Care Home: Seeleys House

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well People using the service are assessed prior to admission by the local authority in order that their care requirements are ascertained, recorded and made available to staff at the service. There is good regard for the diverse needs of the people living at the service and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Activities are available to people using the service to provide them with stimulation. Food is well prepared and presented attractively to make sure that nutritional needs are met and respecting people`s preferences and religious or cultural requirements. The health and personal care needs of people living at the service are being met, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that their medication is managed safely. Complaints and safeguarding are effectively managed to listen to views of people who live at the service and reducing the risk of harm to them. The management and administration of the service promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? Improvement has been made to accessibility and decor of the premises to provide comfortable and brighter surroundings for people using the service. What the care home could do better: A revised version of the service users` guide needs to be produced which people will be able to understand and make better use of, so that they have information that is accessible to them. Certificates to verify attendance and completion of safeguarding training need to be obtained where necessary and placed on staff files. Where these cannot be obtained, fresh training should be undertaken this (calendar) year. Gaps to employment history and discrepancies between information on application forms and references need to be explored with applicants and the reasons noted. This is to ensure that full background information is obtained about people before they are offered employment. The quality of information obtained about applicants needs to be improved through ensuring that managers of other work places are approached to provide references, rather than less senior staff, and that where these are not written on headed note paper verification is made of their position. This is to ensure that the right people provide information about applicants` suitability to work at the service.Food handling and hygiene training needs to be undertaken by any staff who prepare meals or snacks for people using the service. This is to make sure that proper safeguards are in place to reduce risk of harm. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Seeleys House Seeleys House Campbell Drive Knotty Green Beaconsfield Buckinghamshire HP9 1TF     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: Chris Schwarz     Date: 0 7 0 4 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. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 31 Information about the care home Name of care home: Address: Seeleys House Campbell Drive Seeleys House Knotty Green Beaconsfield Buckinghamshire HP9 1TF 01494670902 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Buckinghamshire County Council The registered provider is responsible for running the service care home 12 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category of service only:Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Seeleys House is situated in Beaconsfield and provides respite care for up to twelve people with learning disabilities. It is located in a residential area outside of the town and is linked to a day service which operates Monday to Friday. A range of shops, cafes, bars and banking facilities are about a mile away in the town centre and there are bus links to neighbouring towns and London and train links to London and the rest of the rail network. The building provides accommodation on ground floor level with Care Homes for Adults (18-65 years) Page 4 of 31 1 7 0 4 2 0 0 8 Brief description of the care home twelve single bedrooms with hand basins. There are two adapted bathrooms to meet the needs of people with disabilities and spacious communal areas. The service has its own transport to help people access the community. Fees for the service vary depending on peoples financial circumstances and are subject to assessment by the local authority. 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 unannounced key inspection was conducted by Chris Schwarz over the course of a day and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place on 17th April 2008. A random inspection was undertaken on 6th January 2009 to look at how the service was progressing with requirements made at the last key inspection. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people living using the service, staff and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. Care Homes for Adults (18-65 years) Page 6 of 31 The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: A revised version of the service users guide needs to be produced which people will be able to understand and make better use of, so that they have information that is accessible to them. Certificates to verify attendance and completion of safeguarding training need to be obtained where necessary and placed on staff files. Where these cannot be obtained, fresh training should be undertaken this (calendar) year. Gaps to employment history and discrepancies between information on application forms and references need to be explored with applicants and the reasons noted. This is to ensure that full background information is obtained about people before they are offered employment. The quality of information obtained about applicants needs to be improved through ensuring that managers of other work places are approached to provide references, rather than less senior staff, and that where these are not written on headed note paper verification is made of their position. This is to ensure that the right people provide information about applicants suitability to work at the service. Care Homes for Adults (18-65 years) Page 8 of 31 Food handling and hygiene training needs to be undertaken by any staff who prepare meals or snacks for people using the service. This is to make sure that proper safeguards are in place to reduce risk of harm. