Care Home: St Annes Road East (85)

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What the care home does well People living in St Annes Road East are well cared for. People are given enough information about the home before admission so they can decide whether they want to live in the home. Staff meet people who would like to move into the home to assess their care and support needs before deciding if the home can meet their needs effectively. Most information in the care records is easy to find and the information is reviewed regularly. Medication is given, stored and disposed of correctly and people living in the home are given medication at the correct times ensuring that it gives them maximum benefits. There are a variety of interesting and stimulating social and leisure activities for people to do in the home and local community. We observed staff interacting with people living in the home. Staff were seen encouraging people to choose what activities they wanted to do and sensitively supporting people who needed help with personal care. Routines in the home are flexible and people spoken to said that they can choose when they get up and go to bed and whether they want to join in activities. Relatives are made welcome at any time. and enjoy being involved in the life of people living in the home. People living in the home and their relatives feel they are listened to and any concerns acted upon quickly. We toured the home and found the environment was homely, well maintained, comfortable, clean and tidy. Most care staff have completed National vocational qualifications (NVQ). NVQ`s are national awards in care that enable staff to gain up to date skills and knowledge about current care practice. This helps staff have up to date skills and knowledge in care practice. The manager and most staff have worked in the home for a long time and know people living in the home well. They know the care and support people want and their needs are well met. What has improved since the last inspection? Care records have improved to provide more easily accessible, detailed information about people living in the home. Staff feel they are working well as a team and they are well supported by the the team leader and feel that the home is more efficient in her leadership. What the care home could do better: Care plans would be improved by including all health issues in care plans where care and support needs are changing. This will make the information easier to find. Job applicants need to give more information about their past jobs and when they changed jobs so that the manager has enough information to know when and where they were working what experience they have had. This will improve the staff recruitment process. A senior person in the organisation needs to make unannounced visits to the home regularly, look around the home talk to people living and working there and write a report of the visit. This is so everyone knows about how the home is run and what people living in the home and staff think of it. Key inspection report Care homes for adults (18-65 years) Name: Address: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF     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: Pauline Caulfield     Date: 1 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF 01253789074 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Steve.Turner@unitedresponse.org.uk www.unitedresponse.org.uk United Response care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home 85 St Annes Road East is a small care home for adults with learning disabilities, registered for six people. The well-established national charitable organisation United Response is the registered provider. The home is a semi-detached three-storey house providing good access to local services and amenities. The organisation provides a vehicle to enable people living at the home to take part in leisure activities and access amenities. The staff team support individuals in all aspects of daily living according to their assessed needs and as identified via the care planning process. Individuals are supported and encouraged to develop their independence and take part in all aspects of community living. The service adopts an active support approach, providing people with practical day-to-day support, in order that individuals can take as much control of their lives as possible. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 0 4 0 9 2 0 0 9 Brief description of the care home There is a statement of purpose and service user guide which is given toall people who may want to move into the home. This written information explains the care service that is offered, who the owners and staff are and what the individual can expect if they decide to live at the home. The fees for the home are between £644 and £1,352 per week. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit undertaken as part of the inspection process which commenced at 10am for seven hours. Before the visit the home completed an annual quality assurance assessment (AQAA). This is a document that provides CQC with written information and an assessment about the quality of the services the home provides. The registered person is asked to provide us with this information each year. The inspection involved case tracking two people living in the home as a means of assessing the care provided in the home. Case tracking means the inspector looks closely at a small group of people living in the home. We talk to them about the home if they are willing to and are able to talk to us. If they cannot talk to us we watch how staff care for, talk to and involve them in activities. We look at any information about their care and support and look around the home, particularly at rooms the case Care Homes for Adults (18-65 years) Page 6 of 29 tracked residents use. We also spend time talking to other people in the home. We also talked to some staff and looked at administrative records in the home. Comment cards were received from two relatives and two members of staff. We have put this report together from watching the care provided, from comments received from people living in the home, relatives and staff and written information we saw before or during the inspection. The last key inspection on this service was completed on 13th January 2009. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care plans would be improved by including all health issues in care plans where care Care Homes for Adults (18-65 years) Page 8 of 29 and support needs are changing. This will make the information easier to find. Job applicants need to give more information about their past jobs and when they changed jobs so that the manager has enough information to know when and where they were working what experience they have had. This will improve the staff recruitment process. A senior person in the organisation needs to make unannounced visits to the home regularly, look around the home talk to people living and working there and write a report of the visit. This is so everyone knows about how the home is run and what people living in the home and staff think of it. 