Care Home: Squirrels

What the care home does well From observing the interaction between staff and users of the service it appeared that residents were happy living at the home and we observed that staff and residents got on well together. The home had comprehensive risk assessments in place to protect service users. Risk assessments contained details of any identified risk and also had control measures to minimise any risk. Risk assessments were regularly reviewed and amended as required. Each service user has an individual timetable set up to meet their identified needs. The timetables enable service users to understand what is going on each day and they also provide a balance between activities and education. Service users at the home are supported to maintain family links and friendships both inside and outside the home. Residents are provided with a balanced diet in pleasant surroundings at a time convenient to them and the home offers a choice at meal times and there is a varied diet. Meal times at the home are flexible and the home has 3 sittings for meal times so that service users can enjoy their meals in a pleasant environment. The home is a large and spacious and offers an excellent standard of accommodation. The property has been suitably adapted to meet the needs of the service users who live there. The home has comprehensive quality assurance systems in place, which takes into account the views of the people who live at the home and also the views of other relevant people. Questionnaires and newsletters are sent to residents, relatives and other interested parties to keep them up to date with what is happening at the home. What has improved since the last inspection? This was the first visit to the agency since it was registered with the Care Quality Commission. What the care home could do better: No requirements or recommendations were made as a result of this inspection. However areas identified for improvement are contained in the main body of the report. General observations were; The home uses some homely remedies, however their use needs to be approved by the services users GP. This will help ensure that there are no adverse reactions to any medication administered at the home. We also noted that the home needs to ensure that if any controlled drugs are kept at the home they are kept in a suitable cupboard which meets the required standards. This will ensure that the home complies with the law. The homes completed AQAA also highlighted and identified the homes own areas for improvement. Key inspection report Care homes for adults (18-65 years) Name: Address: Squirrels Squirrels Manor Road Chilworth Southampton Hampshire SO16 7JE     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: Mick Gough     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Squirrels Squirrels Manor Road Chilworth Southampton Hampshire SO16 7JE 02380768329 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cambian Education Services Ltd Name of registered manager (if applicable) Miss Hayley Cole Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Squirrels is a large detached property which is spacious and offers a good standard of accommodation. The home is situated in Chilworth and is close to good transport links to Southampton, there is a local shop a short distance from the home. The home provides a purpose built environment that has taken into account the needs not only of the young people who live there but also the neighbours and the wider community. The home is over two floors; the ground floor comprises of 3 bedrooms all of which are Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 9 Brief description of the care home ensuite, there is a separate bathroom with WC, staff toilet, office, staff meeting room, large kitchen, dining room, laundry, activity room, class room and a sensory room. On the first floor there are 6 en suite bedrooms, a bathroom and staff office. Communal areas are spacious and well decorated. Access to the property is via an electric security gate and there is parking at the front of the property. The home has a very large rear garden which is landscaped and secure and provides a safe environment for service users. 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 peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of the visit was to assess the quality of service provided by Squirrels. This was the first visit to the home since it was registered with the Care Quality Commission in August 2009. The inspection took into account the homes Annual Quality Assurance Assessment (AQAA), which was sent to us when we asked for it. The AQAA is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. As part of the inspection process an unannounced visit to the home was carried out on the 1 December 2009. For this visit we involved 4 members of staff. Also the manager of the service, her line manager and the administrative officer assisted us throughout the visit. Other evidence for this report was obtained from reading and inspecting records; including pre admission assessments, plans of care, risk assessments, recruitment and Care Homes for Adults (18-65 years) Page 6 of 30 training records, staff Rotas, incident forms and some of the homes policies and procedures. We were also able to observe staff supporting service users in the home and to see the interaction between staff and users of the service. The home is registered to provide support for 9 residents and at the time of the inspection there were 8 people living at the home Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made as a result of this inspection. However areas identified for improvement are contained in the main body of the report. General observations were; The home uses some homely remedies, however their use needs to be approved by the services users GP. This will help ensure that there are no adverse reactions to any medication administered at the home. We also noted that the home needs to ensure that if any controlled drugs are kept at the home they are kept in a suitable cupboard which meets the required standards. This will ensure that the home complies with the law. The homes completed AQAA also highlighted and identified the homes own areas for improvement. Care Homes for Adults (18-65 years) Page 8 of 30 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 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 10 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. Prospective new service users have a full assessment of their needs before they move into the home. Evidence: During the recent registration process the home was asked to update its statement of purpose to include information on the age range of service users who are supported by the home. During our visit we looked at the statement of purpose and found that this had been recently updated and it included good information to prospective service users on the services provided at squirrels and provided prospective new service users with the information they need to make an informed decision about whether or not they would like to move into the home. The home was registered with the CQC in August 2009 and all of the current service users are settling in well. The home uses its own detailed assessment form to establish if they can meet