Care Home: St Brigas

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What the care home does well There is a range of useful and up to date information available for people to find about the home and what sort of care and support is provided there. Residents care plans are detailed and up to date and give a really good picture of what sort of care and support each person needs to live a fulfilling life both in and out of the home. Residents are being really well cared for and supported in the home. Residents are cared for by staff who are caring and kind to them and work very hard to try and meet their needs. Residents take part in a range of really innovative and suitable social and therapeutic activities. Residents can enjoy a varied and well cooked choice of meals. The environment is well suited to the needs of the residents. There are adaptations in place through the home. Staff are offered a commendable range of training opportunities. This helps them gain a really good understanding of the residents in their care and how best to support them. This training is extended to non-care staff such as the domestics and the cook, as they also have regular close day to day contact with the residents. The home is really well run and is run in the best interests of the people who live there. What has improved since the last inspection? This is not applicable as the requirements set at the `random` inspection were not reviewed on this inspection. What the care home could do better: We did not set any requirements at the inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: St Brigas 2-3 Jesmond Road Clevedon North Somerset BS21 7SA     The quality rating for this care home is:   three star excellent 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: Melanie Edwards     Date: 1 6 1 1 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 28 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 28 Information about the care home Name of care home: Address: St Brigas 2-3 Jesmond Road Clevedon North Somerset BS21 7SA 01275870653 01275879900 stbrigas.culley@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs June Lloyd,Miss Anne Ball,Mr David Whitehouse,Mrs Lynne Whitehouse care home 17 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home St Brigas provides care and support to seventeen people who have learning disabilities. Situated on a hillside overlooking Clevedon, it comprises two Victorian houses. One quarter of the accommodation is used as an activity centre for people with learning disabilities and is not regulated by the CSCI. The accommodation is located over three floors and access is by means of various staircases. The lounge and dining room overlook the well maintained garden at the front of the building. The home is located close to a park and the town centre is 10 minutes walk away. Four partners own St Brigas, one of whom is the manager, and another provides the maintenance support. They meet regularly to review and discuss the home. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 17 17 Brief description of the care home The current range of charges is 340.07pounds to 1138.48 pounds (figures taken from recent account records). Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Please note due to their disabilities some of the residents have communication difficulties. We met ten of the residents living at the home. We met the manager and one of the owners of the home, Mrs Lyne Whitehouse who owns the home with her husband. We met four support workers, two domestic staff and the cook. We talked to them about the work they do and what they do to assist and support residents. Staff were observed assisting residents with their needs. We looked at a selection of records relating to the daily running and management of the home. We looked at the statement of purpose, two care plans, two assessment Care Homes for Adults (18-65 years) Page 6 of 28 records, six medication records, menus, the complaints book, staff duty records,staff training records, three staff members employment information, supervision information, accident records, fire records and information about quality assurance in the home. We walked around the environment both inside and outside. We have used the aqaa, an annual quality assessment document,that all homes are required to complete has been used to help form the judgments in the report. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the home. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 28 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 9 of 28 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. The care that residents need is being planned and worked out really well. This means people get the right sort of support when they move to the home. The information that is available to inform people about the home is really useful and up to date. Evidence: We read a copy of the service users guide and statement of purpose to find out what sort of useful information is available for people to know what sort of care and service the home provides. We found the information in the statement of purpose is detailed and helpful. We saw photos included, as well as the aims and objectives of the home and the type of care that people can expect. We saw the name and contact details of the owners, the experience of staff and the manager of the home are also included. This information helps the reader to understand how the home will aim to support and care for people who live there. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: We read some useful and simply written information in the service users guide.This helps people to know about the care and daily life in the home. There is a website that tells people about the home and useful information about the service provided. We read two residents assessment records to see how they are supported to meet their needs. Assessments are the information that the home use to plan and work out the right sort of care and support that the person may need. We saw detailed assessments of the physical, mental health and social needs of each person has been carried out. The assessments included a personal profile about the person. This includes the persons life history, mental health history and information about family and friends. We saw that the assessment records included information about how to promote the independence of the person in their daily lives. The assessment records had been evaluated and updated on a regular basis. This helps show that the home have a really clear idea of the right sort of care and support to give to the residents, as well as how to give it. We read some really useful information in the aqaa document about how the home ensure that the views of