Care Home: Simmins Crescent Care Home

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What the care home does well Managers and staff spend a lot of time finding out about people`s needs. This means that staff can meet people`s needs in the right way.People`s support plans tell staff exactly how they like their needs met.People receive very good support to stay healthy.Staff help people to visit their families.People can go on holiday and on day trips.Staff receive lots of training to make sure that they know how to meet people`s needs.Managers give lots of support to staff so staff can do their job well. What has improved since the last inspection? The last time we visited Simmins Crescent was on 24th July 2006. We did not ask them to make any improvements. What the care home could do better: We did not ask Simmins Crescent to make any improvements at this visit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Simmins Crescent Care Home 2-6 Simmins Crescent Eyres Monsell Leicester LE2 9AH The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ruth Wood Date: 2 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 36 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Simmins Crescent Care Home 2-6 Simmins Crescent Eyres Monsell Leicester LE2 9AH 01162781152 01162781152 peter.kazakevics@vistablind.org.uk www.vistablind.org.uk VISTA care home 15 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 15 15 15 15 learning disability sensory impairment Additional conditions: Minimum age for admission to the home is 16 years. Persons admitted to the home who fall within category LD must also fall within category SI - ie dual disability. Date of last inspection 2 4 0 7 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home Simmins Crescent is a care home for 15 people with learning disabilities who cannot see very well. Some people who live there also need help because they have difficulty walking or moving around. There are 3 bungalows and 5 people live in each bungalow. Care Homes for Adults (18-65 years) Page 5 of 36 Each bungalow has its own lounge, dining room, kitchen, laundry and bathroom. All the rooms are on the same level so it is easy to get around. The bathroom in one bungalow has a special bath for people who find it difficult to move without staff support. Each person has their own bedroom. Care Homes for Adults (18-65 years) Page 6 of 36 Each bedroom has a bathroom with a shower, toilet and washbasin. There is a separate bungalow where people can do things like draw and paint. There is a sensory room in this bungalow. In the sensory room people can listen to music and sounds, look at coloured lights and touch different things. This bungalow is also used for meetings by the people who live and work at Simmins Crescent. Care Homes for Adults (18-65 years) Page 7 of 36 Each bungalow has its own small garden. There is also a large garden for everyone who lives at Simmins Crescent to use. In 2009 it cost between £792 and £1,714 to live at Simmins Crescent. Care Homes for Adults (18-65 years) Page 8 of 36 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 Care Homes for Adults (18-65 years) Page 9 of 36 How we did our inspection: This is what the inspector did when they were at the care home Before we visited Simmins Crescent, we looked at the information the manager had sent us in the Annual Quality Assurance Assessment. This is a document that tells us about how Simmins Crescent is run and the kind of people who live and work at Simmins Crescent. We looked at information sent to us about what had been happening at Simmins Crescent since we last visited on 24th July 2006. Care Homes for Adults (18-65 years) Page 10 of 36 We sent surveys to 4 people living at Simmins Crescent. All 4 people replied to our survey. We asked if people are happy with the care and support in the home. We asked if people make choices about their lives. We sent surveys to 5 staff working in the home. 4 staff replied to our survey. We asked about the training they get. We asked about the support they get from managers. We visited Simmins Crescent on 27th July 2009. We arrived at 1:30 in the afternoon and left at 7:15 in the evening. Care Homes for Adults (18-65 years) Page 11 of 36 We looked at all the rooms in the 3 bungalows. We spoke to 3 people who live at Simmins Crescent. We watched how staff spoke to the people living at Simmins Crescent. We looked at 3 peoples support plans. Care Homes for Adults (18-65 years) Page 12 of 36 We spoke to staff about how they supported people. We spoke to staff about the training they had done. We looked at staff records. These told us about the checks done to make sure staff have the right skills and are safe to work in the home. We spoke to the family of one person who lives at Simmins Crescent. Care Homes for Adults (18-65 years) Page 13 of 36 What the care home does well Managers and staff spend a lot of time finding out about peoples needs. This means that staff can meet peoples needs in the right way. Peoples support plans tell staff exactly how they like their needs met. People receive very good support to stay healthy. Care Homes for Adults (18-65 years) Page 14 of 36 Staff help people to visit their families. People can go on holiday and on day trips. Staff receive lots of training to make sure that they know how to meet peoples needs. Managers give lots of support to staff so staff can do their job well. Care Homes for Adults (18-65 years) Page 15 of 36 What has got better from the last inspection What the care home could do better We did not ask Simmins Crescent to make any improvements at this visit. Care Homes for Adults (18-65 years) Page 16 of 36 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ruth Wood CQC East Midlands Citygate Gallowgate Newcastle upon Tyne NE1 4PA Telephone: 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 17 of 36 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 18 of 36 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 have access to good information about the service so they can make an informed decision about living at Simmins Crescent. Thorough assessment procedures ensure that staff know how to meet peoples needs. Evidence: The service users guide gives information about what it is like to live in the home and the services provided. The guide is available in a range of formats, including large print and audio. We were given a copy of the guide in a standard written format and one with pictures that has been written so that it can be easily understood by people with learning disabilities. All four people who responded to the Commissions survey said that they had received information about the home before they moved in and had been asked if they wanted to live there. One of the bungalows currently has a vacancy. The deputy manager outlined the assessment process being followed for the person who may be coming to live at Simmins Crescent. This has included a meeting with all the people currently involved in their care and support. Their representative has been given the service users guide, a copy of the most recent inspection report and has visited the service to look around. Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: The deputy manager has spent several days directly observing the person in their existing setting and speaking to people currently involved in supporting them. The manager showed us the detailed notes that she had made. These cover all aspects of need and will be used to produce a formal assessment. From this a support plan will be written and will be in place, before the person moves in to Simmins Crescent. As part of the assessment process, staff from Simmins Crescent (who will work as the persons key worker) will also visit the person in their existing setting to work with them and develop an understanding of their support needs. Assessments from commissioning social workers and other professionals are also obtained as part of the process. The person will be given the opportunity to make short day and possibly overnight visits to Simmins Crescent before moving in. Care Homes for Adults (18-65 years) Page 20 of 36 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 well supported to make choices and take reasonable risks to enhance the quality of their lives. Support plans give accurate information about how peoples needs should be met and how they like to be supported. Evidence: We looked in detail at how three people are supported at Simmins Crescent, one from each individual bungalow. We looked at each persons support plan and spoke to staff involved in their care. We spoke to two of the people about the kind of things they did inside and outside of the home and spoke to one persons parents, friend and care manager. All three people have a comprehensive support plan, which tells staff how to meet their needs. Two of the plans are also written in a person centred format with pictures and symbols to help the person understand their plan. Staff working with the third person intend to develop a person centred plan with them and staff working in the home have received training in this area. One persons parents said that they were pleased with the care and support their Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: relative receives and the relationship that they had with staff; The care is perfect and the rapport with the staff is brilliant. They also commented on the level of detail in support plans, which ensures that their relatives needs are met in the way they like. Plans cover all aspects of need and also contain detailed risk assessments; these enable people to take part in activities while remaining safe. An example of how risk is managed in the home is the planning and assessment which takes place before people go on holiday. Each aspect of the trip is considered and assessed to ensure that risk has been minimised and the person can safely enjoy their trip. A full planning meeting takes place and a member of the management team always accompanies the person on their holiday, with a number of additional staff members based on the persons needs and the length of stay. This level of planning has enabled one person to have the first holiday of their adult life this year. Plans include information on how people communicate and staff are well informed about each persons communication needs. We observed staff communicating successfully with people throughout the inspection visit. Each person has a keyworker and keyworker meetings take place approximately every six to eight weeks to review the persons plan. Meetings can also involve the persons families. The plans we saw show evidence of regular review and updating. In our survey of people living at Simmins Crescent, the four people who responded said that they could do what they wanted during the day, evening and at weekends and could make decisions about their lives. One person said that they choose their clothes and what time they get up and go to bed. We observed people being offered choices about what they ate and drank during the inspection visit. Care Homes for Adults (18-65 years) Page 22 of 36 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. Peoples cultural and leisure interests are well met. People enjoy good, nutritious food in pleasant surroundings. Evidence: Each person has an individual activity plan but there are usually sufficient staff on duty to enable deviation from this plan, should they wish to do something different. One person attends an external day resource three days per week and another person attends an art course at the David Attenborough Centre; examples of their work are displayed on their bedroom wall. Most peoples day time activities are facilitated by staff from Simmins Crescent and include art and craft work in the central bungalow, which is used as a resource centre. People also go out shopping, to the park and bowling. One persons family commented that they would like to see a little more structured day time activity for their relative. All people living at Simmins Crescent have the opportunity to go on holiday and various day trips and outings are also arranged. One person tolds us how much they Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: enjoyed their holidays on a narrow boat. Another person told us about the trip to the zoo they had been on the day before. They also asked their keyworker to arrange a hairdressing appointment for them next week. The keyworker explained that this would be a full days outing involving lunch and shopping as well. Peoples varied spiritual needs are met with one person attending church and two people attending their local Hindu temple