Care Home: St Brannocks

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What the care home does well The same manager is in post as at the last inspection. The manager and staff are stable and know service users well. Everyone is having a holiday this year. Service users have been involved in choosing their holidays and said they are looking forward to their holidays. People can get out into the back garden and get fresh air when they want to. Everyone is involved in the running of the home including planning meals, going food shopping and doing the housework. People have the opportunity to attend community based activities. One person said I love going to literacy classes. What has improved since the last inspection? The manager has completed the work for a National Vocational Qualification at level 4. He is awaiting external verification. This means that he will have the qualification required by the Minimum Standards. Information about the home is now more user friendly as there are colour photographs, pictures and quotes from current service users. This means that prospective service users will have some up to date information about what the service has to offer. Two people told us about their new jobs. They said they enjoy their jobs. Extra staff come in to support people to attend evening activities like discos and dance classes. Service users told us that because service users are calmer the atmosphere at the home is calmer. Service users said there are fewer incidents and because of this people are getting on better and the home is a nicer place to live. A service user said, I can talk to people if I get stressed. Service users are involved in developing their care plans. Staff are talking to people about their personal goals for the future. Personal goals are being recorded and most have plans for staff to follow to help people achieve their goals. The review of care plans by staff is more detailed in that staff now write out a monthly review of each part of a persons care plan. This means that any changes in a persons needs can be picked up and acted on quickly and staff know if they are providing the right support or not. Staff that sleep in at night now sleep in the office rather than the conservatory. This means that staff have more privacy and that service users communal space is not used. What the care home could do better: We found that staff let themselves into the home without knocking. The manager agreed to review this as it is disrespectful to the people who live there. We found that personal goals have been identified and recorded but for one person we found no plan in place to support a goal to meet a spiritual need. This means that the person may not achieve. The manager said that there was a previous plan but could not find it. The manager said he would address this. We found that one persons goal is recorded and each month, since early 2009, staff are reviewing the progress towards the goal. It is clear that the person is not achieving their goal. The manager agreed that the staff support may need reviewing and changing or the goal needs reviewing with the person to ensure it is realistic and achievable. The manager should have the opportunity for a one to one meeting with a line manager at least 6 times a year. This is to ensure he has the coaching, mentoring and support he needs. Key inspection report Care homes for adults (18-65 years) Name: Address: St Brannocks Dymchurch Road New Romney Kent TN28 8UF     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: Kim Rogers     Date: 0 2 1 0 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 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 Brannocks Dymchurch Road New Romney Kent TN28 8UF 01797366663 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: st.brannocks@craegmoor.co.uk www.craegmoor.co.uk Parkcare Homes (No.2) Ltd care home 7 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 7. 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 care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home St Brannocks is a home providing personal care and support for seven people with learning disabilities. The registered provider is Parkcare Homes Ltd. This is part of the Craegmoor group of companies. The registered manager is Richard Carden. The home is arranged over two floors and has seven single bedrooms and plenty of communal space. There is a lounge/dining area and a large conservatory. Outside there is a safe and enclosed rear garden. St Brannocks is situated on the main road at St Marys Bay, close to the small town of New Romney. It is within half an hour drive of the larger towns of Folkestone and Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 7 1 7 1 1 2 0 0 8 Brief description of the care home Ashford. The fees for this home commence at about 1,584 pounds per week. Additional charges may be made should the assessed needs of the client indicate the need for additional support. For more information about the fees and services please contact the provider. 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: This was an unannounced Key inspection of the service. This means that we assessed the Key Minimum Standards. The last Key inspection of this service was 17.11.08. Copies of this report are available from the Provider or can be viewed on our website. We spoke to the people who use the service. We spoke to staff and the manager and sampled various records. We made observations and had a look around the home. We looked at the last Annual Quality Assurance Assessment or AQAA. The manager completed this and it gives information about how the home has improved and how they intend to improve further. We looked at any notifications from the home about accidents and incidents. We sent surveys to the people who use the service and other stakeholders. People told us what they think about the home. We received 4 surveys back from service users and 3 from Care Homes for Adults (18-65 years) Page 6 of 29 staff. All made positive comments about the service. Service users said in surveys, They look after me The home keeps me safe and secure I would like to go out more I would like to go out better More trips out would be better To find more things to do with people my own age would be better Take me out on more trips and let me cook more often We told the manager about the comments and he has plans to address the issues and improve the service. We made four requirements at the last inspection relating to restraint, managing challenging behaviours, staffing levels and care plans. We found that these requirements have been met. Service users said We do not get restrained any more, which is good. Staff talk to us more. 