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What the care home does well People are referred and assessed before they use this service so they know the staff can support their needs. The people in charge listen to the people that use this service and have changed things in the ways that they want. People are supported to attend appointments to see the doctors, nurses and social workers, if this is required during the time they use this service. Staff at the service work hard to make sure people receive support the way they want. Their preferences are recorded in a care plan so staff know what support people need. The staff receive training to ensure they have the skills to support people in a respectful and dignified way. The staff are employed to work here after many checks are completed to ensure they are suitable.The managers at the service do a good job and people can go and see them at any time. The building is new and has been fitted with lots of specialist aids and equipment to help people do things for themselves. What has improved since the last inspection? This is a new service and their first inspection What the care home could do better: We did not find any shortfalls during our visit. We found that people received the service they wanted and which met their needs. Key inspection report Care homes for adults (18-65 years) Name: Address: South Derbyshire and Dales Short Break and Assessment Service The Bungalow Off Meadow Lane Newhall Swadlincote Derbyshire DE11 0QU 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: Claire Williams Date: 1 5 0 9 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 30 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 30 Information about the care home Name of care home: Address: South Derbyshire and Dales Short Break and Assessment Service The Bungalow Off Meadow Lane Newhall Swadlincote Derbyshire DE11 0QU Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Diane Hickman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 10 0 care home 10 Derbyshire County Council learning disability Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following categories of service Care Home only: code PC To service users of the following gender: Both Whose primary care needs on admission to the home are within the following categories Learning Disability: Code LD Date of last inspection A bit about the care home This service is owned by Derbyshire County Council, who have their main Care Homes for Adults (18-65 years) Page 4 of 30 office at County Hall in Matlock. This is a new service, and the building is purpose built to meet the specific requirements of the people it has registered for. The service was registered in March 2009, to provide personal care and accommodation for up to 10 people, of either gender who have a learning disability. The service is separated into two units. One of these is called the life skills unit. The purpose of this service is to provide 5 places for people who want to learn and gain independent living skills. The second unit provides 5 places for people who live in the community to have a short break. The service is close to, local amenities and is near to a bus routes. The service currently has an accessible mini-bus which is used for recreational activities and transport. Information about the service is provided through the Statement of Purpose and Service User Guide. These documents are available in a written and pictorial format to enable people to access them. People will have access to the inspection report which will be displayed in the foyer area. The current fees for the service are dependent on the outcome of a financial assessment. The minimum fee is £56.55 per week and the maximum fee is £344.82 per week. Care Homes for Adults (18-65 years) Page 5 of 30 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 Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home We came to the home without telling the manager before we came and spent a day there. We had received a lot of information about the home from the manager, the staff and people living at the home before we came. The information we received before we came helped us plan what we would do when we arrived. At the service we spoke to the Manager, staff and spoke to people that were using the service at that time. We also observed the way staff supported people in the service. We looked at a lot of records and documents that told us about the service, and the way it is managed. We spoke to five staff who were working during the time we were at the home. We spoke to 2 people about their experiences of using this service and we looked at the rooms they were using. We walked around the service and saw how people were being supported by staff and we joined people for their evening meal. Care Homes for Adults (18-65 years) Page 7 of 30 This is the first inspection of this home since it was registered on 12th March 2009. What the care home does well People are referred and assessed before they use this service so they know the staff can support their needs. The people in charge listen to the people that use this service and have changed things in the ways that they want. People are supported to attend appointments to see the doctors, nurses and social workers, if this is required during the time they use this service. Staff at the service work hard to make sure people receive support the way they want. Their preferences are recorded in a care plan so staff know what support people need. The staff receive training to ensure they have the skills to support people in a respectful and dignified way. The staff are employed to work here after many checks are completed to ensure they are suitable. Care Homes for Adults (18-65 years) Page 8 of 30 The managers at the service do a good job and people can go and see them at any time. The building is new and has been fitted with lots of specialist aids and equipment to help people do things for themselves. What has got better from the last inspection What the care home could do better We did not find any shortfalls during our visit. We found that people received the service they wanted and which met their needs. Care Homes for Adults (18-65 years) Page 9 of 30 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 Claire Williams Care Quality Commission (East Midlands) Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 0300 061 61 61 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 10 of 30 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 11 of 30 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. 