individual needs. The form contains information on the following; diagnosis, physical and medical information including problems and issues, medication, communication, personal and social development, continence, dressing, Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: washing and bathing, personal care needs, grooming, likes, dislikes, awareness of dangers, relationships, educational needs and behaviour. The assessment is carried out by the home manager or their line manager and the assessment process is thorough. Potential new service users are invited to visit the home if appropriate and family, care managers and other relevant people are involved in the assessment process. The homes completed AQAA told us; prior to admission into the home all young people are fully assessed and we were able to confirm this on the day of the visit. Care Homes for Adults (18-65 years) Page 12 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. The assessed needs and personal goals of residents are reflected in an individual plan of care and this enables them to lead fulfilling lives. People who use the service are well supported and are encouraged to make decision about their lives with assistance given by staff. Residents are supported to take responsible risks and this allows them to live an independent lifestyle as much as possible. Evidence: Care and support plans were seen for 2 residents and these were comprehensive documents and were clear and easy to follow. Care plans were person centred and they gave clear information on individual, problems and needs and included information on daily routines, night routines, general health, eating and drinking, likes and dislikes, hair care, personal care, mobility and communication, including signing and visual communication. There was also a detailed plan about individual behaviour. This gave staff clear information on how the person displayed behaviours when they were becoming unsettled and the plan went on to explain to staff what measures they should take to calm the situation. Care plans also had detailed support plans, which Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: identified individual needs. The plans gave information on desired outcomes and provided staff with information on how to achieve them. The detailed information in the care plans gave staff the information they needed to be able to support the residents in the way they wanted to be supported and allowed residents to be as independent as possible. Care plans are regularly reviewed and each service user has a six monthly review, which includes input from their advocates (parents and social workers), staff, an assistant psychologist, a speech and language therapist, occupational therapist, medical practitioners and other specialists as required Daily recording was clear and detailed what the person had been doing throughout the day and night and recording also provided good evidence of care delivery. Residents are supported to make decisions about their day to day lives and staff were observed interacting with residents and taking their views into account. Care plans and recording gave good information on how staff involved residents in decision making and staff told us that they would respect residents wishes. We were not able to speak with residents to obtain their views due to their communication needs. However we observed staff interacting with service users and they were patient and allowed service users to make their own decisions as much as possible and were on hand to offer guidance and support as required. Those care plans looked at contained risk assessments and they gave details of the assumed risk. We saw a number of risk assessments that were in place including risk assessments for; road safety, self harm, hot surfaces and trips out into the community. The risk assessments detailed control measures to minimise the risk and they gave staff good information on any support that was required. Each time a resident leaves the home to go out on an activity a risk assessment is completed. On return from the activity an evaluation of the outing is made to enable adjustments to be made to the risk assessment if needed. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to take part in appropriate activities and they have opportunities for personal development and are encouraged and supported to be part of the local community where they engage in appropriate leisure activities. The homes visiting policy supports residents to maintain family links and their rights are respected. Residents are offered support to plan their own menu and are provided with a balanced diet in pleasant surroundings. Evidence: The homes completed AQAA told us that service users are encouraged to learn independent living skills and undertake as much as possible for themselves. Teaching staff set up individual learning programs for each young person and these are monitored through the review process and teaching staff are assessed according to the Department of Further Education regulations. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: During our visit we found that each service user has a timetable, set up with the individuals needs in mind. These included work skills and living skills; this provides a balance between activities and education. Staff support service users to undertake everyday tasks and they are encouraged to participate as much as possible. The home employs a further education tutor and a teaching assistant. The home has a classroom where individuals can learn literacy and numeracy as well as learning other skills. There is an activity room and a sensory room where service users can learn and also relax. We observed one service user using the sensory room and this was a calming and relaxing environment. The home provides a range of outdoor activities and on the day of our visit 3 service users were going to a local leisure centre to go swimming. The home also has a woodland walking path adjacent to the home and service users are encouraged to go for both long and short woodland walks. The home has a vehicle for transporting service users into the local community; shops etc and they intend to have a minibus in the near future to enable service users to access the community. All of the service users have regular contact with their families and the home supports residents to maintain contacts with family and friends. Residents are supported to exchange greeting cards and write letters. Some service users speak to relatives on the phone and some relatives visit the home. A number of service users are supported to go and visit relatives. The home has a clear visiting policy and visitors are always welcome and we were informed that staff would respect residents wishes on who they wish or do not wish to see. Daily routines in the home promote residents independence as much as possible and they are encouraged to participate in day to day routines. During the visit staff were observed interacting with residents and they appeared to get on well together. Staff used residents preferred form of address and they were seen to be very patient and understanding of the residents needs. Staff were seen to communicate with residents in a number of different ways to meet individual needs. The manager told us