodge have complex needs and mostly no verbal communication. However during the day staff supported people to try and make choices. Pictures are available for use, and as seen from peoples lifestyle plans staff are aware of the ways in which residents communicate using body language and facial expression. Peoples right to make choices is recognised and encouraged. Examples were given during the day of how staff try to engage residents to make choices. Although residents are not able to fully understand or express their views regular residents meetings are held. One resident attends a user group set up by the provider. Everyone living at Sandy Lodge has an advocate who visits and is consulted about aspects of their needs as necessary. Alongside this management are being proactive proactive in seeking assessments from other professionals, and ensuring peoples rights are recognised and protected through assessments under the Mental Capacity Act and Deprivation of Liberties safeguards. Care files contained comprehensive and clear risk assessments relevant to individual needs. Actions and processes for managing these risks was in place. Care Homes for Adults (18-65 years) Page 16 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 enjoy a lifestyle that suits their needs and preferences. Evidence: People are encouraged to take part in a variety of different activities and recreation both in and outside the home. Some people attend regular formal day care on some days each week. Others stay at home. Personal files, weekly timetables, talking to staff and other information showed that people enjoy going for walks, shopping, eating out, going to London, trips to places of interest, seeing shows and other activities according to their personal preferences. There was evidence around the home of activities undertaken by people. This included photographs. The AQAA said that they did well, Continuous research for new experiences and activities for the service users. We offer the service users taster sessions and monitor and record service users reactions to the new experiences they have tried. Under plans for the next 12 months the manager said, To find new venues for holidays. Encourage service users to broaden their horizons. People are supported in using, and being part of the local community. For example during the day one person went for a walk in the local area. Local shops and amenities are used. In house activities take place. Residents have Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: regular opportunities to enjoy both massage sessions and sensory sessions from visiting professionals. Peoples rooms reflect their own interests and all have the opportunity for listening to music or talking books. Some people have their own sensory equipment. The home has a minibus available to facilitate local community access, and trips further afield. People living at the home also have opportunities to socialsise with other people through social events and parties involving people from other homes run by the provider. Examples of this were given such as a summer ball held at a local hotel, and a recent Caribbean afternoon held at Sandy Lodge. Most people living at Sandy Lodge have families who visit either regularly or occasionally. People can welcome their friends or family at any time and their involvement is welcomed. Staff interacted well with residents during the day. Staff are aware of when people might want time alone and people were assisted in having time in their own rooms at different times in the day. The home uses a six weekly rotating menu, which staff said was changed as necessary to accommodate the needs of the day and residents choices. Menus viewed and records of what people had eaten showed that a range of different foods are offered. People are encouraged to make individual choices through the use of pictures. The lunchtime meal looked plentiful and appetising. Lunch was a relaxed occasion. Where people needed assistance or supervision with eating this was done in a sensitive manner. Care Homes for Adults (18-65 years) Page 18 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 receive good personal and health care support to meet their individual needs. Evidence: People living at Sandy Lodge benefit from being looked after by a core team of staff who have mostly worked at the home for some time. Staff know the residents very well and support them in maintaining their preferred routines and style. This is supported by a good key worker system and good care planning. People living at Sandy Lodge were not able to express their views about the care they receive, but all looked relaxed and comfortable. Relatives felt that residents receive good care: The home looks after my [relative] very well, Great care to all the patients, and, They care for my [relative] and always keep me informed about their health and care were some of the comments made. Records viewed showed that people access good health care support to meet their varied needs. A range of different professionals are involved in individual residents ongoing care including doctors, chiropodist, optician, dentist pharmacist, occupational therapists physiotherapists and equipment specialists. Records showed that peoples health is monitored. A number of residents have epilepsy and good records are maintained relating to this. Peoples health care needs are reflected in care planning. Because the home is small and the residents known well by the permanent staff, any concerns or changes are quickly picked up and Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: appropriate actions taken. Training records showed us that permanent staff undertake relevant training to support peoples healthcare needs such as epilepsy, continence promotion, posture management, tissue viability, oxygen usage and bone health and falls prevention. Peoples weight is also monitored so any changes can be noted and actions taken as necessary. As well as information in care planning each person has a Health Information File in place. These are small ring binders that contain all relevant heath and other details about the person. These are taken to scheduled health appointments, and on trips away so that all information is readily to hand in the event of an emergency. No one living at Sandy Lodge is able to