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. Evidence: Information is provided to people about the service and the area in which it is located. These documents are available in written and pictorial format to enable people who use this service to access them. The feedback we received from peoples relatives also confirmed they had enough information to enable them to assist people to make a decision, about using this service. As this is a specialist service, people make a referral and then an independent panel decides if this service is right for them. This is based on an initial assessment of their support needs. This means that all people are referred to the service by their Care manager and after it has been agreed by the panel. We looked at the files for two people, and the records demonstrated that a detailed assessment of their support needs had been undertaken before they started to us the Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: service. One of these individuals was supported to visit the service as part of the transitional process. During our visit we observed that another person was visiting the service for a tea-visit as part of their transition. We spoke to them about their experience and they said, I like it here, it is very nice, the staff are nice and have showed me around. The manager told us in the self assessment that the service is value for money as they are now receiving more referrals and the number of people that now use this provision on a regular basis has increased. The records we looked at confirmed this. They also told us that they undertake pre visit calls to people and their family, and follow up calls to people following their stay. This is part of the quality assurance systems in place. The records seen confirmed this practice. This ensures the staff are aware of any changes in peoples needs since their last visit, and enables the staff to gain valuable feedback from them about the stay and any suggested improvements. Care Homes for Adults (18-65 years) Page 13 of 30 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. Peoples care needs have been assessed, risk factors identified and care planned in ways that reflect their individual preferences and abilities. Evidence: We looked at 3 peoples care more closely and looked at their files. As stated in the self assessment we received, we found that each person had written information in place to help staff know how to support peoples care needs and to minimise risks. This information was detailed and up to date and was written respectfully and positively and considered peoples individual preferences and needs. The nominated key-workers are in the process of developing pictorial care plans from the written format. This will enable people to access their plan, and to understand the areas of support that are being addressed. In the files we found that well being records were in place and completed regularly to ensure good communication is maintained between the staff regarding each person. We did find that not all of the files we looked at contained all of the required personal information or a photo of the person. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Staff that we spoke to demonstrated their knowledge of peoples needs, and they had a good understanding of peoples preferences and their communication style. Information was recorded in peoples care plans about their preferred communication methods and any aids they may used to assist them such as symbols and photographs. This ensures the staff have the information to enable people to lead a full life that promotes independence and choice. The manager told us in the self assessment that the staff team aim to promote peoples choice, control and independence. Our observations of the way the staff members interacted with people supported this. We observed the staff members offering choices throughout our visit, and they encouraged people to be independent when undertaking daily living tasks. We spoke to one person who told us, the staff are good they help me to do things for myself, they give me choices and help me to make my own decisions. This person also told us they had been consulted and helped to develop their support plan. Feedback provided in the surveys also told us that people and their representatives felt their needs were met to a good standard. Care Homes for Adults (18-65 years) Page 15 of 30 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 living at the service enjoy opportunities to develop life skills and wider social contacts; links with families and friends are promoted and supported Evidence: On our arrival people were present in the service, and they were supported to go out to the local park and had chips out for their lunch. On their return peoples facial gestures indicated they had enjoyed their outing. The manager told us in the self assessment that after receiving feedback from people they have now implemented themed nights for each unit. They are also aiming to provide activities from a person centred approach for people with complex needs. Discussions with staff members and the records seen confirmed this. We was told the themed outing for this month was a day out at Drayton Manor Park, which people was said to have enjoyed. The records seen indicated that individuals recreational, social, educational and leisure interests and hobbies were generally well met. The records identified individual choices and preferences in relation to the activities they liked to participant in. Risk assessments Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: were in place in relation to these as appropriate to the needs of the individual. This enables the staff to support and promote individuals independence within their chosen activity or interest as much as possible. Discussions with the staff team confirmed that the staffing levels were adapted when possible to ensure sufficient staff were on duty to support people in community based activities and events. However at times and due to the current sickness levels this is not always possible. The staff team told us they focus on encouraging in house activities, when it is not possible to access the community. During our visit we observed people being supported to play on the Wii console and to use the garden area, which they seemed to enjoy. The records seen included information about peoples preferred routines. This enables the staff to work in a consistent way when supporting peoples needs. Observations during our visit supported that the routines were flexible and lead by people currently using this service. People we were able to speak to told us we can do what we want, when we want. People told us the staff supported them in a dignified and respectful way, and observations supported this. We joined people for their evening meal. In order to enable individuals to choose their option, a pictorial menu was displayed in the dinning area. Staff members were observed asking each individual, their choice of food using this pictorial aid. The meal time was relaxed, and those individuals that required assistance received this in a dignified and respectful manner. Feedback provided in the surveys demonstrated people satisfaction in respect of the activities, experiences and the food provided. We received surveys from relatives who told us they were satisfied with the service provided. They told us the service tries to ensure people have fun and positive experiences. Care Homes for Adults (18-65 years) Page 17 of 30 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. People receive personal support from staff in the way they prefer and want. They receive their medication as prescribed, which promotes peoples health and welfare. Evidence: The records we looked at and the feedback from the surveys demonstrated that, people receive support with their personal care in the way they liked. In the information provided about the service the manager told us they provide support from a person centred approach, and our