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed assessments are carried out before admission so that staff know what care people need and individuals considering moving into the home know their needs can be met Evidence: There has been one new admission to to the home since the last inspection. The admission process included the person making regular visits to the home, at least twice weekly. Initially the visits were short and just for a cup of tea and a chat followed by visits for a meal, then overnight stays and weekend visits before finally moving into the home. This took place over several months and allowed the person to familiarise himself with the home, other people living in the home and staff and all involved to get to know the individual. There was a detailed assessment which had been carried out by the learning disabilities partnership before admission to the home and there were detailed records regarding the residents visits which were used to provide information in the care plan. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most areas of the care records are in place and up to date and staff encourage people living in the home to make decisions about their lives Evidence: We case tracked two of the five people living in the home. One resident had only been in the home a short time and it was clear that information was still being gathered. The information available on each person includes current and previous health needs or concerns, care needs using the individual support plan and personal support plan, communication profile leisure choices and likes and dislikes, as well as information on professional visits. Staff were aware of his social and leisure likes and dislikes and activities had already been planned or commenced. a member of staff said, We maintain clients individual care plans. Care plans were in place. They had been regularly reviewed, where appropriate and most of the information needed was in place. However some health information for one resident was not easily accessible and the information was limited. This should be Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: recorded more clearly and in detail so that everyone supports people in a consistent way. There were daily individual records showing activities the person has been involved in, any changes in care or support and any achievements or any concerns or issues that may have arisen. This assisted staff with information so they knew what support people had needed and activities they had been involved in. The active support schedules for each person look at the support needed to ensure people in the home are not put at risk (risk assessment) and are regularly updated. One person living in the home was getting up regularly during the night, possibly through confusion. Staff were considering using a door pad to alert them when the person got up during the night, as she could then be at risk and staff currently are on sleep in rather than waking nights. Use of a door pad may affect the individuals privacy and needs to be discussed, involving the person, looking at her best interests, alternatives to the door pad and the impact of the door pad on the care and support provided. Any decision that may restrict the privacy or rights of an individual should be looked at in this way records kept of the decision and regularly reviewed. Staff support and encourage people living in the home to make decisions, with support and guidance if needed. Communication between staff and people living in the home was good. During the inspection, staff were observed interacting with service users. They frequently chatted, discussing choices of activities and planning together what time these could go ahead. This helped to show that people are included as much as possible in daily events and in the different aspects of daily living. It is clear from the records and from observing staff that the views of people living in the home are usually taken into account and staff listen to what they want, who they want to be with and what they want to do. During the inspection staff were routinely spending time with people living in the home talking to them about the leisure and social activities they wanted to do that day and later in the week. People living in the home were very positive about the care they received. One person said, They look after me, they are good Another person said I am very happy. People living in the home are encouraged to make choices and routines are flexible with staff encouraging them to make decisions, with support as needed about what they want to do. A relative commented, The needs of the clients are attended to at all times. A member of staff said, We respect the wishes and needs of individuals. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are encouraged and supported to choose and participate in meaningful and appropriate activities. Evidence: Each person living in the home is involved in regular activities of their choosing and said they enjoyed them. Staff are familiar with the likes and dislikes of people living in the home and encourage them to try out new activities. People living in the home also attend college courses if they choose to, with support as needed. A member of staff said, We support the clients to attend their activities. During the inspection very poor weather had reduced some activities because of icy pavements, but others were being accessed. Routines in the home are flexible and people spoken to said that they can choose when they get up and go to bed and what they want to do during the day. They said Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: they are treated with respect by staff. A relative commented, All the staff at St Annes Road East are very hard working and I have only good to say about them. It is a very happy home and I hope nothing changes. Meal times are flexible but within the usual times for each meal unless activities affect that. Meals are planned and usually eaten together where possible. We observed staff and people living in the home during the inspection. There was very frequent interaction between staff and people living in the home and staff encouraged people to develop skill and to be part of the community. All people living in the home are White English or Irish and Christian or have no religious persuasion. However the manager said they would meet the needs of people from other religions, ethnic or diverse backgrounds wherever possible and would ensure that all staff were familiar with their needs. Where an individual has religious or spiritual needs, staff enable them to have these needs met. One person living in the home attends church regularly and is frequently visited by and attends social events with church members. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is given in a way the service user prefers. Evidence: Most health information or concerns are recorded clearly and placed together so they are easily available. Although one person has only lived in the home a short while staff are becoming aware of his health and support needs. Staff are working through detailed records and although not all completed they are adding information to the support forms used as they get to know him more. Although this persons individual support plan has been completed it is not very person centred with comments such as use the right communication tools in the section what is important to the individual. Clear and simple instructions individual to the person would be more effective and helpful than this. Another person living in the homes health records show health checks and any previous health issues. Her weight is checked weekly and any loss observed is acted Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: on. There are records showing involvement with the continence advisor, GP, district nurses and screening with other professionals. People living in the home have access to appropriate health services. People attend their GP as needed and if necessary they receive GP and District Nurses visits. There is clearly regular contact with the GP and district nurse team regarding one persons health issues and physical care required for this. but the care plan relating to this is limited and would benefit from further developing. Staff are very aware of the health needs of people living in the home and when spoken to were able to explain the support people living in the home needed. However although recorded in daily reports this is not always recorded in the care plan and should be. One person has recently been going through tests which strongly suggest early onset dementia. Although this information and any concerns are written in the health records relating to the professionals involved and the daily records, this information is not easily available as staff have to read through several weeks of records. There are not yet clear and comprehensive records of any additional care and support needs or areas of concern recorded in the care plan. Information should include how to support her when she forgets things, support with fluctuating moods and her sleeping pattern which has been affected. This assists staff to work in the same way and ensures consistency of care. Many areas of care and support were covered in the care and support information including communication, intimate and personal support, religious and spiritual needs and leisure and social wants and support needs. These are clear and concise and provide a good picture of the individual. None of the people living in the home had been involved in any accident recently. The manager was aware of the need to audit to see if any lessons could be learnt or accidents reduced if accidents/falls occurred. Medication was checked and was appropriately administered, recorded, stored and disposed of. The home uses a monitored dosage system and is satisfied that it is working well. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home feel that they are listened to and staff are aware of what to do if alerted to a safeguarding issue. Evidence: There have been no complaints received since the last inspection. According to the AQAA, discussion with the manager and from surveys it is clear that people living in the home know how to tell someone if they are not happy. Staff have received safeguarding adults training on induction and on National Vocational training (NVQ) and have an understanding of the action to be taken if they are alerted to a safeguarding issue. Staff said they could talk to the manager or senior managers if they had any concerns about care and know they would deal with it. The concerns and complaints procedure gave appropriate, relevant and clear guidance. The complaints procedure is available in picture format, helping people to have a better understanding. A copy is provided with the service users guide when a person joins the service. The staff have had criminal record bureau (CRB) checks, helping to show that only appropriate people are employed to care and support vulnerable people. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment in the home is comfortable, clean and pleasant to live in. Evidence: We toured the home and found the environment homely, comfortable and tidy. The home was clean and fresh smelling. People living in the home said it was a nice house and they enjoyed living there. Several people showed us their bedrooms which were pleasant, homely and well personalised. A relative said, St Annes Road East is a homely, comfortable house and the staff do their very best to make the clients feel secure. The standard of cleanliness is high. There are a number of aids and adaptations in place in the home but as people get older or more dependent more aids may be needed. It would be useful to start planning for this as it becomes clear that such aids may be needed. There is a rolling programme of redecoration and all areas of the home are included in this. Improvements have included redecoration around the home and a new kitchen installed. The gardens at the front and back of the house were neat and tidy and maintained to a good standard. Care Homes for Adults (18-65 years) Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most areas of recruitment and selection are robust and thorough and staff are well trained and have the skills and knowledge to support people effectively. Evidence: At the last key inspection there was no team leader/manager responsible for the day to day running of the home. The registered manager gave an assurance that a new team leader would be recruited as soon as possible and this was done. The Team leader/manager has been in post for several months now and all staff feel that this has made a major improvement to the service provided in the home. The Team leader/manager was one of the care staff in the home, she has moved into her new role well and has the respect of the staff spoken to who said she was very supportive. Most of the staff have worked in the home for several years and there is only a small staff turnover. This ensures that staff are familiar with people living in the home and their care needs and they know the people caring for them. We chatted to several staff before and during the inspection as well as through the staff surveys. Staff spoken to or who returned the surveys were satisfied with and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: enjoyed working in the home and generally felt well supported. One member of staff said, Everyone has been fantastic since I started work here. They are all approachable, kind and friendly. Another member of staff said. Its a great team here. Relatives were very complimentary about the care provided at St Annes Road East. One relative commented, At this moment I cannot think of a single thing which needs to be improved on. Another relative said, The staff are very caring. Always keeping the clients entertained and with a good social life. Staff rotas showed sufficient staff on duty doing the inspection. Staff felt that although staffing had been a problem until a couple of months before the inspection since then there had been sufficient staff during the day since then to provide very good care and support to people living in the home. There have been two new members of staff appointed recently. There are usually three staff throughout the day to support people living in the home. Staff had been concerned about a new person being admitted to the home when they were short staffed and had raised concerns about this to managers. Despite this the admission had gone ahead and staff had gone ahead. Staff said that despite being short staffed they had made this worked but felt on this occasion they were not listened to. In addition there have been concerns about