manage their own medication. We looked at systems in place to ensure that this aspect of their care is managed safely. We saw that each resident has their own section in the medication folder that included a photograph medication administration records and other information. Another folder contained good protocols for the administration of medicines that are required on an occasional basis. Letters on individual files showed us that peoples medication is kept under regular review. No errors or shortfalls were noted in the system. A member of staff advised that the system was audited twice a week to check for any errors. We saw that each member of staff have their own medication policy books. These contained relevant policies and guidelines, examples of administration records used. The books also contained Annual Assessment of Administration of Medicines. These were competence monitoring assessments that had been completed and signed off each year by the manager and member of staff. Training files sampled did not indicate that more formal training in medication management had been undertaken. Care Homes for Adults (18-65 years) Page 20 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. People are cared for safely through practice in the home. Evidence: The provider has a clear complaints process in place. This is available in an easy read format to assist peoples understanding. No complaints have been received by the home since the previous inspection. No concerns or complaints have been raised with us, (CQC.) On surveys relatives said that they were aware of how to make a complaint or raise concerns. No safeguarding concerns have been raised at Sandy Lodge. Training records showed us that staff have received training in safeguarding vulnerable adults. Staff spoken with confirmed this and understood about safeguarding. A training pack relating to safeguarding was also available in the home. We saw that the homes own policy relating to safeguarding had recently been reviewed. It did not however appear to be complete. It said that relevant safeguarding contact details were available in an appendix, but this could not be found. Also not found were the local authority guidelines relating to safeguarding. Staff spoken with said that if something happened they would contact the on call number for advice. However a situation may be such that a staff member wanted to report an incident independently. Relevant information and contact details of the local safeguarding teams should therefore be readily available in the home. 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 good 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 pleasant home. Evidence: Sandy lodge provides spacious and comfortable communal accommodation for people. There is a pleasant small garden and patio area with seating for people to enjoy. The home is set within the local community with public transport and other facilities close by. The AQAA said, and staff at the site visit confirmed, that since the previous inspection the home has been redecorated. Further improvements are planed including carpeting bedrooms that up until now have had hard flooring. Bedrooms are available on both the ground and first floors. No lift is available so people with rooms on the first floor need to be able to negotiate stairs. There is only one shared bedroom in the home. The rest are singles. Peoples rooms were individually furnished and decorated, and reflected their own tastes. Only one room in the home has an en suite facility, but very good communal bathing and toilet facilities are available. The home is very well equipped to meet peoples needs with aids such as track hoists, assisted bathing facilities, specialist chairs, beds and other equipment readily available to assist safe care. The home have also installed some assistive technology to assist in Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: meeting the care needs of those with epilepsy. At the site visit the home appeared clean and there were no offensive odours. A suitable laundry area is available. The AQAA said that all staff are trained in infection control. this was seen on some training records sampled. 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 are looked after by caring and well trained staff. Evidence: During the day we saw that staff had a very good understanding of peoples needs, and worked with them in a kind, caring and friendly manner. Permanent staff at the home have mostly worked there for a number of years and know the residents very well. Staff felt that teamwork and support at the home was very good. On surveys people felt that staff had the right skills to do the job. The home have achieved a good level of staff attaining National Vocational Qualifications (NVQ) in care. Out of nine permanent support staff five have achieved NVQ at level three. Two staff are now undertaking NVQ at level three. Four staff have also just completed an NVQ in team leading. This shows that the organisation are committed to having a well trained workforce. The stated staffing levels at the home are four staff during the day, and two awake staff at night. Staff said that these levels were flexible depending on who was going out, people attending day care and so on. Rotas viewed however indicated that the level of four staff when everyone is home is not maintained consistently. On one occasion only two people appeared to have been on duty, on another only three until 09.00 when another member of staff came on duty. On the day of the site visit only three staff were on duty. A further person came in at 10.00. People living at Sandy Lodge have a high level of care needs. Support staff also have to carry out domestic Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: and catering tasks as no ancillary staff are provided. Staffing levels therefore need to be maintained consistently so that time for care is maximised. The person assisting at the site visit was unsure how many staffing vacancies there were. However a number of staff work some 12 hour shifts and also pick up additional shifts. There is also now a system in place whereby staff can cover as bank staff in other Estuary homes, and so may therefore be working more hours. This needs to be monitored to ensure that staff do not become tired and Less competent. In