that residents could be involved as much or as little as they want in the day to day routines in the home. Service users have access to a key for their rooms, which they are supported to use if appropriate and they have access to a locked drawer and cabinet inside their rooms as appropriate. The home operates a four week rolling menu, which is changed seasonally and this includes input from residents and takes into account individual likes and dislikes. One service user is on a special diet and this is catered for. Breakfast at the home is normally cereals and toast and residents are supported to be involved in meal Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: preparation as much as their skills allow. Lunch is the main meal of the day with a hot meal being provided. Supper is normally a snack type meal such as jacket potatoes, pasta bake or beans on toast. Service users are encouraged to eat their meals in the dining room and due to the complex needs of some residents the home has 3 sittings for meal times so that service users can enjoy their meals in a pleasant environment. 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. The health, personal and social care needs of residents are set out in an individual plan of care and residents have access to all relevant health care professionals. The staff at the home supports residents to have regular health checks and ensures that their health care needs are met. Residents are protected by the homes policies and procedures regarding medication. Evidence: The completed AAA told us that staff encourages the service users to carry out their personal care as independently as possible and when support is required, wherever possible this is given by staff of the same sex. All service users are registered with a local GP and have full access to health care facilities. Their health and well being is constantly monitored by staff. Service users have regular input from the occupational therapist, speech and language therapist, and other health practitioners as required. All staff undergo training in the administration of medication at induction with those staff authorised to administer medication having additional training and a written exam. There is a risk assessment in place for the administration of medication. During the visit we found that all service users have clear information in their plan of Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: care on their personal care needs. Some service users require only verbal prompts while others need more staff involvement. Care plans provided good information on what actual support was required and support was offered flexibly to suit residents needs. One plan seen had good information for staff on the persons morning routine and gave clear information on how the person wanted to be supported to brush their teeth. Support plans enabled service users to be in charge of their personal care as much as possible but also enabled the correct support to be given when required. All residents are registered at a local GP surgery and the GP has made appointments to visit service users at the home to carry out health checks. Residents are supported by health care professionals from the Cambian group and this includes; occupational therapist, speech and language therapist and dental practitioners. Additionally service users under the age of 19 receive support from a paediatrician. Medication is supplied to the home by a local pharmacist. We looked at medication procedures at the home and there was a risk assessment regarding medication and there is a clear policy and procedure in place. All staff have completed training in medication procedures and we looked at medication records and those seen were clear and up to date with no gaps. The home keeps some homely remedies for use by service users; however there has been no agreement with the GP to confirm that these remedies are suitable for use by all service users. The manager informed us that she would draw up a list of those homely remedies used at the home and would obtain approval for their use from the GP. Currently the home does not hold any controlled drugs. However it was pointed out that should there be a need for any controlled drugs to be held at the home, they must be stored in a proper Controlled Drugs Cupboard. The manager informed us that a controlled drugs cabinet was on order and was due to be delivered shortly. The Misuse of Drugs (Safe Custody) Regulations 1973 gives full details of the storage requirements for controlled drugs and suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. 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. There is a clear and accessible complaints procedure, which includes timescales for the process and service users can be confident that their views would be listened to and acted upon. All complaints are logged and responded to appropriately. The homes policies and procedures help to protect service users from any form of abuse. Evidence: The homes completed AQAA told us that there had been 4 complaints to the home and this was confirmed on the day of the visit. We looked at the complaints log and all complaints had been recorded and responded to appropriately and within the agreed timescales and all complaints had been satisfactorily resolved. The home has a clear and accessible complaints procedure; however it was not clear if this is understood by the people who use the service. Staff members were aware of the complaints procedure and the manager told us that staff would assist and support any resident who wanted to make a complaint. A copy of the complaints procedure is made available to relatives and representatives of service users. The home has a comprehensive policy on the protection of vulnerable adults and children and they have a copy of the Hampshire Adult Protection procedure and a whistle blowing policy. Staff training records showed that staff receive training with regard to adult and child protection as part of their induction, there is also annual training in Safeguarding. The manager and staff members spoken to confirmed that they had received training and were aware of their responsibilities in this area. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Currently the home is in the process of obtaining individual bank accounts for all of its service users. The home holds some personal spending money for residents and this is kept separately and there is a clear record of all transactions with receipts kept. This provides a clear audit trail of service users finances. 