Care Home: Selborne Mews

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What the care home does well People told us that they like living at the home they told us: "You could not get a better place than this." and "its like a family here. "The manager ensures that no person moves into the home without having their needs assessed in full. The manager can also be sure that the service is able to meet those needs. People who live at this home can feel confident that they will supported in leading as independent life as possible. They can be sure that their health care needs will be met and regularly monitored at Selborne Mews. One person said; " the help I have had from staff in the last two years has enabled me to be able to look after myself so that I can live in my own flat." Accommodation is well presented, each person has their own self contained apartment that is fully furnished and provides a relaxing place for them to live. People told us: " I love my little flat." Staff are recruited and selected in a manner that safeguards people who live at Selborne Mews. All new staff receive an induction that introduces them to the home and the people living there. Staff feel supported by the manager and are confident that he will support them. What has improved since the last inspection? The home has made improvements to ensure that the administration of medicines is safer. The manager has also told us that they have continued to develop the staff team and they now have two unit managers. The service also include the people living at the home in the interviews of staff who will support them. The home has been so sucessful in developing people to be more independent that they have people who are moving out to supported living. The service continues to develop its staff training it is also positive that some of the people who use the service are doing the same training as the staff such as; food hygiene, infection control, and person centred planning. The front of the building has been re-signposted to use one entrance for visitors to make the home more secure for people living there. What the care home could do better: We have not made any requirements of recommendations of this service. We did advise the Manager that minor improvement is needed to ensure that all complaints and their investigation is fully recorded, to show that people are listened to and concerns fully acted upon. Key inspection report Care homes for adults (18-65 years) Name: Address: Selborne Mews 36-37 South Road Smethwick West Midlands B67 7BU     The quality rating for this care home is:   three star excellent 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: Amanda Hennessy     Date: 0 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Selborne Mews 36-37 South Road Smethwick West Midlands B67 7BU 01215555615 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Selborne Care Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide personal care (inculding nursing) and accommocation for service users of both sexes whose primary care needs on admission to the home within the following categories: Learning Disability (LD) 20 Date of last inspection Brief description of the care home Selborne Mews provides care for up to twenty people in three separate units. Fontwell, Exeter and Hexam. The home is unique in its design and enables people to receive twenty-four hour care and attention in the comfort of their own apartments. Each apartment has a kitchen with a dining area, bathroom, bedroom and a living area. There are three, two bedroomed apartments for those people who wish to share accommodation. The home is situated close to Smethwick town centre and is accessible by bus and train. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 20 Brief description of the care home The homes Statement of Purpose says that the service aims to work in partnership with the public sector and identified stakeholders to provide highly specialised and individual packages of care based on individual assessments and care programmes to enhance the lives and independence of the residents of Selborne Mews. Fees detailed in the services service user guide range from £1600 to £2600 per week depending upon the individual care needs of people. This charge does not include extra services such as hairdressing costs, newspapers and magazines and telephone calls if service users choose to have their own private telephone line installed. The reader is advised to contact the service direct for up to date information on fees charged. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced Key Inspection was carried out by one inspector on one day from 9.45 to 18.15, neither the home nor the provider knew that we would be visiting. There were sixteen people living at the home, with four vacancies at the time of our visit. The National Minimum Standards for Younger Adults were used as the reference for the inspection. Information for the report was gathered from a number of sources: a questionnaireAnnual Quality Assurance Assessment (AQAA) was completed by the Manager and was sent to us before the inspection; We visited communal room and some flats when we were able to gain permission from the occupier. Records about the safety of equipment and the building were also checked. Four written surveys were returned directly to us from people living in the home and Care Homes for Adults (18-65 years) Page 6 of 28 their relatives, these survey forms are known as have your say about Selborne Mews, to enable people to tell us about their experiences of life at the home. We had discussions with the Manager, Area Manager, Unit Managers, care staff and people who live in the home, to gain their views of what it is like to live at the home. We looked at how the service has responded to concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people who live in the home. Three people who live in the home were case tracked, this process involves Establishing peoples experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at their care records and focusing on outcomes of the care that they receive. Tracking peoples care helps us to understand the experience of people who use the service. As part of this process we also looked at peoples medicines, how they are ordered and the records of their administration. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. Evidence: The service has a comprehensive statement of purpose and service user guide. The service user guide is available in alternative formats such as pictorial versions (this version is on the main notice board of the home). The manager is also planning a video version of the service user guide and told us that clips of people who are currently living at the home and telling others what it is like to live there have already been recorded. We found that significant time and effort is spent planning to make admission to the home personal and well managed. People are only admitted to Selborne Mews once a comprehensive assessment of their needs has taken place. We looked at the files of three people who had come to come at the home since our last inspection all had a comprehensive assessment of their needs undertaken both by the home alongside the persons social worker and other professionals who may support them. The Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: assessment of their needs is used to form the basis for care planning alongside appropriate and robust risk assessments. We saw from care records but people also told us that they are involved in their care planning including any restrictions of their freedom and choice that may be necessary. People have the opportunity to visit Selborne Mews before they and the service decide that the service is an appropriate place for them to live. We saw records of one person who has had a number of visits to the service starting with short visits progressing to overnight and weekend stays. The visits enable the person to meet other people already living at the home and enables them to make a decision whether the home is right for them. Care Homes for Adults (18-65 years) Page 12 of 28 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 are fully involved in decisions about their lives, and play an active role in planning the care and support that they receive. Evidence: The key principle of the home is that people living at the home are enabled to be in control of the lives. Support plans alongside risk assessments support this principle but with actions to ensure that the safety of people is always the main consideration. People have their own individual plan that comprehensively details all of their care and support needs. We found that support plans are person centred this means that they identify all the persons needs, capabilities and choices. It was also positive that support plans identified all levels of needs giving staff instructions on care that people will need if their mental health deteriorates. The support plan is drawn up with the persons involvement and is agreed by them. Support plans when appropriate identified the persons goals and comments about what they felt were their care needs one example of this was: I want staff to assist me so that I can keep my appearance Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: up and look smart at all times. One person we spoke to told us how he had become more independent since coming to live at the home and with the support of staff. Support plan are all reviewed at least monthly or when needs change, senior staff also regularly audit care plans and when needed identify any areas that require further updating. There are good systems in place for dealing with limitations on freedom, in accordance with the Care Programme Approach and Probation Service. This means that both staff and the person is aware of the restrictions placed upon them and they are managed sensitively. Staff encourage people living at the home to make decisions about their lives, they do this by offering them choice and giving them information needed to make decisions. A staff member told us; we always give people here a choice. People living at the home also have direct access to Advocacy services, and not only is there information about advocacy services displayed but Advocates also visit the home and talk to people about the assistance they can offer- one such visit took place on the morning of our visit. People told us that they manage their own finances others said that they also administer their own medicines and the home supports them in doing so. People have their own individual risk assessments that enables him or her to live as independently as possible. All risk assessments show the potential risk, such as violence to others, self harm and misuse of substances and the methods of risk reduction. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices about their lifestyle, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet their expectations. Evidence: Central to the homes aims and objectives is the promotion of peoples right to live an ordinary and meaningful life both within the home and also within the community. Peoples goals are identified and staff facilitate and support them to meet their goals. We found that several people living at the home have been supported to find employment, others told us that they are going to college to improve their chances of finding employment in the future saying: I want to be able to have a job like X. People living at the home are able to enjoy a full and stimulating life. People are Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: supported to integrate into the local community with people telling us on the day of our visit that they had been to the bank, shops, the local library and swimming and another person told us that was going to the cinema later. Staff told us that people have a choice of how they spend their day and can choose to take part in either group of individual activities. The services AQAA identifies: We have no visiting times and families are welcome at any time. We found that several people also regularly go out and visit their family and friends. People are also supported to meet new friends one person told us that: Im going clubbing down Broad Street at the weekend. People living at the home have the opportunity to make suggestions for trips, holidays and other outings that they are interested in. Everyone living at the home has the opportunity to on holiday at least once a year, the home will pay for this but they do have to provide their own spending money. People told us about their recent holidays to Weston and Scotland during our visit. There are no fixed meal times due to the individual nature of the cooking arrangements. People are encouraged to sit with their key worker on a weekly basis and plan their shopping and menu for the week. Each person has £4 a day to spend on food. Staff will help each person to prepare and cook their meals as outlined in their individual care plans. One person told us that they did all their own cooking and shopping, someone else said they wanted to achieve this in the future. The home routinely completes risk assessments for each person that looks specifically at their nutritional intake. People are supported to make choices about their diet . It is positive that dieticians have been asked to come and advise people on their diet and give them the information they will need to make choices about healthy eating . Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent 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 that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: There are appropriate arrangements in place to ensure that people have the health and personal care that they need. We saw evidence that people living at Selborne Mews are seen by other professionals such as psychiatrists, community psychiatric nurses, doctors, chiropodists, dentists and opticians depending on their needs. We were also able to see that staff support people to take responsibility for their health care needs such as with visits to dentists and opticians. We also saw support plans for healthy eating with the persons comments: I want to eat healthy, because I dont want to get sick. We also saw that peoples physical and mental health care needs are recorded and regularly monitored. Care plans for the management of psychological needs are in place along with other specific medical conditions such as epilepsy. We looked at one care plan that gave comprehensive instructions to staff how the persons epilepsy was managed including when a seizure occurs. Other care plans we looked at addressed Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: specific mental health issues, which included information on relapse triggers and actions for staff to take to ensure that the person did not become too distressed. Care plans also included the individual preferences of people when receiving personal care from staff, such as a male or female worker to assist them with personal care. Other documentation in relation to health care management viewed includes risk assessments for pressure sores, poor nutritional, falls, self harm and moving and handling. The home has a policy and procedure for the safe handling of medication including homely remedies. All staff receive training prior to taking any responsibility for peoples medication. One person told us that they has done so well since they came to live at Selborne Mews that they were now self administering all their own medicines following ongoing support from staff to become more independent. The self administration of medicines is risk assessed to enabling people to be kept well and also as independent as possible. Care Homes for Adults (18-65 years) Page 18 of 28 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 who use this service are able to express their concerns, and have access to a robust, effective complaints procedures. The service ensures that people are protected from abuse and have their rights protected. Evidence: The homes complaints procedure which is also available in pictorial formats is widely available throughout the home. The service has had three complaints since our last inspection. We saw that two of the three complaints were investigated by the Home Manager within the required timescale, the third complaint was investigated by the Local Authority and is still unresolved. We did advise that a more detailed record of the investigation of the complaint is available. We have not had any complaints about this service. Staff and people living at Selborne mews told us that the manager has an open door policy and that they can speak to him whenever needed- his mobile number is on board as are the other managers if we need to contact him . When we asked people living at the home what they would do if they had any concerns or were not happy. They said: Id talk to Kevin. others said staff but all were confident that any concerns they had would be resolved. One person told us; You could not get anywhere better than Selborne Mews. The home has told us that there have been four safeguarding referrals. We have seen that the home ensures that when any concerns are raised these concerns are shared with ourselves and the local authority. The manager has also when requested Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: undertaken a comprehensive investigation of any issues raised and have also attended meetings to discuss any safeguarding referrals. The manager has also referred a member of staff to the protection of adults list as a result of the concerns highlighted. The manager ensures that all staff have had or are currently have a place to undertake safeguarding training which is also regularly updated . At this inspection we found that staff we spoke to were clear of what may constitute abuse and what actions they should take to keep people safe and minimise any risk to them. We were told that staff all receive at least three days training on the management of violence and aggression and how they should deescalate any incidents of aggression. Staff also receive training in restraint to enable them to protect themselves and others when needed, although any restraint is rarely used. It is positive that the manager makes a log of all untoward incidents and any actions that staff have taken. Care Homes for Adults (18-65 years) Page 20 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well maintained and provides excellent accommodation for people who live there. Evidence: All areas when we visited were well maintained and clean. The home is made up of self contained apartments, all of which have their own front door and their own door bell. All of the apartments have a kitchen so that people can cook for themselves, a bathroom to maintain their privacy and their own individual living area and bedroom. There are three two bedroomed apartments in total for those people who choose to share. There is also a small communal meeting room where people can relax with others and take part in leisure activities should they choose to do so. There is a large and pleasant courtyard at the back of the home with outdoor furniture and patio plants. People told us: I love having my own flat so that I can be on my own if if want to but can always come down and have company when I want. Maintenance and housekeeping workers are employed to ensure that the current standard of maintenance and cleanliness is kept. There are individual laundry facilities in each apartment but staff do have a central laundry and sluice to access if needed. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by competent and qualified staff. There are sufficient staff to meet peoples needs. Evidence: There are enough members of staff on duty to meet peoples needs. There is always a trained nurse on duty and support workers who assist them. The majority of people who live at Selborne Mews require intensive support from nursing and care staff, this is often on a one to one basis with some people requiring two staff with them when they go out. Staff allocation and who they are supporting on each shift is identified. Most of the staff have now completed or are in the process of completing their NVQ level 2 in healthcare. People told us staff are very helpful and staff are very nice here and X is great, he takes me fishing.. Staff recruitment and selection is undertaken appropriately and meets the required standard. All required checks such as criminal records checks and references are checked before staff start work at the home and ensure that any risk of unsuitable people working at the home is minimised and protecting people who live there. We were told that people living at the home also interview staff who will be supporting them and have a say whether they feel they could work with that prospective staff Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: member. We were told that all new staff receive formal induction training that meets Skills for Care standards. A new member of staff who was on duty on the day of our visit told us that she had been an addition to usual staffing numbers for two weeks which had given her the opportunity to meet and get to know the people who she would be supporting and read all the care files. Each member of staff has their own individual training plan and the organisation has good systems in place to identify when staff are due for updates in training. This ensures that all staff has the required knowledge and skills to care for people living at the home. All staff have regular supervision, this gives them the opportunity to discuss their progress and to identify any specific training needs they may have. The manager will also complete an annual appraisal for each member of staff once they have been employed for a year. Staff we spoke to during the inspection told us that they were all satisfied with the support and supervision they received. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and peoples health, welfare and safety is promoted. Evidence: The manager of the home is Mr Kevin Taylor, he is a registered mental health nurse (RMN) and has many years of experience both working in hospitals and social care. Mr Taylor is a qualified trainer and uses his skills to train and update staff on a regular basis. During discussions with Mr Taylor it is clear to see that he is enthusiastic about developing the home into a place where people achieve their goals and aspirations. We were also able to see that the manager, senior staff, and staff at all levels have a good understanding of risk assessment processes which is underpinned by promoting peoples independence, choice and autonomy, these principles are taken into account in all aspects of the running of the home. The Manager completed the homes AQAA, which was returned to us when we asked for it. The AQAA gave us excellent information about the service and plans for improvement and development that are in place. There is a quality assurance system in place, this includes the regular auditing of the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: environment, medication, and care planning, and the manager also audits untoward occurrences, accidents and incidents. This helps identify any trends that may occur and allows the manager to formulate an action plan to reduce any risk to people. Regular resident meetings are held which give people opportunity to discuss the home. proposed trips out and holidays. Surveys are sent out to people living at the home, their relatives and other professionals annually in a attempt to seek further information about peoples satisfaction with the home or how they can continue to improve. The home has efficient systems in place to ensure that the peoples money is kept safely. People are supported by staff to manage their own money. One person told us that he had been so successful at the home he was leaving to live by himself and staff had supported him to identify a weekly budget to enable him to pay his bills. We were able to see that the home has implemented and ensures that the Mental Capacity Act 2005 deprivation of liberty safeguards, are well managed to protect people living at the home. Staff have received training and understand the Mental Capacity Act and the deprivation of liberty safeguards and their implications for day to day practice and care planning. No one is being unlawfully or inappropriately deprived of their liberty. Record keeping at the home is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. Safe working practices within the home are a priority and all staff have annual updates or statutory training. This helps to keep their knowledge and skills updated. The manager has a training matrix that identifies when staff training is due so that all staff are assured of a place and do not miss out. Safety certificates for the building are all up to date; the manager indicated this in the AQAA document he completed prior to our visit. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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