one person living in the home becoming restless at night and getting up several times during the night. As staff are not waking night staff but sleeping during the night they are concerned that the person may be at risk if they do not hear the her when she gets up. Also as a consequence of being up during the night staff are tired and are then working a full shift. This situation needs looking at to support the person who is having disturbed sleep patterns and to assist staff who have been up in the night supporting her. The records of two members of staff were checked. Both applicants had an application form with work history although these only had a short work history. A complete working history from first to present job exploring any gaps is required so that the manager has full details of applicants previous jobs, duties and the length of time they remained in these jobs. The enables the employer to gather more information about the skills and experience the prospective member of staff has. The staff files checked had two written references in place, but for one person this did not include a reference from the last employer and should do, particularly so as in this Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: case the previous employer was a care organisation and could have provide information on the applicants suitability to work in care. There was health information in place and staff checked had PoVA checks and CRB checks. These are checks made to see if a potential member of staff is unsuitable to work with vulnerable people. Staff had copies of training certificates in place and they received an induction so that they were aware of the care and support they needed to provide and how they should do this. All except one new member of care staff have completed National vocational qualifications (NVQ). This is well above the requirement that fifty percent of staff complete this training. NVQs are national awards in care that enable staff to gain up to date skills and knowledge about current care practice. The care staff in the home who has not completed NVQ training is beginning working towards National vocational qualifications (NVQ)as she has just completed her detailed induction. Staff spoken to or who completed comment cards said they received regular training including moving and handling, medication and dementia training. The manager said that further dementia training was planned. One member of staff said, We are kept up to date and fully trained with any new courses. There were supervision records in place. Formal supervision is carried out regularly with detailed records kept. Staff supervision allows the member of staff and manager or other nominated person to meet regularly and look at the member of staffs care practice and the care practice in the home, and any improvements that can be made. They also look at future plans in the home, training and the individuals career developments. Staff said that they had regular supervision and appraisal. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is competently and effectively managed ensuring the safety of and involvement of people living in the home and staff. Evidence: Mr Steve Turner is the registered manager. He was not seen on this inspection. Staff said they felt well supported by the registered manager and the team leader and felt that they were fair and willing to listen. The registered manager is also responsible for three other care homes in the Lytham area, with each of these homes having a team leader in place to maintain the day to day running of the home. After a considerable length of time without a day to day manager, the team leader at St Annes Road is in place and settled. This has improved the management and support to people living in the home and the staff team. One member of staff said, The house is more settled now that we have a manager in full time. Information on health and safety certificates and checks was provided. Including gas Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: certificate, electricity, and portable appliance testing (PAT). There were records to show that fire safety checks, smoke alarms, emergency lighting and the checking of water temperatures are regularly carried out. This helps to ensure the health and safety of the people who live and work at the home. The home holds money for some people living in the home. Records are kept for all transactions and receipts obtained. There are some systems are in place for quality assurance. There are regular staff meetings and service user meetings and issues discussed affect and improve care practice in the home. This gives the manager or team leader the opportunity to impart any information and for staff and people living in the home to discuss any issues, concerns or ideas about the home. The team leader said she does regular checks of all aspects of care and health and safety, but does not keep written records of these. The organisation does not complete regulation 26 visits and should do. This is where the responsible person or an employee not directly concerned with the care home, visits the home unannounced atleast once a month. The person carrying out the visit must talk privately to people living in the home and to staff, to form an opinion of the standard of care provided. The person also inspects the premises and prepares a written report on the conduct of the home. People living in the home are asked what they want from staff and the home regularly. Surveys are occasionally sent out to relatives to ask their opinion of the service. These measures help keep the service focused on the people living at St Annes Road East. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 15 All health issues need recording clearly in the care records. So that staff have easy access to all relevant information. 01/03/2010 2 34 19 A full working history needs to be obtained for all prospective staff members. To ensure that the management team know the jobs previously held and experience gained by the prospective member of staff and their skills and abilities in previous jobs. 01/03/2010 3 39 26 There must be unannounced 01/03/2010 visits to the home, at least monthly, by a senior person in the organisation. These visits must include an inspection of the premises and interviews with people living in the home and staff Page 27 of 29 Care Homes for Adults (18-65 years) 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 in private and a written report of the visit. This is so all involved are aware of how the service is being managed. 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 Any restrictions of rights or of privacy should be discussed, alternatives considered and the decisions recorded clearly so that everyone is aware of the issues and decisions made. Care records and plans should have personalised, clear and simple information so that everyone understands exactly what is expected. Managers should look at how to ensure staffing meets the needs of people living in the home at all times. The references of potential staff should be include the last employer so that the most recent information about the applicants work is provided. 2 19 3 4 33 34 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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