Care Home: Shady Trees Respite Service

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What the care home does well Supporting people to maintain their individuality is central to the home`s ethos and approach. Everyone`s differences are valued and the people are supported to lead their lives in the way they prefer. The introduction and assessment procedures are thorough and make sure that the home is able to support the individual`s needs and that the person is sure they would like to have respite breaks at Shady Trees. Everyone said they are treated very well by the staff and one person also said that their family agree with this. Everyone said that staff listen to them and act on what they say and they can always do what they want to. There is good and friendly interaction between the people who stay at the home and the staff. The staff on duty try to make sure they have time to spend with people in conversation, as well as offering people support to take part in individual and group activities and outings. The home`s recruitment procedures are thorough, making sure that staff are safe to work with the people who live at the home All the staff said they enjoy working at Shady Trees and felt they were well supported by their manager. They said the training is good and helps them to do their job well. More than half of the support staff have achieved a National Vocational Qualification (NVQ) at level 2 or 3. The complaints and adult protection systems work well and people said they know and understand what to do if they have a concern. The home is comfortable and clean and everyone said that the home is always kept fresh and clean. What has improved since the last inspection? This section does not apply as this was the first inspection of this new service. What the care home could do better: The care plan files would benefit from being re-organised, giving more emphasis to how people`s social care needs are to be met and making the `Summary of Support` document more easily accessible. It would be good practice for the person, or their family or carer, to sign their support plan to confirm that they agree with it. One member of staff reflected our concern that sharing the adapted vehicle with all the other services at Oxfield Court, and the mileage charges of 55p per person per mile, means that they are unable to take guests out for leisure activities as often as they would like to. The staff member also said that because it is a large vehicle only a limited number of staff can drive it. One health and social care professional said they would like to see `Continuity of staff and less reliance on agency and bank staff`, adding that these staff `...do not know the service users well or how to meet their nursing/personal care needs.` It would be beneficial for everyone if the home could make progress on recruiting more permanent staff, to eliminate the need to use bank and agency staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Shady Trees Respite Service 4, Oxfield Court Albany Road W Yorkshire HD5 9UZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Liz Cuddington     Date: 2 4 1 1 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 29 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 29 Information about the care home Name of care home: Address: Shady Trees Respite Service 4, Oxfield Court Albany Road W Yorkshire HD5 9UZ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) St Anness Community Services Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. The Registered person may provide the following category of service only: Care home with nursing -Code(N) to service users whose primary care needs on admission to the home are within the following categories: learning Disabilities- Code(LD), maximum number of places: 4 2. The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home Shady Trees is a respite care home, providing nursing care and accommodation for up to four people at a time. It is part of a complex of small residential homes and a day centre, for people with a learning disability. The house is comfortable and attractively decorated and furnished. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The weekly fees the home charges are those agreed with the health authorities, who are responsible for funding the persons placement. This was the first inspection of this recently registered service. The purpose of this inspection was to assess the quality of the care and support received by the people Care Homes for Adults (18-65 years) Page 5 of 29 who go to stay at Shady Trees. The visit to the home was carried out over one day by one inspector. The methods used to gather information included conversations with the people staying at the home and the staff, as well as looking at care plans and examining other records. We received surveys from six people who use the service, one member of staff and two health and social care professionals as well as the homes self-assessment questionnaire. These gave us a lot of useful information about the home and helped us plan the visit. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The care plan files would benefit from being re-organised, giving more emphasis to how peoples social care needs are to be met and making the Summary of Support document more easily accessible. It would be good practice for the person, or their family or carer, to sign their support plan to confirm that they agree with it. One member of staff reflected our concern that sharing the adapted vehicle with all the other services at Oxfield Court, and the mileage charges of 55p per person per mile, means that they are unable to take guests out for leisure activities as often as they would like to. The staff member also said that because it is a large vehicle only a limited number of staff can drive it. Care Homes for Adults (18-65 years) Page 7 of 29 One health and social care professional said they would like to see Continuity of staff and less reliance on agency and bank staff, adding that these staff ...do not know the service users well or how to meet their nursing/personal care needs. It would be beneficial for everyone if the home could make progress on recruiting more permanent staff, to eliminate the need to use bank and agency staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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. Before people start to use the service, there is an assessment and introduction procedure. This makes sure the home will be able to meet the individuals needs and the person is satisfied that they want to have respite stays at Shady Trees. Evidence: When someone is considering going to the home for regular breaks, they are given information to help them make a decision. The Service Users Guide is attractively presented, using straightforward language and illustrations. The home is currently looking at the best ways to produce information in other formats, such as in other languages and as an audio version. People and their families are also invited to visit as many times as they need and share a meal with people who are already staying there. People can also have overnight visits, if that would help them reach a decision. These all give the person the opportunity to make an informed decision and helps the home decide if they are able to meet the persons needs. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: This procedure, along with other professional assessments, also helps the staff to start developing the plan of care and support. Before someone arrives for their first stay, a member of staff is appointed as their keyworker. The keyworker is involved in preparing their support plan and provides continuity of care. Care Homes for Adults (18-65 years) Page 11 of 29 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. People are involved in planning and agreeing the level of care and support they need and how this is to be provided. Evidence: We looked at two individual care and support plans. They showed that wherever possible people are involved in developing and reviewing their plans. The plans reflect the individuals preferences and needs and demonstrate the persons involvement in making the decisions that affect them. Other people also contribute to the care plan review procedure, to make sure a full picture of the individual is obtained. These people could include the persons relatives, the homes management, their social worker and someone from any other services he or she is involved with. The staff sign to confirm that they have read the plans. It would be good practice for the family or carer to also sign the plan, to confirm that they agree with it. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Everyone is supported and encouraged to make their own choices about how they lead their lives, while staying at Shady Trees. The support plans reflect this and are updated regularly, to make sure they always reflect peoples wishes. Where any activity involves a potential risk, an assessment is made and plans are agreed to minimise the risk, while still supporting peoples right to independence and freedom of choice. The risk assessments are very detailed and as well as plans to minimise any physical risks to the person, they also show how emotional risks, such as social isolation, can be reduced. These assessments are reviewed regularly, along with the rest of the plan. The files we looked at also included a very good, eight page illustrated Summary of Support. This describes all the persons social and health care support needs and how they are to be met and gives the reader a vivid picture of the individual. The ones we saw were in the middle of the files, inside a single plastic envelope. It would be good practice to take them out of the envelope and perhaps put them at the front of the plans, so that staff can easily refer to them if they need to. This could be particularly valuable as a reference for staff who are new or who do not work regularly at Shady Trees. The plans are up to date and reflect peoples individuality. They contain sufficient detail to guide staff and help them understand each person. The plans are consistent and straightforward and include a lot of very good information. They do, however, place the emphasis on peoples health and medical needs, while their social and leisure needs appear later in the plan. This does not necessarily reflect the way people are supported during their visits. Our observations showed that the staff work hard to meet peoples social needs. It was clear that the staff understand peoples needs and support them to live their own lives and maintain their individuality. All the evidence we saw clearly indicated that the homes staff support people to maintain their independence and improve the quality of their lives. From talking to the people who were staying at the home and the staff, as well as reading the notes, it was clear that everyones personal choices are respected and supported. People are also supported to meet their own cultural and spiritual needs. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: All the written information is securely stored and confidential information about people is only shared with those who need to know. Care Homes for Adults (18-65 years) Page 14 of 29 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 are supported to follow the activities they choose, to make sure their needs and expectations are being met. Trips out are limited by cost and the availability of transport and drivers. People are offered a good choice of meals, and other foods, to make sure their dietary needs and preferences are met. Evidence: The care and support plans include information about each persons choice of recreational and leisure pursuits and their goals. The activities people follow depend upon what they want to do during their stay. On weekdays, people carry on with their regular social and leisure activities, unless they are unwell and need to stay at home instead. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: When we visited people spent the evening relaxing in the sensory room, watching television, listening to music and in conversation with the staff. People also like to go out for walks, visit parks and events such as local festivals as well as doing crafts and painting and having relaxing hand massages and spa baths. Shady Trees is part of Oxfield Court residential and day care services. There is an adapted vehicle that people can use to go out in, when its available. There is an additional charge for this of 55p per person per mile, which makes it rather expensive for many people. Taxis are also used for going out to places of interest. One member of staff said that sharing the adapted vehicle with all the houses and the day centre means that they are unable to take guests out for leisure activities very often. This staff member also said that because it is a large vehicle only a limited number of staff can drive it. The staff we spoke with had a good understanding of peoples needs and how each person likes to be supported. They understood the ethos of the home and the importance of respecting peoples right to self-determination and their right to be left in peace if they wish. It was clear that the staff understand how to support people to maintain their dignity and self respect. Individual choices about spiritual and cultural matters are reflected in the plans and the staff all know and understand each persons needs and preferences. At mealtimes there are always alternatives available if people do not want the choices on the menu. People enjoyed their meals and anyone who needs assistance is helped discreetly, following the persons own pace. People are offered hot and cold drinks and snacks throughout the day. People get involved in some meal planning and preparation and records are kept of peoples preferences and any changes in diet. Special meals are prepared for those people who require, for example, a halal or a vegetarian diet. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples personal and healthcare needs are met. People are protected by the homes medication systems. Evidence: Peoples health and wellbeing is observed and monitored, and any concerns are followed up with the family and relevant health or social care staff, where appropriate, and their advice is followed. The plans contain details about the individuals healthcare needs. Information in the plans, and conversations with staff, confirmed that peoples individual preferences are understood by everyone and are central to the care and support they are offered. Each plan reflects the persons choices for all aspects of their life. They are well set out and the way people prefer their care and support to be provided is clearly detailed. This makes sure that staff know exactly how each person likes to be supported and the routines they like to follow. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Information about peoples healthcare needs is kept up to date and relevant healthcare professionals are consulted, to make sure people receive the best healthcare possible during their visits The support plans are kept in a secure place; they are up to date and detailed and include good daily records that show what the individual has done that day and note anything of significance. The staff that administer medication have received suitable training. This helps to make sure that medicines are administered safely and that staff understand this area of their work. There were signatures on the Medicines Administration Record (MAR) charts to confirm that staff had administered the medicines according to the instructions. All the medicines are brought into the home in their original packaging and the procedures for checking, storing and administrating medicines are safe and accurate. Our observations during the inspection confirmed that the staff always respect peoples privacy and dignity. Their approach is excellent; supportive, calm and understanding. Care Homes for Adults (18-65 years) Page 18 of 29 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 aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people staying at the home are safe. Evidence: The staff training records showed that all of the staff have taken adult protection training. Conversations with the staff showed that they understand their responsibilities towards people with regard to protecting them from any risk of abuse or poor practice. Staff are made aware of and understand the homes whistle blowing policies and procedures, to be used if they suspect abuse or see examples of poor practice. They are expected to understand the policies and procedures concerning adult protection and have taken training in these areas of their work. The home uses a DVD from Kirklees Social Services, made by people who use services, which aims to raise awareness of adult protection issues. The staff watch it with people who stay at Shady Trees and discuss the content with them, to make sure they understand it. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: People we spoke with, and people who completed our surveys, said they feel safe and know how to make a complaint or raise a concern if they need to. The evidence we saw confirmed that there are systems in place to keep accurate and detailed records of any concerns or complaints and any improvements made as a result of complaints investigations. Care Homes for Adults (18-65 years) Page 20 of 29 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. The home provides a safe, clean and comfortable environment. Evidence: Shady Trees is a purpose built single storey house, designed to offer suitable accommodation for the people who use the service. The whole house is comfortably furnished and attractively decorated. The shared rooms are welcoming and are very pleasant places for people to spend time doing activities or relaxing in each others company. There is an adapted bathroom and the shower room has a new drop down seat with a padded seat and arms, which will make it more comfortable for people. The home has a sensory room, which is still being developed. It was being used when we visited and provides a relaxing place for people to spend time. There are gardens surrounding the house where people can sit out. There is a lot of work to do in order to make the gardens at the back more attractive and accessible to everyone. The manager has plans for the improvements and hopes to involve the homes carers group. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The house is clean and fresh throughout. Protective gloves and aprons are available for staff to use when necessary, as part of the homes infection control measures. Care Homes for Adults (18-65 years) Page 22 of 29 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. Sufficient well trained staff are employed to meet peoples needs. People are protected by the recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Evidence: The staff rotas confirmed our observations that there are enough nursing and support staff on duty to meet most of the care and leisure needs of the people who go to stay at the home. The staffing levels are adjusted, depending on the needs of the people who are staying at Shady Trees. The home is currently using bank and agency staff to fill any gaps in the rotas. At present this is only necessary to cover for staff sickness absences. The manager said they try to have the same bank and agency staff each time, to make sure there is some continuity for people who visit the home. As well as an interview, all new staff complete an application form and provide two written references, as well as completing satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks before they start work. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The manager is looking at ways to involve the people who stay at the home in the interview and selection process. New support staff take the mandatory health and safety training and they all follow an accredited induction training course. This prepares them for moving on to take a National Vocational Qualification (NVQ) course. From a total of five support staff, three have achieved the NVQ qualification at either level two or three and one is studying a relevant subject at degree level. Other specialist training, including courses on person centred planning and The Mental Capacity Act, is provided to make sure staff skills and knowledge is kept up to date. The staff we spoke with said they enjoy working at Shady Trees; they like the variety and getting to know different people. The staff said it is important that they keep up to date as peoples health and social care needs may change between visits. It was clear that the staff knew and understood the people who were staying at the home when we visited. The records, and the staff, confirmed that all the staff are having regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed and run in the best interests of the people who use the respite service. Evidence: The manager has the necessary experience and qualifications to manage the home effectively and in the best interests of the people who use the service. To maintain confidentiality, peoples personal information is stored in an office that is locked when it is not being used. Where the home helps people to manage their personal finances, accurate records are kept of all transactions. Regular audits are carried out to make sure the records and amounts are accurate and each cash sheet is checked daily. The policies and procedures provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner and staff have basic health and safety training. Fire drills are Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: also held, to make sure everyone knows what to do in an emergency. All these measures make sure that the health, safety and welfare of everyone at the home is promoted and safeguarded. The home asks people who use the service, their relatives and professional visitors to complete quality assurance questionnaires, in order to find out what people think about the care and support the home offers. The staff said they felt supported by the management team and enjoyed working at Shady Trees. At present there are no people who stay at the home who are subject to a deprivation of their liberty authorisation, under the Mental Capacity Act 2005. We received the homes annual quality assurance self assessment. It contained very detailed information about the service, the support that is provided, the improvements they have made and their plans for the coming twelve months. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 6 It would be good practice for the family or carer to sign their relatives support plan, to confirn that they agree with it. It would be good practice to put the Summary of Support at the front of the plans, so that staff can easily refer to it if they need to. Peoples opportunities for going out would be increased if more affordable and accessible transport were available to them. It would be beneficial for everyone if the home could make progress on recruiting more permanent staff, to eliminate the need to use bank and agency staff. 2 6 3 13 4 33 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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