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 assessed prior to admission by the local authority in order that their care requirements are ascertained, recorded and made available to staff at the service. Evidence: All of the people using the service are referred via the local authority and assessed by care managers. The manager and other staff who were spoken with said there had been improvement to receiving information about new users and also to receiving updated information for existing users. A sample of assessments was looked at in care files and found to be in good order, with clear information and risk screening about peoples personal care needs. A recommendation was made at the last inspection for the manager to make sure that pre-admission assessments of prospective users, carried out by staff at Seeleys House, are recorded in order that there is evidence of them taking place. The manager advised that only one new user had come to the service since last year, before a new Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: assessment record had been established. A copy of the assessment record was looked at and had been divided into various sections such as dressing and undressing, social skills, bathing and showering, use of toilet, nail care, teeth/denture care, community knowledge, eating out and public amenities. When put to use, it should provide a good template to record information obtained by staff. A second recommendation was made at the last key inspection for the service users guide to be revised so that people using the service are able to understand and make better use of it. The manager advised that this had not been attended to yet. The recommendation is repeated and a copy is to be sent to the Commission when available. A service user spoken with during the inspection indicated that there was continuity of care when she visits Seeleys House and said she is usually given the same room. People who completed surveys, or were assisted by their relatives, did not raise any issues about the admissions process. The complaints and compliments file at the service contained a compliment from an assistant team manager from the local authority who described an emergency admission as an excellent piece of work expertly managed. 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. There is good regard for the diverse needs of the people living at the service and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plans were in place for each person who uses the service. A sample of files was looked at and found to contain good information about peoples care needs and how these are to be met. Each file had a basic information sheet with details such as the persons preferred form of address, date of birth, address, doctor, care manager details, next of kin and emergency contact. All but one had a photograph of the person. Information was recorded about important people in their lives, leisure activities, cultural and religious needs, likes and dislikes, their dietary needs and whether they needed any assistance with managing mail or money. Information was provided on any medication they were taking, known allergies and whether they have Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: epilepsy. Instant information forms had been completed covering areas such as washing, habits, toileting and activities. Each care plan was signed and dated with evidence of review. Care plans of four people with complex epilepsy were looked at during the random inspection to check compliance with a requirement to provide more information about peoples epilepsy. Improvement was noted at that time. The files looked at on that occasion contained medical information and consent forms which provided details of pre-seizure signs if any, the type of seizure, severity, after effects and guidance on the use of rectal diazepam. These forms had been completed by the persons doctor or hospital consultant and risk assessments on epilepsy had been produced. A consent form on the use of rectal diazepam and buccal midazolam was being introduced then, and seen to be in use during this inspection. One person, who was met during the course of the inspection, had contributed to the contents of her care plan and said she was satisfied with the care she was currently receiving. Known risks were indicated in care plans alongside measures to reduce them. Care managers had completed risk screening summaries in each of the files. Individual risk assessments had been completed for a range of situations such as likelihood of pulling other peoples hair, assisting to the toilet, managing adverse behaviour, epilepsy and falling during transfers. People using the service or their relatives who assisted them, said in surveys that they can make decisions about what to do whilst they are at Seeleys House. Observation of practice showed this to be the case for those service users who were around whilst the inspection was taking place. They could, for example, choose whether to be in communal areas of the building or in their room, one person was seen using a mobile telephone to make contact with a relative and received a visitor, making the decision where to see them, and a member of staff was observed asking a service user what type of drink she would like to take her medication with and then provided her with her choice. 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. Activities are available to people using the service to provide them with stimulation. Food is well prepared and presented attractively to make sure that nutritional needs are met and respecting peoples preferences and religious or cultural requirements. Evidence: People using this service usually attend day services during the week leaving the premises empty until around 4:00 pm. A few service users were around during the day on this occasion and were seen taking part in activities such as colouring, watching television, listening to music and one person spending time with a visitor. Staff were unable to locate the activities book, having relocated all records whilst the building was being redecorated and refurbished, although some photographic records were available showing outings to Black Park, Woburn Safari Park, Wendover Woods and Denham Park. In the complaints and compliments file, a relative had recently made a Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: compliment about being given a photograph of their son/daughter on an outing. A four week menu is in use at the service, providing a range of meals. Records in daily notes showed that individual diets are catered for, such as halal diets, and records of food intake are kept where necessary. On the day of the inspection service users enjoyed a lunch of cauliflower cheese with mashed potato followed by chocolate pudding and custard. One person commented that it was very good. The manager was made aware that two packets of open meat in the fridge did not have labels showing how long they had been opened and she is advised to monitor this to make sure that staff consistently follow safe procedures in the kitchen. Care Homes for Adults (18-65 years) Page 16 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. The health and personal care needs of people living at the service are being met, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that their medication is managed safely. Evidence: Information about peoples personal and health care needs was recorded in their care plans. Improvement to the recording of needs for users with epilepsy is noted earlier in the report. Any assistance that people needed during the day was carried out in private; staff had access to disposable items such as gloves and aprons to prevent cross-infection. Bedroom and bathroom doorways had been widened as part of the recent refurbishment and this provided far better access for people using wheelchairs, as demonstrated by one user who has an electric wheelchair. Work to reconfigure a bathroom to provide better access to the adapted bath and shower had not been undertaken as part of recent works and the manager advised that the intention had been for this to be done during the current financial year. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: At the random inspection, medication practice was examined and found to be improved. The controlled drugs section of the trolley had been made secure and separate arrangements had been set up for storage of controlled drugs and unwanted medicines. Medication practice was looked at on this occasion as well. The trolley was locked and the keys kept by a senior member of staff. Since the building had been redecorated and refurbished, the chain to secure the trolley in the duty office had not been replaced therefore the trolley was moveable where it had been located in the corridor on the day of this visit. The manager advised that the trolley could now be kept in her office when not in use, which is lockable. Consent forms were in place where people using the service need assistance with managing their medication. One persons most recently completed consent form (2008) showed that an antibiotic had been stopped. The antibiotic was being prescribed again and staff had administered it during her stay but there was no updated form to verify its use. This was brought to the duty seniors attention and effort was made to contact the surgery to obtain a new consent form as soon as possible. Medication administration records were in good order with signatures alongside prescribed dose times. No controlled drugs were being stored or used at the time of this visit. At the previous inspection, mention was made that the policy on medication practice was being revised. On this occasion it was confirmed that the policy was still at draft stage. During a tour of the premises, two pots of cream were seen stored in a bathroom, both of which had been used. Neither was labelled for use by a specific service user and there was a risk that staff may use these as communal creams to be applied to service users as necessary, with the risk of cross infection. The manager was advised to dispose of these, which she did. Audits of medication were being carried out regularly, the most recent undertaken by the manager the day before the inspection. A discrepancy recorded at the last audit had been reported on to senior management for investigation. Care Homes for Adults (18-65 years) Page 18 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. Complaints and safeguarding are effectively managed to listen to views of people who live at the service and reducing the risk of harm to them. Evidence: A complaints procedure was in place at the service which can be made available in a range of different formats and languages. A log was being kept of any complaints or compliments received at the service. Since the last key inspection, one complaint was noted. This was regarding condition of someones clothing, which had been responded to appropriately. Ten compliments had been also been recorded about care practice. People using the service said in surveys they knew who to speak with if they were unhappy, some knew how to make a complaint. Relatives who had assisted people to complete surveys added that staff were able to interpret when service users are unhappy, by their behaviour or noises they make. Staff who completed surveys said they knew what to do if service users or their representatives had any concerns about the service. The service has access to the local authority safeguarding procedures and appropriate notification was being made of any allegations or suspicions of abuse. Staff were seen to maintain body maps where they notice any marks or bruising to service users. The manager advised that no restraint has been used at the service since the last key Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: inspection and one long standing safeguarding referral was in progress. Staff training records showed that of six files looked at, certificates to verify training in safeguarding were missing in five of them. Informal recording systems at the service (a spreadsheet and entry in a log book) indicated that staff had received the training in June 2008. A recommendation is made for certificates to be obtained from the trainer, if possible, or for those staff without the necessary verification to undertake training again this year. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvement has been made to accessibility and decor of the premises to provide comfortable and brighter surroundings for people using the service. Evidence: Two weeks prior to this visit, the service had not operated from the premises for a month whilst work was undertaken to improve the environment. This included redecoration throughout and wider door openings made to bedrooms and bathrooms. The building looked brighter, fresher, more modern and new furniture had been purchased for the lounge; one service user was enjoying trying out a reclining chair in the afternoon and said the furniture was a big improvement. Pictures and artwork were waiting to be put up to finish off the new look. The manager advised that there was funding to replace the dining room furniture and dining room carpet this financial year. All bedrooms at the service are single occupancy and vary in size. One of the rooms near the duty office has been changed from a bedroom to the managers office so that she is now located in a more accessible part of the building. Bathrooms and toilets are located close to communal rooms and bedrooms and have Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: the necessary adaptations to meet the needs of people with disabilities. As referred to earlier in the report, work will take place this financial year to reconfigure one of the bathrooms to improve access to the bath and shower. All parts of the building were clean at the time of this visit and those people who returned surveys said it is always kept clean. There were no unpleasant odours around the building. Toilets and bathrooms were stocked with the necessary supplies. Care Homes for Adults (18-65 years) Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to induct and train new staff but recruitment practice needs to be improved to make sure that people using the service are cared for by staff who have the right skills and competencies to meet their needs and to protect them from risk of harm. Evidence: People using the service said that staff treat them well and that they listen and act on what they say. A relative said he considered himself lucky for his daughter to have a place at Seeleys House and added that he was grateful for their dedication in duty. Another relative said the service was very good and good staff that look after my daughter very well. Staff who completed surveys said they are usually given up to date information about peoples care needs, a couple of staff adding that this was dependent on the local authority supplying them with the information in a timely manner. They said they had received an induction which covered the areas they needed to know about. One person said the induction period was clearly structured and concise, carried