observations supported this. The service works in partnership with a range of health care professionals in order to support peoples health care needs. People are supported to access health care services, such as G.P appointments and hospital visits, when this is required during their short term break in this service. The people that are currently living in this service until a permanent placement can be found, are supported to access all health care services. Each person has a health action file in place that is used to support them in understanding their health care needs and allows them to take ownership of their own health care. This file is used to record appointments in, and is taken to health care appointments to enable individuals with staff support, to record any advice or treatment given. The records in place included pictorial Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: formats to assist individuals understanding. These files are a useful tool for staff and health care professionals, as personal information that may be required at health care appointments is recorded. This can include other health care professional contacts, the communication methods used by the individual, medications prescribed, dietary requirements and the persons health care history. This ensures all of the required information is accessible to meet peoples health care needs. In order to promote peoples independence, their prescribed medication is stored in a lockable facility in their bedroom. At the time of our visit one person was managing their medication themselves. The records seen demonstrated that a risk assessment had been completed to ensure the person received the required support to undertake these tasks safely. We found that the receipt, administration and disposal of medicines for the people who are using the service are generally being recorded accurately and showed that people are taking their medicines as their doctor has prescribed. We did find one gap where the medication record had not been signed, but the medication had been dispensed. The manager told is in the information provided by the service that all staff have received accredited medication training. The records seen, and discussions with staff members confirmed this. The records also demonstrated that staff have an observation of their practice to ensure they are competent at administering peoples medication. We have received two notifications from the service informing us about medication errors, whereby people have not received their medication as prescribed. The service was able to demonstrate that appropriate action was taken to safeguard the people involved, and the staff members are currently being supervised until they have received refresher training. Care Homes for Adults (18-65 years) Page 19 of 30 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 protected by having their rights to complain upheld and through staff understanding their responsibilities to report concerns. Evidence: The manager told us in the information provided by the service, that all staff are trained to respond to issues and all training is up to date. They said people are safeguarded, as all staff have had police checks to ensure they are suitable to work with vulnerable people. Discussions with staff members and the training records seen confirmed this. The staff members spoken to demonstrated their knowledge and their responsibilities in relation to responding to any complaints or safeguarding issues. The manager also told us in the information provided about the service, that people are involved in the continual development and improvement of the service. Records seen and feedback in the surveys confirmed this and people told us they felt listened to. We spoke to people who told us they would speak to the staff or to someone they can trust, if they were not happy with something, or if they didnt feel safe. As stated in the information we received from the service; an accessible complaint and safeguarding procedure is in place. This enables people to be aware of the processes in place and to understand what constitutes as abuse. These accessible documents can assist people to talk about their concerns, and to be aware of their rights. Copies of these documents are displayed within the foyer area of this service. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The service told us they have not received any complaints or had any safeguarding incidents since they became operational, and we have not referred any issues to the service. We spoke to a person who told us; I am happy and feel safe here and if I wasnt I would tell the staff. All of the people currently using this service have requested for their finances to be managed by the staff team. We looked at the systems in place and found these to be satisfactory. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the service enables people to live in a safe, wellmaintained and comfortable environment which encourages independence. Evidence: This is a new service and therefore the building is fit for its stated purpose, and meets all of the legal requirements. The manager told us in their self assessment that the building has been built for the future, with many adaptations and specialist equipment. We had a brief tour of the building and can confirm that the physical environment provides for the individual requirements of the people who use the service. All rooms are single, with en-suite facilities or with 2 people sharing an assisted bathroom. There is specialist equipment in place such as ceiling tracking system, which is available in all bathrooms and bedrooms to support peoples mobility. The bathrooms are also fitted with height adjustable sinks to enable any person to access them. All rooms are fitted with aids and equipment to assist and maximise peoples independence. The service is separated internally into two units. There is short term care unit providing respite care for people who live in the community; and a life skills rehabilitation unit. The aim of this unit is to enable people to learn independent living skills. However at the moment this unit is accommodating people who still require a permanent residential placement. Therefore it is not currently operating in accordance with its stated purpose Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: and objectives. The kitchen is this unit has height adjustable surfaces, ensuring that people who are able bodied and people who use a wheelchair can access and use all areas. The communal areas are separate in each unit, but people share the same large garden. The garden has a small wood at the end which people can walk through. It has many seating areas and a fountain for relaxation. It also has a large chess board and chess pieces for people to use as a recreational activity. People who spoke to us told us It is a nice building and brand new, I like it and the garden is lovely It is a big, homely and brand new. It has lots of aids for me, I like it and am very pleased thank you. The rooms used for short term care have been designed and furnished to reflect a homely style. They have lockable storage and people are encouraged to have a key if they so choose. The bedrooms in the Life skills unit - have been personalised in accordance with