relation to staffing Sandy Lodge also relies on agency staff to cover the rota. It is unclear why this is as the home has a very low staff turnover. The AQAA said that in the three preceding months 428 shifts had been covered by agency staff. Staff on duty said that most agency staff are regulars and know the home, but this situation is still not acceptable and sufficient permanent staff should be employed to cover the home properly. A number of male residents are accommodated and at the moment the home has no male carers. People cannot therefore be assured of having a choice of gender to carry out their intimate care. Recruitment of staff is carried out centrally by the organisation so local staff and residents do not have input into the process. Staff said that sometimes prospective new staff came to look round and this gave the opportunity to see how they would fit in. The previous inspection identified that the recruitment of staff was carried out to a good standard so that residents were safeguarded. Only one new member of staff has been recruited and remains at the home since that time. Records viewed indicated that recruitment had been carried out to a satisfactory standard. The home also demonstrated good practice in confirming that agency staff were who they said and had been safely recruited. In looking at staff files we noted that Criminal Records Bureau (CRB) checks held for some staff dated from as log ago as 2003/2004. It would be good practice for these to be renewed. The file of a new member of staff showed that they had attended a corporate induction that was undertaken over one day. This covered organisational issues and health and safety matters. The member of staff had also undertaken a good range of core training such as moving and handling, fire safety and food safety. There was nothing however to show their induction into the homes procedures, routines, care needs and so on. A member of staff said that new staff work alongside established staff for two weeks to learn everything, but that apart from the diary identifying who would be mentoring, nothing is recorded. We saw that there was a local training plan in place for 2009/10. This identified what training was to take place and individual training plans for the year. No training matrix was available but training records sampled and staff spoken with showed that good training opportunities are provided for staff and that they undertake a range of core and additional training relevant to their role, such as different conditions associated with learning disability. Some specialist training however took place a while ago now and the AQAA said that what they could do better was, More specialist training to be offered to staff to assist service user needs. One member of staff said that equality and diversity training was on of the courses due to take place soon. We did not view supervision records, but a timetable a timetable in place and discussion with staff showed that staff receive regular supervision and support. A Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: member of staff said that an appraisal system is just being introduced, and that they will have their first appraisals soon. Minutes viewed that monthly staff meetings take place for staff and management to discuss any relevant issues and plan future developments. 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. People live in a safe and well managed home. Evidence: Sandy Lodge benefits from having an experienced and competent manager in post who has appropriate qualifications. The manager was not present at this site visit. The person in charge of the shift was knowledgeable, experienced and competent in running the home in the managers absence. The AQAA was completed by the manager. All sections were completed, but part one was very briefly completed and did not give much detail. For example the Conduct and Management of the Home section did not highlight what happens at the home in terms of quality assurance. The person in charge at the time of the site visit was also not sure about this area. It is not therefore clear if, apart from required visits, regular quality audits or consultations take place. As is required by Regulation, a monthly visit is carried out to the home by a senior person in the organisation. This is to ensure that the home is complying with standards. No health and safety issues were highlighted during the site visit. The AQAA and records seen during the inspection identified that systems and services are checked Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: and maintained on a regular basis. The staff training files sampled showed that staff training in core areas such as moving and handling, food hygiene and first aid is ongoing with updates planned over the coming year. Fire records viewed were well maintained and a fire risk assessment was in place. A recent fire service visit in January this year had highlighted no concerns. Although no records were seen, staff said that a recent environmental health officers visit had been satisfactory. At the site visit the kitchen was clean and well organised. 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 33 18 Sufficient staff must be provided to provide adequately for the holistic needs of residents at all times. 01/10/2009 So that people receive consistent care. 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 20 Staff should receive formal training in the management of medicines to ensure that their practice is based on up to date knowledge. Information about making safeguarding referrals and relevant contact details should be readily available in the home for staff to access. Sufficient permanent staff should be recruited to reduce Page 30 of 32 2 23 3 33 Care Homes for Adults (18-65 years) 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 reliance on agency staff and ensure that people are always cared for by people who are familiar to them. 4 35 The development of staff skills and knowledge through a robust induction process, in line with Skills for Care standards, over the first few weeks of employment needs to be properly recorded. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone : 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. 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