people who use our services are promoted and incorporated into what they do: We have residents meetings, keyworker and resident meetings. We have in house reviews, social services reviews and we work with families. Care Homes for Adults (18-65 years) Page 11 of 28 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. Residents care plans clearly show the support and care that each person needs. Residents are being well supported in their daily lives. Residents are being supported to take risks in their daily lives. Evidence: In our discussion with all of the staff we met, we were told that one of the main aims of the home is to actively promote residents rights and to encourage them to develop their independence in their daily lives. We were told a really good example of this, which is that that residents go on regular holidays and short breaks abroad and to London. We saw detailed evidence that residents are really well involved in the choice of meals served in the home. Residents are well supported and have regular house meetings, they set their own agenda and discuss what they feel matters. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We read some really helpful information in the aqaa document about how residents individual needs and choices are promoted in the home : We are prompt to identify individuals changes of needs and to identify risks around the change of need; we support individuals in a calculated risk. If it means that the resident wishes to continue to live at St Brigas and there could be risks we would work with the appropriate professionals to limit risk and enable the person to live and participate in the life style they choose. Residents have user friendly action plans, made up with themselves and others involved in their care. We saw detailed information in residents care plans that showed us staff support residents very well to maintain their independence in daily living activities in and out of the home. This shows residents are well supported by staff to make decisions and keep independence in their lives. We read two residents care plans so that we could find out how residents are supported to meet their care needs. We found that the care plans contained a really helpful amount of information about each persons range of needs and what to do to help them meet those needs. We saw a good level of information in the care plans about the life history of the person and what matters to them, such as important family and friends. We saw that the care plans had been reviewed and updated regularly. This demonstrates residents needs are clearly identified and the home can still give the best help and support to each person. We saw evidence that the residents had been involved in writing their care plans. Care Homes for Adults (18-65 years) Page 13 of 28 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. Residents are really well supported to do a really good variety of different therapeutic activities. Residents are well supported to be a part of the community and to have personal relationships in their lives. Evidence: Mrs Whitehouse explained that there is a relaxed and flexible policy for residents who wish to meet visitors. We were told that residents are supported by staff to keep in touch with people who matter to them. We saw this information explained in the service users guide. We met two visitors who told us staff are really welcoming to them. We saw art works on display through out the home. The home has its own art room Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: and there are voluntary arts and crafts fund raising projects taking place involving residents and staff. These are really good examples of how residents are encouraged to take part in meaningful activities. There are pigs being cared for at Mrs Whitehouses home, this is a really good example of a therapeutic activity for residents to be part of if they want to. Residents visit the pigs and we saw photos of them on display in the home. We looked at a copy of the current records of meals that residents have eaten over the last four weeks. We saw there were a variety of dishes recorded as available for each day. We saw a daily menu in the dining room telling people what meals were going to be served that day. We also saw a notice board where people can tell the cook what meal options they like, or do not like. The residents told us that the cook comes and asks them what meals they would like on a really regular basis. This is a really good way that residents make choices in their daily lives. We saw a varied choice of meal options available for the residents. Meal choices included a range of traditional, nutritional meals. The lunchtime meal of a variety of freshly prepared sandwiches looked tasty and appetising. We read some really useful information in the aqaa document about what the home do to ensure residents live a varied and fulfiing life:Individuals have their own health action plans, as well as care plans and activity plans. These are worked out with the individual and any one involved in their support. Individual timetables in all formats are around the living area to enable a person to ask what is on their plan, some people have them in their rooms. Individuals have communication passports and an all about me section for information that needs to be available to any one involved in their care. Visitors, health professionals and people in the community can communicate on the level preferred by the resident which helps to keep hospital, dental and other appointments less stressful around communication. We make sure that all of our residents have sessions to participate in that meet their preferable choices. We like to access many areas in the community including cinema, swimming pools, pubs and other local amenities. Each individual that attends the day centre also have an individual progress report where we can monitor their progress and set new targets. We have pictorial sheets for cereals and spreads, with eight different choices on each encouraging residents to make a choice. The home has relevant information for our residents in a user friendly format. Care Homes for Adults (18-65 years) Page 15 of 28 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. Residents health and personal care needs are met. Residents medication is looked after safely. Residents are really well cared for. Evidence: To find out some more about how residents are supported to meet their care needs we read two care plans. We found that there was really helpful information in both care plans. The care plans showed how to give the right support and care for the residents, who have very complex learning disabilities. We saw that care plans had been reviewed and amended regularly. This show us that the home keeps a really, close eye on residents needs to make sure they can still give them the right support and care. We saw all of the staff on duty help and support the residents in a kind and sensitive way. We also discussed with the staff the care needs of the residents. The staff demonstrated that they had a really good understanding of residents range of needs. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We looked at the way that residents medication is given to them, stored and disposed of to see if this is done correctly. We looked at the medication administration charts of five residents. The medication administration charts were legible up to date and had the signature of the staff giving out the medications. This helps demonstrate medication is given to residents safely. We also saw extra information written by the staff at the home explain the ways that people like to take their medications, as well as what they are for. This information should mean residents are given medication in the way that suits them best. The stock of medication we saw was satisfactorily organised. We saw that staff sign in medications amount and quantity in a record, to show that medicines have arrived at the home from the pharmacy and that they are stored safely. We saw the staff help and support the residents in a really kind and sensitive way. We were told by visitors that they are extremely satisfied with the care that is provided. We saw staff helping the residents in the way that is explained in peoples care plans. This helps to show staff are provide residents with the right care that they need. We read some really helpful information in the aqaa document about how residents health and personal care needs are well met . We have quoted this extract:We have regular staff training for and around medication. Helping persons to access all relevant health checks flexibility in the staff team to enable individuals have the person they work well with around health issues accompany them to appointments. If it is in our residents care plans that they need particular personal support i.e. having their hair coloured or nails done we arrange and accompany them to these appointments. We dye a couple of our ladies hairs in house monthly. One of our ladies visits the nail parlour monthly which she finds therapeutic, another one of our residents look forward to visiting the hair dressers for highlights and a cut.We have health action plans, health records and traffic light system for hospital staff to work to around the needs of individuals show that we do these well. Our residents feedback and excitement toward treatments show that we are meeting their needs. It is in our residents care plans on how to tailor each individual personal health care treatment therefore successfully providing them with the personal support they need. Care Homes for Adults (18-65 years) Page 17 of 28 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. Complaints about the service are dealt with really well. Residents are safe and well protected from abuse Evidence: We checked the complaints records to see how complaints are dealt with by the home. There had been a number of complaints made by residents about other residents since before the last inspection. We could see from the information we read that residents are listened to and given a chance to make their views known. We also saw that where needed action is always taken by the home. In our discussions with staff who we met, they conveyed to us a really good understanding of the importance of supporting residents to make their views known, if they are unhappy about any aspect of life in the home. All of the residents who we met said they could talk to the staff if they need to. We saw a copy of the complaints procedure kept in the home. This has our contact information as well if people need to get in touch with us We were told that there are regular residents meetings. The meetings are used as a way for residents to make known any complaints they may have. This is a way residents take control in their lives and can make complaints if they need to. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We saw a copy of the homes policy relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. The staff do training courses in understanding the principle of the protection of vulnerable adults from abuse. The staff we spoke to had a good understanding about the subject of abuse and how they protect residents in the home. Care Homes for Adults (18-65 years) Page 19 of 28 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. Residents live in a home that is safe and homely and well maintained. Evidence: St Brigas is a converted residentail builidng that is near to private houses and a short distance from the town of Clevedon. It is near to bus stops into the city centre of Bristol, this helps residents to be a part of the community and to enjoy life away from the home if they want to. We saw that the home looked clean and tidy in all areas that we saw viewed. The building is wheelchair accessible, we saw that there are different types of adaptations in place to help assist residents and visitors with disabilities throughout the building. However there is no lift to get to the first floor. We saw that the bathrooms have specially adapted baths to assist residents who may have reduced mobility. Toilets are in close parts of the home near to communal areas and bedrooms. The bathrooms and toilets were very clean and were well stocked with hand towels and soap to help minimize risk from cross infection. Residents looked very relaxed and comfortable in their surroundings. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Bedrooms looked individual and personal with residents personal items and photos in them. We saw furniture and fittings provided including a wardrobe a comfortable chair a bedside cabinet and a chest of drawers in each room. There are bedrooms on the ground and first floor. The home is set in its own grounds. The gardens are satisfactorily maintained and there are patio seats where residents can sit Two residents showed us their bedrooms and said they liked them. The bedrooms were satisfactorily clean and tidy. The standard of the decoration and the quality of the fixtures and fittings was satisfactory. The kitchen is open plan design and is next to the dining room. It is a domestic in style design and was very clean tidy and organised. There are toilets and bath facilities located within close proximity of the rooms on each floor which is convenient for residents use. There is a laundry room. It contains washing machines and a tumble dryer. This helps to minimise the risk of cross infection in the Home. Staff demonstrated a good understanding of procedures to minimise the risks of cross infection in the home and wore gloves and plastic aprons when needed. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by an effective staff team. Residents are supported by staff who do a commendable range of training. Residents benefit from staff who are supported and supervised in their work. Evidence: We checked the staff duty record for the last four weeks to see how many staff there is on duty at any time to support residents. There are a minimum of six support staff on duty as well as at least one senior member of staff working during the day. There is extra staff available at busy periods. There are two support staff who work at night and an on call manager available if needed. Mrs Whitehouse works full time hours. The number of staff on duty each day is flexible and adjusted depending on what activities, appointments, or events residents are attending that day. This is really good evidence of how the staff team work flexibly to the needs of the residents. We did not check the number of catering domestic and ancillary staff however we saw these staff carrying out their duties during the inspection. We observed all of the staff who were on duty have clearly built up warm and very Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: positive relationships with residents. The majority of the staff team have worked at the home for a number of years and enjoy really close supportive relationships with the residents they care for. We checked the recruitment information of three staff to see if the home carries out employment safety checks before they recruit new members of staff. We saw written confirmation that all new staff have a criminal records bureau check undertaken to confirm that they are suitable to work with vulnerable people. We also saw evidence that two references are taken up before a person can start work at the home. Staff have been on a range of study days in subjects relevant to the needs of residents. Study days that staff have been on include a range of topics designed to help them support the residents effectively. The staff team including the domestics and the cooks have been on training course to help them respond positively to residents if they get distressed or angry. This is commendable as it means all of the people who work at the home will be able to respond in a consistent and safe way to the residents who live there if they are distressed or really angry. The staff do training in food hygiene first aid and fire safety. The majority of the staff have done national vocational qualification in care awards to level two, or level three. Mrs Whitehouse and the deputy manager supervise the staff in the home. We did not look at supervision records on this occasion. However based on the discussions with the staff on duty it was evident that the staff are really well supported. This clearly benefits residents if staff are supported. We read some really helpful information in the aqaa about the effectiveness of the staff team and we have quoted this extract:A good training plan each year designed around staff and resident needs, our staff are dedicated and have worked along side each for a number of years. Some of our staff have been here for ten years and more. The residents are well, happy and have a good structured activity plan as well as leisure where they are supported by staff they have also known for a long period of time. If our residents attend extra activities and trips we provide extra staffing like we do for trampoline club twice a week. Staff show evidence of effective communication via the communication book. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is really well run. The overall standards of care and service in the home is monitored and reviewed regularly. The health and safety of residents and staff is satisfactorily protected. Evidence: Mrs Lyn Whitehouse has been the manager and owner of the home for over ten years. She has a significant amount of experience caring for people with a range of needs and learning disabilities. She is registered with us as the manager of the home. Mrs Whitehouse is supported in her work by her husband, who overseas day-to-day matters to do with the running and up keep of the home. She is further supported by a deputy manager. This demonstrates she is fit and competent to be the manager. The staff also told us that Mrs Whitehouse was really approachable and they could go to her with any concerns at anytime. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Mrs Whitehouse runs regular managers meetings with other managers who run care homes in Clevedon. This is a really good way for managers to get support from each other and to keep up to date with current practice to do with care homes. As already mentioned residents there are residents house meetings and residents can set an agenda and talk about what ever they want to. This is a good example of the open management style in the home. We saw a good system for monitoring the quality of the care and the service that residents receive. We saw the information that had been obtained from a recent in house, as well as external survey involving relatives and significant others. We saw that residents are well consulted about a varied range of matters to do with the service. An annual newsletter is written each year about the previous years main events in the home involving the residents. There are photos of residents engaged in various therapeutic activities during the year. This is for residents and significant people in their life such as their families. We found that the environment looked safe and satisfactorily maintained in the areas we saw. We saw detailed and up to date health and safety risk assessments done about the home environment. This information is used to keep people safe in the building. The staff do regular training food safety. This is a really good way for staff to help residents to prepare and cook food in a safe way. We saw records that showed staff check the temperatures of all high-risk cooked food before it is served to people to make sure it is hot enough and safe to eat. The staff do training in health and safety matters including first aid, infection control and fire safety. This should help protect residents if staff are knowledgeable and well trained in health and safety principles and practices. We checked the fire logbook record and we saw that the required weekly and monthly tests of the fire alarms and the fire fighting equipment are being carried out and are up to date. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 27 of 28 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. 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