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: We found that staff let themselves into the home without knocking. The manager Care Homes for Adults (18-65 years) Page 8 of 29 agreed to review this as it is disrespectful to the people who live there. We found that personal goals have been identified and recorded but for one person we found no plan in place to support a goal to meet a spiritual need. This means that the person may not achieve. The manager said that there was a previous plan but could not find it. The manager said he would address this. We found that one persons goal is recorded and each month, since early 2009, staff are reviewing the progress towards the goal. It is clear that the person is not achieving their goal. The manager agreed that the staff support may need reviewing and changing or the goal needs reviewing with the person to ensure it is realistic and achievable. The manager should have the opportunity for a one to one meeting with a line manager at least 6 times a year. This is to ensure he has the coaching, mentoring and support he needs. 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. There is information available about the home to help people decide about moving in. People know an assessment will be carried out before they move in. Evidence: There is information available about the home. This information is written. Since the last inspection the manager has updated this information and added colour photographs and pictures. He has included quotes and comments from current service users about what they think about the home. This means that the information is more meaningful to people who may be thinking about moving in and service users have been involved in producing it. There have been no new admissions to the home since the last inspection. The manager said that the provider company is in the process of improving the assessment tool so that it meets the Minimum Standard. This means that prospective service users will have their aspirations as well as their needs assessed before they move in so the manager can be sure the home can meet their needs. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Care Homes for Adults (18-65 years) Page 12 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. Service users know that their needs and goals will be supported. Risks are assessed and managed and people have the support they need to make choices and decisions. Evidence: We found that each person has a care plan that details the support they need. We sampled three care plans. We found that since the last inspection service users have been involved in developing their care plans. The manager said that staff have been working with service users to improve the care plans to make sure that everyones needs and goals are recorded. People have been talking to their key workers about their aspirations and goals for the future. These aspirations have been recorded. We found that most goals have a plan of support for staff to follow but some have not. This means that people may not achieve their goals. The manager said he will make sure that plans of support are in place for all goals. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: We found that people are achieving things they have always wanted to do. For example one person is going to have a tour of their favourite football club and stay in a hotel. We found that for one person more effective evaluation is needed of the current support as they have not achieved a personal goal. The manager agreed that this may be because the support is wrong or the goal is unrealistic and may need reviewing with the person. We found that all plans are written. Service users have been involved in choosing and designing covers of their choice for the plans. The manager said that he and four staff have attended a one day course in person centred planning. We found that risks are identified and assessed with the person. We found that risks assessments are reviewed monthly as are care plans. This means that any changes can be picked up and acted on by staff. We found that the way people prefer to communicate is recorded in individual plans. We observed staff communicating with service users patiently and respectfully. Information is available to people including the staff duty rota and the menu for the day. The manager said he has spoken to service users about displaying staff photographs to show who is on duty. The manager said that service users decided against this. Service users told us they have been involved in choosing their holidays and what courses they attend at local centres. People said they also have a say about the menus and other activities like organised outings. 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 have opportunities to take part in leisure activities and life long learning activities. People have had support to get jobs. Relationships are supported and everyone is involved in the running of the home. Evidence: We found that people have the opportunity to take part in a range of activities in the community and when at home. People told us that they like going to literacy classes and to bingo at a local community centre. There are a range of sessions on offer and this is run by the company who run the home. There are board games, films and books available in the dining room for people to help themselves to. There are evening activities like discos and dance classes. The manager said that extra staff come in to enable service users to attend. Each person has a weekly activity plan covering seven days and some people have written these themselves. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People told us they like going to markets at weekends. Two people told us about their new jobs at a local shop and garden centre. Both said they are enjoying their jobs. We found that people have the support they need to keep in touch with family and friends. Relatives details are recorded and visits to and from family are supported. People told us that they are getting on better with each other. They said the atmosphere at the home is more relaxed and they feel calmer. Service users told us that they take part in the cooking and in keeping the house clean. There is a housework rota displayed in the dining area. This means that everyone is involved and can increase and develop their skills. The manager said that everyone is involved in planning the menu and shopping at the supermarket. Service users confirmed this. Currently people cook for themselves once a week. One person said they would like to cook more. Another persons care plan said they want to be better at cooking. The manager said that opportunities are limited due to the size and location of the kitchen. However there is opportunity to create a separate training kitchen in the detached out building as this already has a power and water supply. The manager agreed that this would give people more opportunities to cook and also give privacy if people want to entertain friends and family. Service users told us that the kitchen is not locked so much as it was. The manager said this is due to a decrease in the amount of incidents of problem behavior. Because people are calmer and more relaxed there are more opportunities to access the kitchen and be involved. The menu is accessible and is written. The manager said this is not meaningful to everyone so they use laminated pictures to show the meal choices. People have support to access the community like local pubs, shops, and cafes. People said they use the local shops. There is a vehicle that staff can use to support people to access community facilities. Some people are taking part in gaining an award though Mencap. 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. People know their personal care and health needs will be supported. Medication practice is safe protecting service users. Evidence: We found that the support people need with their personal care and health needs is recorded in individual care plans. We found that additional information has been added so staff know how people prefer to be supported. We found that people have booklets in their care plans about being healthy called All about my health and Being healthy. Health needs are recorded so staff know what support people need. We found that staff monitor peoples weight and nutrition. Service users told us that they have support to attend health appointments. The manager said people are having support to take more control of their medication. Medication is now stored in individual rooms giving more privacy and some control to service users. Service users said they are happy about having their medication stored safely in their rooms. One person said that staff do not do it for you, they let us do it. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: The manager said that there has been some training in the safe administration of medication since the last inspection. 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 know who to complain to and are confident their complaints will be acted on. People are protected from harm and abuse. Evidence: We found that there is a written complaints procedure displayed in the home. This is also produced with text and symbols. The manager said that there have been no complaints about the service since the last inspection. The Commission has received no complaints about the service since the last inspection. Service users told us that they know who to talk to if they have a complaint. Service users said that staff would sort it out for them. There is a safeguarding vulnerable adults and whistle blowing policy and procedure. Staff attend training in safeguarding vulnerable adults. Following the last inspection we made a safeguarding referral as we felt that one or more service users may be at risk of harm due to the way staff managed problem behaviour. This means that the safeguarding coordinator and her team at social services investigate. This investigation is ongoing. For more information please contact the provider. We found that guidelines about supporting peoples problem behaviours have been Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: reviewed and updated. Guidelines tell staff about what the behaviour looks like and what the triggers may be. Guidelines tell staff what they should do when someone shows problem behaviour. We made a requirement at the last inspection that people with problem behaviour should have clear, agreed up to date guidelines. We also required that any use of restrictive physical intervention or restraint is used in line with the National Minimum Standards. We found that these requirements have been met. The manager said that the use of restraint has reduced. He said that staff talk to service users to calm them down and other techniques are used. One person told us they go to their room and listen to music when they feel angry or stressed. One person said they have a stress cushion that helps. Service users said they feel calmer and the atmosphere of the home is calmer. One person said we do not get restrained any more. The manager says that incidents involving problem behaviour have reduced. Care Homes for Adults (18-65 years) Page 20 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 home is clean and well maintained. Evidence: The home is well maintained with adequate furniture and fittings. There are communal areas like lounge, dining area and conservatory and each bedroom is single with a wash hand basin. This means that people can have some private space if they need it. People said there are enough bathrooms and showers for them and that they are happy with their rooms. Service users have support to take part in keeping the house clean. The home was clean and smelled fresh on the day of our visit. People told us that the home is always clean and smells fresh. There is unrestricted access to the back garden so people can get fresh air when they want. Service users have keys to their rooms and three service users said they did not have a front door key. They said only staff have keys to the front door. We observed three members of staff letting themselves into the home through the front door without knocking. The manager agreed to review this practice as it may be disrespectful. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: We found that people have more access to the kitchen. The manager said that access to the kitchen is less restricted due to the decrease in the number of incidents of problem behaviour. Two service users told us that they would like to cook more. Currently service users cook once a week for themselves. The manager agreed that doing more cooking would be beneficial as people can increase their skills however he feels the current facilities are not adequate. He agreed that there is potential for an area in the out building, housing his office, to become a training kitchen. This area already has a sink, water and power supplies. The manager agreed to talk to service users about this opportunity. Some parts of the home have been redecorated since the last inspection including the lounge. The manager said there have been some repairs to the roof and they plan to buy new sofas and flooring for the conservatory. There are plans to increase the parking space and have a new patio area. The manager has moved his office to a detached out building in the garden. This means that staff now use his previous office and staff can sleep in here at night rather than giving to sleep in the conservatory. This means that staff have more privacy and service users communal space is not being used for staff to sleep in. Staff said they much prefer having a dedicated sleep in room. Care Homes for Adults (18-65 years) Page 22 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. There are enough staff to meet service users needs. Staff have access to mandatory training and service users are involved in recruiting staff. Evidence: We found that there is usually four to five staff on duty. The manager said that the rota is planned around service users appointments and activities and that extra staff come in when needed. For example an extra staff member comes in to support people to go to a weekly disco and a weekly dance class. On the day of the visit there was five staff on duty with the manager. Service users said they have enough staff to give them the support they need. We found that staff have access to mandatory training courses. The manager said that staff are mostly up to date with this training and more courses are planned to ensure people have the updates they need. The manager said that he and four staff have attended a one day course about person centred planning since the last inspection. Staff told us that they have the training and support they need. We found that Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: recruitment checks are carried out before a person starts working at the home. The manager said he plans to involve service users in a forthcoming interview as there is a staff vacancy. The manager said that service users will be asked for their opinion of the prospective staff member. This means that people have a say about who may potentially support them. We observed staff taking calmly and respectfully to service users. One staff calmed a person down who was becoming anxious by talking calmly to them and reassuring them. The practice of staff carrying large bunches of keys on their belts has been reviewed. The manager said staff have essential keys on their person and he has asked them to keep keys in their pockets. The manager said staff continue to work 15 hour long shifts. He said he is in the process of reviewing this to shorten the shift length so that staff do not get tired or stressed Care Homes for Adults (18-65 years) Page 24 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 well managed. There are quality assurance systems in place that take service users views into account. Peoples health and safety is protected. Evidence: The same manager is in post as at the last inspection. The manager is registered with us so he has passed the fit person process. The manager said he has now completed a National Vocational Qualification at level 4 and is waiting for this work to be externally verified. He has attended training about the Mental Capacity Act and a one day course about Person Centred Planning since the last inspection. The manager said he would like to complete a qualification relating to learning disabilities in the future. The manager has reflected on his and staff practice and the systems they use including the care planning system. He said that they have made changes which he feels have improved outcomes for the people who use the service. Service users now have more control over things like their medication and their money. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Service users told us the home is calmer, there are fewer incidents, the kitchen is not as restricted and they are not restrained by staff now. This has lead to a calmer atmosphere in the home and increased opportunities like two people getting jobs. We found that there are some quality assurance systems in place. The manager completes weekly and monthly returns for head office. Surveys are sent out to stakeholders by head office to gain peoples views about the service. We found that service users meetings are held so people get to air their views. Service users told us they discuss the menu, holidays, activities etc. Service users said they have been involved in choosing paint colours for recent decorating work. The manager said the manager of another company home makes monthly visits to the home. These visits monitor practice. We found that reports are completed and show that service users and staff are spoken to. As at the last inspection we found that the manager needs more frequent supervision to meet the Minimum Standard. The company also carries out audits of the service including a financial audit and health and safety audit. The last AQAA shows that health and safety checks are carried out. We found that staff attend training related to health and safety including food safety and first aid. We found that regular fire drills are held and fire equipment is checked regularly. Care Homes for Adults (18-65 years) Page 26 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 27 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 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 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). 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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