Care Home: Sign, 100 Bowfell Road

Similar services:

• SignHealth
• Mere Hall View
• Beechfield Lodge
• Christopher Grange (Rhona House)
• Sense
• Auden House
• Deafway

What the care home does well Bowfell Road is a specialist service for people who are deaf and have associated mental health needs. The service continues to provide an excellent standard of support for people who live there. So that people are kept informed and involved in the day to day running of the home, information is provided in different formats, which meets the various needs of both tenants and staff. Advocacy services are also utilised to promote tenants independence as well enabling them to express their needs, wishes and opinions both in and away from the home. The management and support team have remained very stable and is made up of both hearing and deaf staff, all are able to communicate fully using sign language. This has enabled them to maintain a supportive environment. The team has developed positive working relationships with specialist health care professionals enabling them to support and advise tenants ensuring the health and well being is maintained. Robust procedures are in place ensuring only those staff employed to work at the home are suitable to do so. Staff continue to receive on-going training and development ensuring they have the knowledge, skills and competencies needed to support tenants fully. Staff members have a very good awareness of tenants individual needs and wishes and adapt the support to meet these. Individual support plans are person centred and developed by both tenants and staff on the specific needs and wishes of each person. Records are provided in different formats so that information can be more easily understood. The current five tenants have now shared the home for sometime and have developed good relationships with each other. Individuals were relaxed and happy to speak with us. Those spoken with expressed that they were happy and settled living at the home. They were comfortable with their surroundings and felt they had everything they needed. Comments included; `I am happy where I live and I have all my personal possessions`, `I am happy living at Bowfell Road, it has given me the confidence and I have good relationships with staff`, `I am happy with the way things are` and `I am happy here, I like my flat and I feel safe`. Relationships with staff were positive and they were happy to speak with them if they needed to. Staff comments were also received about their work and the support they offer. They expressed; `fully supports the tenants in a safe caring environment`, `it supports people to move into the community at a suitable pace`, `it involves the service users in their own support process`, `it focuses on a family atmosphere within the home`, `aim for clients to become independent living in the community in their own flat`, `we are well organised and follow procedures`, `we work together as a team` and `it allows staff to develop at their own pace, and encourages internal promotion` and `it allows a democratic system for staff and service users to have their say`. What has improved since the last inspection? The service continues to support and promote tenants is living a lifestyle of their choosing enabling them to be as independent as possible. The team has spent some time developing more east read documents and information. This enables tenants to take more control over their own lives and enables them to clearly express their needs and wishes. The team continues to receive training in areas of care and support, including areas specific to the needs of tenants. The service encourages continuous personal and professional development which enables them to provide a quality service to those who live at Bowfell Road. What the care home could do better: This service is proactive at reviewing how it performs and makes improvements as they become apparent. No improvements were identified as part of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Sign, 100 Bowfell Road Bowfell Road 100 Bowfell Road Urmston Manchester M41 5RR     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: Lucy Burgess     Date: 2 3 0 3 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Sign, 100 Bowfell Road Bowfell Road 100 Bowfell Road Urmston Manchester M41 5RR 01617478156 01617472566 mpayne@signhealth.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): SignHealth Name of registered manager (if applicable) Mr Michael Payne Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia sensory impairment Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Sensory Impairment - Code SI Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Bowfell Road is registered as a care provision to provide accommodation within selfcontained flats for up to six service users within the category of sensory impairment. Service users may also have associated mental ill health. 6 6 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home The accommodation comprises of six, single, self-contained flats with en-suite bathroom, lounge and kitchenette. The design and lay out of the building enables those residents living there to lead independent lives. The grounds are spacious and there is a car parking facility to the side of the building. The home is situated in a residential area of Flixton and is close to local shops and leisure centre. The home is close to public transport routes and there is easy access to local motorways. The home employs skilled staff, trained in communicating, using British Sign Language. The current charge for accommodation and support service is 1221.00 pounds per week. 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 was a key inspection, which included a site visit and took place over one day. The service did not know that they were to visit. Arrangements were also made for an British Sign Language Interpreter to accompany the Inspector during the visit so that the views of tenants could be sought. As part of the inspection process the manager was asked to complete an Annual Quality Assurance Assessment (AQAA). This was completed prior to and returned as requested. Information was comprehensive and provided detailed information about what the service provides, improvements made and their plans for the forthcoming year. During the visit time was spent looking at records including care files, recruitment and health and safety. Time was also spent looking at the environment, routines and the management of medication. Care Homes for Adults (18-65 years) Page 6 of 28 The home has consistently demonstrated a high standard of service delivery. During this visit we found that the home continues to provide and excellent service which effectively meets the needs of those people living at the home. As part of the inspection process we had sent out feedback surveys to people living at the home and staff. We received completed surveys from the 5 tenants and 9 staff. Comments received in the surveys and during the visit have been added to the report. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: Bowfell Road is a specialist service for people who are deaf and have associated mental health needs. The service continues to provide an excellent standard of support for people who live there. So that people are kept informed and involved in the day to day running of the home, information is provided in different formats, which meets the various needs of both tenants and staff. Advocacy services are also utilised to promote tenants independence as well enabling them to express their needs, wishes and opinions both in and away from the home. The management and support team have remained very stable and is made up of both hearing and deaf staff, all are able to communicate fully using sign language. This has enabled them to maintain a supportive environment. The team has developed positive working relationships with specialist health care professionals enabling them to support and advise tenants ensuring the health and well being is maintained. Robust procedures are in place ensuring only those staff employed to work at the home are suitable to do so. Staff continue to receive on-going training and development ensuring they have the knowledge, skills and competencies needed to support tenants fully. Staff members have a very good awareness of tenants individual needs and wishes and adapt the support to meet these. Individual support plans are person centred and developed by both tenants and staff on the specific needs and wishes of each person. Records are provided in different formats so that information can be more easily understood. The current five tenants have now shared the home for sometime and have developed good relationships with each other. Individuals were relaxed and happy to speak with us. Those spoken with expressed that they were happy and settled living at the home. They were comfortable with their surroundings and felt they had everything they needed. Comments included; I am happy where I live and I have all my personal possessions, I am happy living at Bowfell Road, it has given me the confidence and I have good relationships with staff, I am happy with the way things are and I am happy here, I like my flat and I feel safe. Relationships with staff were positive and they were happy to speak with them if they needed to. Staff comments were also received about their work and the support they offer. They expressed; fully supports the tenants in a safe caring environment, it supports people to move into the community at a suitable pace, it involves the service users in their own support process, it focuses on a family atmosphere within the home, aim for clients to become independent living in the community in their own flat, we are well organised and follow procedures, we work together as a team and it allows staff to develop at their own pace, and encourages internal promotion and it allows a democratic system for staff and service users to have their say. Care Homes for Adults (18-65 years) Page 8 of 28 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. 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 are fully informed and included within the assessment process ensuring the service is able to meet their assessed needs. Evidence: As previously identified the home has extensive information about the services they offer. All information is available in different formats, which meet the needs and understanding of those who are deaf and associated mental health needs. A clear and thorough process of assessment is undertaken when resettling prospective residents. Information is gathered from a number of sources, which enables both the individual and the service to make an informed decision about the suitability of the placement. Prospective tenants are provided with opportunities to meet the staff team and other tenants they may be living with. The time taken for the moving in process varies depending on the person allowing them time to get to know people and feel confident about the move into the home. Through discussion with the manager and team leader it was clear that the service has Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: good professional relationships with those agencies that make referral to the home. Both parties liaise on a regular basis to allow for information to be shared as well as supporting those individuals who are looking at alternative accommodation. Once placement has been agreed, information gathered is used to inform the development of a support plan. Placements are reviewed periodically to ensure that peoples needs are being met and the placement continues to be suitable. 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. Tenants are actively involved in the development of their support plans ensuring they reflect their current and changing needs and wishes. Evidence: As identified at previous inspection visits, detailed information is held for each of the tenant living at the home. Individual files are held for each tenant which include past and present information. Records seen were orderly and included initial assessments, daily reports, support plans, risk assessment, monitoring sheets, medication records, formal reviews and correspondence. An up to date support plan and risk assessments are in place. These vary depending on the specific needs of each person. Plans and assessments are reviewed and updated to reflect the tenants current and changing needs. This ensures tenants are being supported in a way in which she wanted whilst ensuring that her needs were still Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: being met. It was clear that plans had been developed on the specific needs and wishes of tenants. Through discussions and from documents seen the process of support planning is encouraged as a positive experience for tenants enabling them to see where they have developed their skills as well as identifying areas where they could develop further so that they can be as independent as possible. As already stated tenants are actively involved in the development of their plans. Information is person centred and is provided in both a written and pictorial format, so that it can be more easily understood. This also promotes and enables people in being more independent allowing them to take more responsibility and control over their daily lives. The home continues to provide access to advocates, if necessary, who can act on behalf of tenants ensuring their independent views are made known and understood. Tenants are aware that information is stored about them. Arrangements are being for individual files to be provided to each tenant, which will include their agreed plans and assessments. It was clear through observations and discussions with the manager staff and tenants that people are consulted with and informed about all aspects of the home. Staff are clearly aware of the support needs of people and formal handovers are undertaken at each shift change so that staff are fully informed. 