regularly. As well as meeting peoples spiritual needs this helps people to make and maintain links with their local community; a staff member commented that if X didnt go to church then someone always contacted them to find out why. One person living at the home has also joined a local working mens club. Most people do not get actively involved in cooking or preparing meals but some people will occasionally help. In all three bungalows we noted a wide variety of food in stock, including fresh fruit and vegetables. People are asked what they would like for each meal and there is a great deal of flexibility about what and when people eat, although people are encouraged to eat a healthy and balanced diet. One staff member explained that meal times had to be flexible as people were doing different things and also some peoples health conditions meant that they did not feel well enough to eat at set times. What each person has eaten at each meal is recorded and monitored by their keyworkers. On the day of the inspection visit one bungalows evening meal was fresh gammon steak with potatoes and fresh vegetables. This looked and smelt very appetising and people living in the home said that they had enjoyed it. People are supported to maintain contact with their families. People can visit at any time. One persons family said that they frequently just drop in but there are also formal events such as Christmas and Birthday parties, which they attend and we were shown photographs of some of these. One person told us that staff had supported them to visit their mother the previous week and people are also supported to stay in contact by telephone. Care Homes for Adults (18-65 years) Page 24 of 36 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. Peoples individual personal and health care needs are very well met. Evidence: Each person living at Simmins Crescent has their own lockable storage cabinet for their personal medication. There is a special controlled drugs cabinet in one bungalow and the registered manager said that any persons controlled medication would be stored here. If the medication was needed for an extended period then a similar cabinet would be installed in the bungalow where the person lived. We looked at the medication records for the three people whose care we looked at in detail. These were completed accurately and procedures for booking in medication and returning unwanted medication are also in place. All staff who administer medication have received appropriate training and staff members spoken with said that this was regularly updated. Peoples medication is reviewed every three to six months by their GP or by their Consultant. Clear guidance is in place for each person about when to administer as required medication and homely remedies such as pain relief and medicine to relieve cold symptoms. Each person has a Health Action Plan which details in an easy read format how their health needs should be met. All staff have received training in how to complete these. Information about how to meet peoples health care needs is very detailed and the Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: three people whose care that we looked at in detail, all have significant health and/or personal care needs. Plans were in place to inform staff how to meet peoples continence needs, pressure area care needs, manage their diabetes and their epilepsy. In all cases managers and staff work very closely with outside professionals (and in some cases families) to ensure that people are correctly supported. Staff spoken with demonstrated a good understanding of peoples individual healthcare needs and their recording in individuals notes also reflected this. To ensure that peoples healthcare needs are fully met the service has regular contact with Consultants from various disciplines, specialist nurses, physio and speech therapists, podiatrists, opticians and dentists. The way that people like their personal care needs to be met is also outlined very clearly in their support plans. The parents of one person commented that their appearance was exceptional. Individual preferences in toiletries, clothes and routine are recorded. People can choose to have a bath or a shower. Care Homes for Adults (18-65 years) Page 26 of 36 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. Peoples concerns are listened to and they are protected by good practice. Evidence: All four people who responded to our survey said that they knew who to speak to if they werent happy and three of the four people said that they knew how to make a complaint. We were given a copy of the complaints procedure, which is currently in a standard written format only. This format of the complaints procedure is also available in large print, Braille or on audio cassette or CD. The registered manager said that they hoped to produce a version of the procedure with symbols, making it easier to understand for people with learning disabilities. All staff have completed training in safeguarding vulnerable adults and receive an annual refresher of this training. Senior staff have been trained by the local Safeguarding Partnership to deliver this training. Staff spoken with demonstrated a good understanding in this area and the four staff who responded to our survey said that they knew what to do if someone had concerns about anyone living at Simmins Crescent. We looked at the systems in place to make sure that peoples money is safe. Full records are kept of each transaction together with receipts, which are numbered so that they can be easily linked to records. Two staff sign after each transaction and balances are regularly checked by each bungalows manager. Representatives from the parent organisations accounting team audit the records. Care Homes for Adults (18-65 years) Page 27 of 36 Care Homes for Adults (18-65 years) Page 28 of 36 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and comfortable environment which meets their needs. Evidence: Each bedroom has a toilet, shower and wash basin en suite but there is a central bathroom in each bungalow for those people who prefer to have a bath. One bungalow has a specially adapted bath, suitable for people with physical disabilities. One persons room is also adapted to meet their physical needs. Each persons bedroom is individually decorated and