out professionally with support and supervision from all members of the staff team. A newer member of staff said there is a lot of support available, I only have to ask. Staff said training was Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: being offered to them which was relevant to their role, kept them up to date with new ways of working and helped them to understand peoples needs including those arising from equality and diversity. One person added the training programme at Seeleys is planned and run to ensure that all staff have the mandatory training and alongside this, the manager positively encourages staff to participate in a wide and varied number of courses relevant to our work. Staff said they are supported in their roles and that communication systems worked well. They said there are usually enough staff to meet peoples needs and felt they had the right support, experience and knowledge to meet different needs. Recruitment files of four new staff were looked at as part of the inspection. All contained the required checks and clearances with evidence of enhanced Criminal Records Bureau and Protection of Vulnerable Adults disclosures. Two files were brought to the managers attention. One persons work history contained gaps from 1984 until 2006 and from 2007 until October 2008. There were no supporting documents or notes in the interview records to explain what the person had been doing during these periods. The interview notes and a reference stated that the person had worked for a provider that was not mentioned on the application form and this did not seem to have been picked up either. A reference relating to working for this provider had been written by someone at team leader level rather than the manager; referees in these positions may not be aware of a persons full working history for reasons of confidentiality and it would have been better practice to make sure the reference was addressed to the manager. A second file contained a to whom it may concern reference which was not on headed note paper to verify that the person writing it was in a position to comment on the applicants suitability. Requirements are made to improve recruitment practice at the service to ensure tighter safeguards are in place to protect users. Information on agency workers was contained within a folder with individual profiles supplied by the agencies. Training records of six staff were looked at. Most mandatory training was up to date with certificates to verify completion of training. Some specialist courses had been undertaken as well such as equal opportunities, infection control, eating and swallowing (aimed at working with people with learning disabilities), physical intervention, epilepsy awareness, working with people with autism and gastrostomy care. The manager had obtained copies of the Department of Health guide for hospitals and care homes on the deprivation of liberty safeguards. Comment has been made earlier in the report regarding the need to verify safeguarding training has been undertaken by some staff. Evidence of food handing and hygiene training was only seen in two of the files and will need to be undertaken by other staff who have involvement in preparing meals and snacks for people using the service. A requirement is made to address this. Care Homes for Adults (18-65 years) Page 24 of 31 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 management and administration of the service promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The manager is registered with the Commission and has the Registered Managers Award. The deputy manager has also achieved the Registered Managers Award. One person who completed a survey said the manager and deputy manager were outstanding. At the time of the random inspection, significant progress was noted in improving the service and meeting requirements set last April. The only requirement at that time where the manager had not had opportunity to improve practice centred on recruitment, which has been an area looked at on this occasion and one which needs to be strengthened. Monitoring of the quality of care has been undertaken by the provider with reports of visits up to December 2008 available. These showed that the format of visits has Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: included speaking with people using the service and staff, a tour of the premises and sampling of records. The random inspection report referred to a quality assurance audit taking place in August 2008, to comply with a requirement. Health and safety was being managed effectively. There was a current gas safety certificate in place. Electrical hard wiring had been checked in March this year with no report or certificate available yet. Portable electrical appliances had been checked in December 2008 and regular fire safety checks were being undertaken. The most recent environmental health inspection took place in January 2009 when the service was accredited with the bronze award for hygiene standards. The award certificate was found but the report could not be located; some minor action was described by the manager as needing to be attended to. Care plan files showed that staff are completing accident records and taking action to minimise risks to people using the service. A trailing cable in the dining room, noted at the last inspection, had been tidied up by the time the random inspection was carried out. 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 34 19 The quality of information 31/05/2009 obtained about applicants needs to be improved through ensuring that managers of other work places are approached to provide references, rather than less senior staff, and that where these are not written on headed note paper verification is made of their position. This is to ensure that the right people provide information about applicants suitability to work at the service. 2 34 19 Gaps to employment history and discrepancies between information on application forms and references are to be explored with applicants and the reasons noted. This is to ensure that full background information is obtained about people 31/05/2009 Care Homes for Adults (18-65 years) Page 29 of 31 before they are offered employment. 3 35 18 Food handling and hygiene training is to be undertaken by any staff who prepare meals or snacks for people using the service. This is to make sure that proper safeguards are in place to reduce risk of harm. 01/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 A revised version of the service users guide is to be produced which people will be able to understand and make better use of, so that they have information that is accessible to them. Certificates to verify attendance and completion of safeguarding training are to be obtained where necessary and placed on staff files. Where these cannot be obtained, fresh training should be undertaken this (calendar) year. 2 23 Care Homes for Adults (18-65 years) Page 30 of 31 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. Copyright © (2009) 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. 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!