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. Service users live in a homely and comfortable environment and the home is clean and hygienic and free from offensive odours. Evidence: The home is a large and spacious and offers an excellent standard of accommodation. The property has been adapted to meet the needs of the service users who live there. The home is over two floors; the ground floor comprises of 3 bedrooms, a separate bathroom with WC, staff toilet, office, staff meeting room, large kitchen, dining room, laundry, activity room class room and a sensory room. On the first floor there are 6 bedrooms, a bathroom and a staff office. Each service user has their own bedroom with an ensuite bathroom, a flat screen TV/DVD, arm chair, wardrobe, bed and bedside cabinet. Individual rooms have been personalised and decorated to individuals choice. Communal areas were spacious and well decorated. Access to the property is via an electric security gate and there is parking at the front of the property. The home has a very large rear garden which is landscaped and secure and provides a safe environment for service users. All areas of the home were clean and we were told that residents are encouraged to keep their own rooms clean and tidy and are supported by staff to do this. All hot water outlets in the home have thermostatic regulator valves, which keeps hot water temperatures at a safe level and Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: these are checked weekly to protect service users. There is a utility room which has separate facilities for laundering clothing and this is equipped with a 2 industrial washing machines, which can wash clothing at suitable temperatures. There is also an industrial tumble drier. The manager informed us that she is waiting for the maintenance man to put up some more shelving in the laundry area. Residents do their own laundry with staff support as required. There is suitable protective clothing available such as aprons and gloves and the home has policies and procedures regarding infection control and staff receive training in this area. 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 home provides support for residents in a flexible way to ensure that there is sufficient staff on duty to meet residents needs. Service users are supported by competent, qualified and appropriately trained staff that has the skills and knowledge required to support residents and meet their needs. There is a thorough recruitment process and the homes recruitment policy and practise helps to protect residents. Evidence: We looked at the homes staff rota and this showed us that there is a minimum of 5 staff member on duty between 0700 and 2145. Additional staff are also provided to allow for planned activities. We were told that residents like to have their days planned out, so extra staff are provided as and when required to cover residents social activities. At night there are 4 staff members who are awake throughout the night. We were told that if staff wish to plan any activities the management will ensure there is enough staff on duty to enable the activity to take place. The staff rota allowed for flexible shifts to enable staff to support residents out in the community and additional staff are provided to facilitate activities and appointments. The manager told us that she has a stable staff team who are reliable and flexible to meet residents needs. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The home employs a total of 16 day care staff, 8 night staff, 2 educational staff members, 1 cook, 1 domestic, an administrative officer, 1 property caretaker and handyman and 1 grounds person. In addition the home manager works flexibly throughout the week. As the home is relatively new a number of staff members are still completing their probationary period and once completed staff will be enrolled on National Vocational Qualifications (NVQs). Currently 8 members of staff hold an NVQ. The homes AQAA told us that the home has a robust recruitment procedure. However on the day of the visit we were not able to view recruitment records as the home holds all of its recruitment documents at a central location. All recruitment documents can be made available for inspection on request. Although we could not see original documents we were able to see confirmation that appropriate checks had been carried out on all staff and computer records showed that staff had completed application forms, 2 references had been obtained, Enhanced Criminal Records Bureau checks had been carried out and proof of identity documents including passport and birth certificate are kept on file. The organisation has a human resources department who assist in the recruitment of new staff to meet legal requirements. The organisation that runs the home has a training co-ordinator who organises training for all staff employed at the home. Staff undertake a comprehensive 2 week induction and this includes an introduction to the Cambian group and training in the following areas; communication and signing, health and safety, COSHH, manual handling, abuse awareness. intimate care, infection control, nutrition awareness, complaints procedures, positive behaviour diversity, sensory training, fire, first aid and medication training. The two week induction period also includes shadowing. Additional training is provided as required to meet the needs of individual service users. The manager told us that training needs are discussed as supervision and also at staff personal development planning; she told us that the organisation would support any training that would benefit the residents. 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. Residents benefit from a well run home and the views of residents and other interested parties are sought on how the home is meeting service users needs. The health, safety and welfare of residents and staff are promoted and protected. Evidence: The homes completed AQAA told us that the registered manager has over ten years experience in managing services for young people and is supported by senior management in the organisation. She has recently proved her fitness to manage the service during the registration process for squirrels. The home has comprehensive quality assurance systems in place, which takes into account the views of the people who live at the home and also the views of other relevant people. The organisation carries out monthly regulation 26 visits to the home. These are unannounced visits to establish how the home is meeting its aims and objectives. The person carrying out the visit provides a written report on their findings. Service users at the home have regular meetings where they are able to express their views but this is limited to their level of understanding. Service users are Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: also supported to comment at their review meeting about the service they have received and what they would like to happen in the future. The home sends out anonymous questionnaires to its staff. Additionally questionnaires are sent out to service users, relatives and stake holders. The home also sends out regular newsletters to residents, relatives and other interested parties. The home has only been operating for 6 months and all of the certificates for the safe operation of the home were inspected as part of the registration process. On the day of our visit the fire alarm system was tested and the manager informed us that weekly health and safety audits are carried out. Results of these audits are kept in a file in the office at the home. All staff completes health and safety training as part of their induction. Care Homes for Adults (18-65 years) Page 27 of 30 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 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 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 29 of 30 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 30 of 30 - 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!