reflects their personality and interests. People are involved in choosing their bedrooms colour scheme and decoration. Each person has a key to their own room and a key to their front door. The hours of the maintenance person have recently been increased and families and staff commented that repairs are being completed much more rapidly. One of the bungalows gardens is being re-landscaped and will include raised beds. All four people who responded to our survey said that the home is always or usually fresh and clean. All areas of all three bungalows were fresh and clean on the day of the inspection visit. All staff have received training in infection control. Care Homes for Adults (18-65 years) Page 29 of 36 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 are supported by a very well trained and competent staff team. Evidence: We looked at the recruitment and training records for two staff employed during the last 12 months. Two written references had been obtained for each person and a Criminal Records Bureau check, before they started work in the home. Each persons details had also been checked against the vulnerable adults register. These recruitment checks ensure that only suitable people work at Simmins Crescent. All four staff who responded to our survey said that recruitment checks had been carried out before they started work in the home. The two staff whose files we looked at undertook a Learning Disability Qualification Induction programme, a qualification which prepares them for working with people with learning disabilities. The four staff who responded to our survey said that their induction had covered everything they needed to know. All new staff complete this programme and all staff members are given the opportunity to gain National Vocational Qualifications at levels 2 and 3 with assistant and deputy managers being able to take level 4 qualifications. All staff have training and development portfolios and meet regularly with their line manager to discuss their work and their training needs. All staff spoken with and the family of one of the people living in the home, spoke positively about the amount and quality of training that staff receive, The training of the staff is excellent; The home Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: provide a lot of training for staff for their work role; The training is very good, we get whatever we need. Speaking to staff members and examining training records we noted that a very wide range of training is provided to staff, which is reguarly updated to ensure that they remain competent to meet peoples individual needs. Training has included, understanding epilepsy, managing challenging behaviour, understanding visual impairment and palliative care as well as statutory training such as first aid and moving and handling. Staff also commented favourably about the ongoing support they receive from their managers. In the Annual Quality Assurance Assessment the registered manger said that No staff member is left to support a person unless they feel confident and have been assessed as competent. This was confirmed during discussion with one staff member who said, Everyone has the support that they need. Comments received on staff surveys included, I have good support in all I do at Simmins Crescent, the managers have time to help us if we have any problems. Care Homes for Adults (18-65 years) Page 31 of 36 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 effectively managed in the best interests of the people living there. Evidence: Each bungalow has its own management team of deputy manager and two assistant managers, with the registered manager having line management responsibility for the whole service. Two of the deputy managers are soon to complete their National Vocational Qualifications at level 4 and one deputy manager already holds this qualification, together with the Registered Managers Award. Assistant mangers are also given opportunities to further their qualifications in care and management. Staff are very positive about the support they receive from the management team and say that it enables them to do a good job, The home encourages working as a team and makes it a point that the people we support come first. All staff who responded to our survey said that the systems in place for communicating information about people, work well and this was confirmed during discussion with staff members on the day of the inspection; Information is written in the communication book, in peoples daily notes and given in a verbal handover. Staff receive formal supervision with their line managers and annual appraisals. The social services care manager present during the inspection visit said that peoples Care Homes for Adults (18-65 years) Page 32 of 36 Evidence: review meetings were always well attended with the key worker and unit manager being present and that necessary paperwork was always available. Regular keyworker and staff meetings help to ensure that people who live and work in the home have input into how it is run. Peoples families are also formally surveyed by the service on an annual basis to seek their opinions as to how the home is run. Each individual bungalow is visited on a regular basis by a representative from the parent organisation. We saw written records of these visits for one bungalow and they suggest that the visits take into account the views and opinions of people living and working in the service. Risk assessments for safe working practices are in place, completed and audited by the Deputy managers. Each bungalow has its own locked storage for substances designated as potentially hazardous to health , such as cleaning products. Each bungalow has its own fire risk assessment. Fire systems, including emergency lighting and fire doors are checked or tested on a weekly basis. Discussion with staff and examination of staff files confirm that all staff receive statutory training in such areas as first aid, moving and handling, fire safety and food hygiene and that this training is regularly updated. Care Homes for Adults (18-65 years) Page 33 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 34 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 35 of 36 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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