peoples preferences during this interim period. Observations supported that people were able to move around freely and enjoy the various communal areas. The staff members spoke positively about the new building both during our visit and in the surveys. Some of the comments we received include: It is great working in a brand new building with all of the required adaptations and specialist equipment. I feel valued and so do the people that use this service. It is lovely and the garden is great. Im proud to work here. The new building is fabulous. I really like it and enjoy coming to work as we now have all of the right equipment to help us to do our jobs Care Homes for Adults (18-65 years) Page 23 of 30 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 service has established systems for recruiting, training and supporting its staff, so that the interests of people in their care are protected and their overall welfare is promoted. Evidence: In the information provided about the service the manager told us they have a well trained staff team, and all mandatory training is up to date. They said each staff member has a personal development plan and supervisions are up to date. The records we looked at confirmed this and staff told us they have many training opportunities. Information provided in the self assessment told us that all of the staff team have completed National Vocational training to a Level 2, and many are now working towards Level 3. This demonstrates the motivation to training by the staff and the provider, and ensures a skilled and competent staff team support people in this service. We were told that the staffing levels are based on the dependency needs of the people accommodated in the service. The staffing levels at the time of our visit was; one staff member working and supporting 3 people in the short term care unit. (One of these individuals was visiting for tea, as part of their transition) to this service. There was 2 permanent staff and one agency staff member supporting people in the life skills unit. Staff members spoken to told us that the sickness levels are having an impact on the staffing levels and existing staff have tried to cover the vacant shifts. However three full Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: time staff members are off on sick leave, so it has recently been agreed for agency staff to assist. These issues were raised in the self assessment, and the manager has identified this as an area they would like to improve upon. Discussions with staff members and the feedback provided in the surveys told us that generally the staffing levels were ok. However we did receive comments concerning how the service can improve and this generally focused around providing more external activities. The current issues with the staffing levels was the main barrier preventing this. Observations during our visit supported that the staffing levels were sufficient to meet peoples support needs. People we talked to spoke positively about the staff team and the following comments were made: The staff are good and nice and help me to do tasks. The staff are nice and friendly. The staff told us both in our discussions and in the feedback they they was well supported and enjoyed their role. Observations supported that the staff members had a good knowledge of peoples support needs and provided assistance in accordance with peoples preferences. We looked at the files for the most recently recruited staff members. The records demonstrated that all of the required checks, and information had been obtained to ensure people are safeguarded, and the staff members are suitable to work with vulnerable people. Care Homes for Adults (18-65 years) Page 25 of 30 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 a well-managed and safe place in which to live and work. People living there are consulted and able to enjoy lifestyles that complement their individuality. Evidence: The service is managed by an experienced registered manager who is qualified for her role. She is supported by an experienced management team who assist with the daily running of the service. A delegate of the provider visits the service on a monthly basis to monitor the standards in place. We looked at the reports from this visits and they demonstrated that the service was meeting peoples needs to a good standard. The manager told us in the self assessment that she promotes equal opportunities and person centred care in order to work towards ensuring effective outcomes for people who use the service. Observations of staff practices demonstrated that the focus is aimed at promoting independence and indivdualised care and support. The staff spoken with confirmed that the manager provided them with the leadership and direction, support and guidance they required. This enables them to work effectively in supporting the needs of the people using the service. The feedback from the staff surveys told us that staff felt supported by the management team and the following comments Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: were made: The communication is good between the staff and management and we all pull together as a team and provide excellent care. The management team are very approachable and we receive regular training and supervision. I enjoy working here I like working here and feel supported in my job. I am excited and looking forward to working in the life skills unit when it is fully operational for its stated purpose The service has implemented a range of quality assurance activities in order to obtain feedback from people, and to include them in the way the service is run. These include regular meetings with people and their advocates, Carers meetings, annual quality assurance questionnaires and staff meetings. The first meeting with Carers and people who use the service have been planned for next month. Feedback has already been obtained from people who have used the short term break service. The manager told us in the information provided about the service, that based on this feedback more focused activities are now in place to meet peoples social needs. As this service is a new build all of the equipment is under warranty and therefore in good working order. Information within the self -assessment stated that all of the required health and safety risk assessments were in place. The self assessment told us how the service has been operating since it became operational. However the information provided in the assessment was at times brief in detail and not all of the sections had been completed. There was limited information in each outcome area to support how the service wants to improve in the next 12 months. One of the areas the service did tell us about was how they intend to work towards achieving an ISO quality standard award. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 1 6 Peoples care files should include all personal information and a photo to ensure staff have access to all of their specific details. In order to assist people to locate their bedroom a photo or a symbol of their choice should be placed on their bedroom door. 2 16 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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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