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. Tenants are encouraged and supported in developing life skills, which enables them to make choices and decisions about how they wish to live their lives. Evidence: The focus of the home is for tenants to live as independently as possible promoting and enabling them to live a lifestyle of their own choosing. Routines vary both in and away from the home depending on each tenant and what they have planned for the day. Tenants have an easy read timetable which shows what they have planned each day. This may include activities of daily living, such as domestic tasks, as well as taking part in everyday life experiences and activities such as college, leisure centre, theatre, shopping and local events. One person spoken with explained that they were hoping to organise some Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: employment at the local airport. Tenants have also enjoyed annual holidays both in the UK and abroad. Tenants were also making plans for their summer holidays. Arrangements in relation to meals are based on their own preferences. Tenants do their own shopping and prepare all their meals within their own flats. Light meals and snacks can be made within the communal kitchen area when tenants meet together. Whilst tenants manage their own personal monies support is offered from staff to budget for food and assist in the planning of meals. Tenants are actively encouraged to maintain contact with family and friends. Tenants spend time or have overnight visits to family as well as occasional holiday breaks. The manager gave an example where one tenant had been supported in traveling by coach to visit family. This had been risk assessed ensuring the tenant was able to manage independently. In doing so this has enabled the tenant to visit family more frequently. Tenants also have the right to form personal relationships should they wish. Opportunities are available for tenants to invite family and friends to stay overnight in their flats. Opportunities are available for tenants to meet together each month and discuss things about the home with each of them deciding what should be on the agenda. Advocacy services are used to facilitate this and minutes are taken. With the aid of the interpreter the inspector spoke with two tenants. Both expressed that they were happy living at Bowfell Road, they felt supported by the team, found staff approachable and were happy and settled. Other comments were received in the feedback surveys. Tenants said they were comfortable with their surroundings and felt they had everything they needed. Comments included; I am happy where I live and I have all my personal possessions, I am happy living at Bowfell Road, it has given me the confidence and I have good relationships with staff, I am happy with the way things are and I am happy here, I like my flat and I feel safe. 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. Tenants are consistently offered the health care support they prefer and need, and are helped to achieve good physical and emotional health. Medication practice is safe and well managed by the home. Evidence: The primary aim of the service is to promote and enable tenants to be as independently as possible and have control over their own lives. As previously identified each of the staff are skilled at British Sign language and consult with tenants in their first language regarding their health care support needs. Tenants choose when they require support from staff, this was observed during the visit. Staff monitor the health of tenants ensuring their well being is maintained and are proactive in assisting tenants to access support and advice from relevant health professionals when needed. This may include; including CPN, GP, Community Nurse, Chiropody, Dietician, Occupational Therapists, Cystic Fybrosis nurses, Art Psychotherapist etc to ensure their health is maintained. Staff provide support if Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: requested. Some tenants were observed carrying out their daily routine independently and attending to their own health care needs, whilst others preferred support from staff. At the time of this inspection none of the tenants required personal care support. Tenants continue to take responsibility for managing and administering their own medication, some under supervision others totally independently. Documents for the recording of medication have been adapted providing a more user friendly format which promotes tenants independence. Tenants sign to confirm that they have taken their medication, records are then witnessed by staff who have observed medication being taken. The home continues to monitor and record all medications entering and leaving the premises ensuring the system in place is afe. 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. Policies, procedures and staff training are in place ensuring tenants are listened to as well as being protected. Information is also provided to tenants in a way that they can understand. Evidence: As previously identified the home has clear policies and procedures covering complaints and protection including the Local Authority Safeguarding Procedure. Information provided on the homes AQAA showed that there have been no issues raised directly with the home. No issues have been raised directly with CQC. The team have received training in adult protection and are aware of the procedure to follow. Further training has been explored and is to be undertaken by all members of the team in relation to Mental Capacity and Deprivation of Liberty Safeguards. The team have developed a user-friendly complaints document, explaining the procedure and what to do if tenants have any concerns. This was displayed within home. Safe systems are also in place with regard to the management of tenants finances and staff recruitment ensuring people are protected. Care Homes for Adults (18-65 years) Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tenants live in a pleasant, comfortable safe environment that offers communal and personal space which has been adapted to meets their needs. Evidence: Bowfell Road is a purpose built home which supports the tenants who live there to live independent lifestyles. The home provides spacious accommodation, which includes six individual flats each comprising of an open plan living/dining/bedroom, kitchen and bathroom. There is also a communal lounge diner with kitchenette, a laundry and toilet, staff sleep in room and staff office. Externally there is a large well maintained garden and patio area and car parking for several cars. The service is considering developing part of the garden area into a vegetable plot so that they can grow their own produce. Two of the tenants agreed for the inspector to look round their flats. Both had chosen their own decoration and had personalised their flats with personal possessions and belongings. Tenants have their own door keys to both the main building and their flat enabling them to come and go freely. There are also individual letter boxes so tenants receive their own mail. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Tenants relax in all areas of the home, freely spending time relaxing in the communal lounge or in the privacy of their own flat. Aids and adaptations are fitted where necessary to assist tenants individual and collective needs. These include flashing door bells, fire alarms, and vibrating pillows. Tenants and staff take responsibility for maintaining the cleanliness of the communal areas, with tenants looking after their own flats as they choose, where necessary support and encouragement is provided by staff. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good recruitment processes, which ensure the safety and protection of people living at the home. Tenants benefit from a consistent staff team that is trained, developed and competent to do their work. Evidence: There has been little change to the staff team. Since the last inspection there has been only one new permanent member of staff recruited to the team. Tenants are involved in the recruitment process with opportunities for them to meet prospective new staff prior to them being appointed. They are then asked for their opinion about whether they feel the person would be suitable. Recruitment information was looked at for the newest member of staff. Information examined included a current photograph, application form including full employment history, CV, Criminal Record Check and 2 written references. The procedure followed evidenced that all checks had been completed prior to the person commencing their employment, so that only those staff suitable for employment are offered work ensuring people are kept safe. As previously identified all members of the staff team have British Sign language skills and communicate affectively with tenants. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The duty rota identified that good staffing levels are provided each day. This allow for flexibility in support based on the needs and wishes of tenants. On commencement of their employment new staff complete a thorough induction programme along with mandatory training courses. New staff must complete a probationary period to show that they have met the competencies needed for their role. Where necessary this can be extended with additional training and support offered to ensure that have the necessary skills. In relation to staff training, an on-going programme is offered covering all relevant mandatory health and safety courses, medication and adult protection. Additional training in areas specific to the needs is sourced from other health care specialist who support and advise the team. The manager monitors and reviews staff performance through supervisions and appraisal. This enables him to identify areas of continuous personal and professional development. With regards to NVQ, all but the newest member of the team have now achieved level 3 or above. Arrangements are to be made for this to be undertaken. As already stated the Manger has already completed the NVQ 4/Registered Managers Award. Arrangements are being made for Team Leader to complete the course. Comments were received from staff about working at Bowfell Road. They said, we are well organised and follow procedures, we work together as a team it allows staff to develop at their own pace, and encourages internal promotion and it allows a democratic system for staff and service users to have their say. 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 overall management of the home remains consistent and reliable for the people living there. Tenants are involved both formally and informally in the day-to-day running and their views are taken into account. Health, safety and welfare are promoted, and so far as reasonably practicable, tenants are protected from harm. Evidence: There have been no changes with regards to the management of the home since our last key inspection. The manager works closely with tenants and staff offering support and advice where needed. The manager has been registered with us since 2004 and has completed all relevant management training. Through discussion it was evidence that he has extensive knowledge, skills and experience Positive relationships have been established between the manager, staff and tenants. Interactions were relaxed and respectful of the individual needs of people. A quality assurance system is in place to review the service provision. This includes internal and external monitoring and reviewing by the service and commissioning teams. Periodically feedback questionnaires are also sent out to tenants, their Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: relatives, social workers, health professionals and commissioning teams. These are carried out so that all those involved are able to comment about the service provided including any areas of improvement, which could be made. Staff receive regular supervision which enables them to comment on the service. Individual group meetings are also held for staff and tenants and minutes are recorded. Regular checks are also carried out in relation to health and safety, finances and care planning ensuring that the interests and safety of tenants are maintained. Information gathered is used to inform the homes business plan. Information was examined with regards to health and safety. A designated staff member takes responsibility for overseeing all checks carried out and records are completed. Servicing certificates were also seen for the gas, 5-year electric, small appliance, fire alarm and equipment, emergency lighting and water. The manager was asked to check that an up to date check had been completed on the emergency lighting and that clarification was sought in relation to the 5 year electric check. During the visit the manager contacted the housing association and requested the relevant information be forwarded to them. Once received by the home these are to be confirmed with us. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!