Care Home: St Michael`s Lodge

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What the care home does well The people tell us that they like living at the home. One person felt that the food was `good` with `plenty to eat`. Another person says that they get on well with other residents and is `happy` with the staff and if they had any complaints, they would see the manager. Other comments include `I am very happy`, `I like my bedroom`, and `I like the meals`. It was also said `I am `very comfortable` and `happy` with their room and staff and if `I have any concerns I talk to the manager or staff`. The comments received from the questionnaires were very positive about the home, the food and the staff and the manager. The home undertakes people`s needs assessments to make sure that they are able to meet the person`s needs before coming to live at the home. Relatives and the people are invited to visit the home and meet the staff and other people in the home. The staff spoken to on duty say that they enjoy working at the home and it was said the place was run as a family home. The staff say that they get good training to help them meet the people`s needs. They were observed talking and listening to the people in a respectful manner. What has improved since the last inspection? The home has bought a Mini Bus to help take people out in the community. No smoking policy in the home was discussed so all the people`s needs are met. A canopy was being purchased for the garden for the people to use when smoking out in the garden. Staff have now received more training so they can look after the needs of the people better. The main lounge down stairs had new chairs, a television, some furniture and the flooring was replaced. Two Bedrooms were decorated and completely refurnished and two Bedrooms were decorated and carpeted. A corridor carpet was replaced in one area. The hole in the laundry room had been repaired. Radon and asbestos testing had been undertaken and a fly screen to the kitchen window was purchased. What the care home could do better: The home should:Ensure all staff receives at least 6 supervisions per year to monitor how they are meeting the needs of the people. Provide `residents` meetings so the people are able to discuss choice of menus and activities that they would like to get involved with in the home and in the community. Review the care plans and risk assessments about the people so the staff have up to date information to meet their needs. Ensure care plans are updated when there is a change in a person`s well being so that the staff have the correct guidance to meet their needs. Ensure regular fire drills are carried out to keep the people safe. Ensure risk assessments are carried out for the radiators to keep the people safe. Key inspection report Care homes for adults (18-65 years) Name: Address: St Michael`s Lodge 6-8 St Michael`s Avenue Northampton Northants NN1 4JQ     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: Ansuya Chudasama     Date: 1 2 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 32 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: St Michael`s Lodge 6-8 St Michael`s Avenue Northampton Northants NN1 4JQ 01604250355 01604638496 a.gowing@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Anne Going,Mr Kenneth Going,Mr Raymond Galbraith,Mrs Marian Galbriath Name of registered manager (if applicable) Mr Raymond Galbraith Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The home may continue to provide care for 2 existing named service users under 45 years of age The Home provides care for Service Users in the Age category of 45yrs to 65yrs and 65yrs and over. Date of last inspection Brief description of the care home St Michaels Lodge is a care home providing care and accommodation for 13 service users with Mental Disorders excluding Learning Disabilities and Dementia. Mr K. and Mrs A. Going and Mr R. and Mrs M. Galbraith own the home. Mr R. Galbraith is the Registered Manager. Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 13 2 5 0 2 2 0 0 9 Brief description of the care home The home is situated within easy access to the local shopping centre and near the town centre. The home was opened in 1989 and consists of a large Victorian three-storey building providing two double bedrooms and seven single rooms. There are two lounges and a dining room and service users have access to the rear garden. The home has a no smoking policy but the people can smoke outside in the garden. The home has a stair lift to the basement floor but this needs replacing as it is old and does not meet the peoples needs. Care Homes for Adults (18-65 years) Page 5 of 32 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 inspection was carried out in accordance with the Care quality Commission (CQC) policy and methodologies which require review of key standards for the provision of a care home for Younger people that takes account of the peoples views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. At this inspection we had an Expert by Experience person. This is a person who, because of their shared experience of using services and or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Their feed back is also used in this report. The report refers to we this is because the report is written on behalf of the Quality Care Commission. Care Homes for Adults (18-65 years) Page 6 of 32 We last inspected this service on the 25th of February 2009. The home completed an Annual Quality Assurance Assessment (AQAA) which is a self assessment tool that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The surveys sent to the home by the Care Quality Commission were completed by the people using the service. During this inspection we tracked the care of two people who use this service. This involved reading their care records and also talking to them wherever possible to obtain their views on the service. We also spoke to most of the other people who live in the home. Documentation relating to staff recruitment, training, supervision, medication administration, and complaints and health and safety were also examined. We had the opportunity to talk to some of the staff who were on duty and a tour of the home was also conducted. We are told that the current weekly fees range from £348 per week and a copy of the service user guide is given to the people when they are being admitted to the home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: The home should: Care Homes for Adults (18-65 years) Page 8 of 32 Ensure all staff receives at least 6 supervisions per year to monitor how they are meeting the needs of the people. Provide residents meetings so the people are able to discuss choice of menus and activities that they would like to get involved with in the home and in the community. Review the care plans and risk assessments about the people so the staff have up to date information to meet their needs. Ensure care plans are updated when there is a change in a persons well being so that the staff have the correct guidance to meet their needs. Ensure regular fire drills are carried out to keep the people safe. Ensure risk assessments are carried out for the radiators to keep the people safe. 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 32 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 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are assessed to ensure that the service can meet their needs. Evidence: The home has a copy of the statement of purpose and a service user guide. One person told us that a copy of the service user guide was given to them when they come to live at the home. The information on how much it costs to stay at the home and additional expenses not covered in the cost of staying at the home was not recorded in the documents. The other homes manager stated that she was going to update both documents and include this information. People spoken to told us that they had visited the home with their family member or with a social worker. All the people said that they wanted to live at the home. The manager of the sister home had also visited some of the people in their own homes and asked them to visit the care home to meet the staff and other people. This was also to give the people the opportunity to find out if the home was suitable to meet their needs. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: The AQAA says that Pre-Assessment includes family & health professionals involvement by all being present at assessment. This ensures that a balanced & professional assessment takes place. Assessment information also includes history from Care Management, Psychiatrist & G.P. It also says We offer a graduated admission procedure where residents can become accustomed to the home environment, making transition into the home easier and have a trial period of three months. All the people in the home have contracts. This is to ensure that they know about their rights and responsibilities of staying in the home. The home has contracts with the funding authorities for all the people placed by them and these are reviewed annually when reviews are carried out by the care management team. Care Homes for Adults (18-65 years) Page 12 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are not always being updated when needs change to provide staff with the information needed to satisfactory meet the peoples needs. Evidence: All the people living in the home had care plans. Some of the people informed us that they had care plans but there were some people who said that they did not know what these plans were but it was said that the staff speaks to them about this plans. The AQAA says that Care plans are formulated with information re residents history obtained from healthcare professional, family & resident & then continually monitored. The plans and risk assessments seen were not being reviewed when a persons needs changed. We were told by the manager that all the plans and risk assessments were being reviewed in a new format and changes in a persons needs would be updated when Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: this happened. The staff did however record information on a daily basis about each person regarding what they did each day. The staff spoken to on duty were able to tell us how they met the needs of the people living in the home. The AQAA says for our plans for improvement in the next 12 months is for Care plans to be more person centred and have Staff training in Person Centred Approach Care. Care Homes for Adults (18-65 years) Page 14 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people are given the opportunity to take part in a variety of activities but this process could be further improved to ensure all the people are involved in making decisions about daily activities. Evidence: The expert by experience person spoke to several people living in the home to see how they are being looked after by staff, and how they were being involved in the running of the home. They also looked at meal times and activities that are carried out to provide stimulation for the people. Below is a summary of those interviews: One person spoken to had been living at the home for 15 years. The person felt that the food was good with plenty to eat. They go out daily to help in a local pub and enjoy their social life. The person was unaware of their care plan and said that they Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: would not attend regular meetings with other residents and would not be interested in education opportunities. We were told if they had any complaints, they would speak to the manager or another member of staff and they assured us that they felt good. Another person spoken to said that they had been a resident at the home for about 3 years. The person felt that the food is good but that there could be more fresh fruit available and would also like more choice on the menu, They felt that regular meetings to discuss menu choice etc, would be a good idea. The person says that they get on well with other residents and is happy with the staff and if they had any complaints, they would see the manager. Recently they went to a pantomime and would like more opportunities to attend organised days out. Following a recent visit to their GP the person is happy with their medication and would like to think that they could work towards independent living. A new person admitted to the home was spoken to and we were told that they were settling in very well saying its the best place I have lived. The person feels the staff are ok and that the food is well cooked. The person goes out about three or four times a week to a workshop dealing with agriculture, office skills and contracting and is pleased that the local community is very friendly towards them. The person said that they had seen their GP for a while but they were happy with their medication. The person told us that they would not be interested in attending regular meetings with other residents but they would like to go on arranged outings in the community. Another person spoken to has been living at the home about ten years. It was said that the person is very comfortable in their home and is happy with their room and staff. The person attends a day centre and is very happy with their daily routine. The person told us that they are comfortable with other residents and staff and are not interested in further education but they would attend residents meetings. Other comments received from the people included, would liketo see a show, go to the seaside and Wickstead Park. It was also said they wanted more choice of hot meals, vegetables, and choices at tea time. The people in the home are given a key to the front door of the house and to their bedrooms to promote their independence. We are told that friends and families of the people living at the home are welcome at the home and the people are able to use the privacy of their room to have private time with their visitors. Some of the people in the home maintain contact with their families and visit them. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: The home has purchased a minibus for out door activities and the people are also are supported to apply for bus passes for the local transport to increase peoples independent living skills. We discussed with the manager about the residents meetings. The manager informed us that they used to have these meetings but it was said that the people did not attend, however she was going to start this again The AQAA says for what we could do better is to have More residents meetings and Find ways to improve residents motivation to join in activities. Ask residents what they want to do & how they want to do it. Re-introduce Bingo Sessions, Cake making, DVD nights, Board Games. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The peoples personal and health care needs are met by the home. Evidence: The AQAA says what we do well is provide emotional & psychological support, which is flexible to meet individual residents needs. Monitoring of physical & mental health is recorded by carers & referrals made to Mental Health Team, G.Ps, Care Managers or Specialist as required. The people spoken to confirmed that when they felt unwell they told the manager or the staff and they make an appointment for them to visit the GP. There was information in the peoples file to state how their personal and health care needs were being met. There are records of doctors and hospital appointments, and people have access to the district nurse, opticians, dentists, general practitioner, and other health care professionals. There was information on medication reviews and mental health reviews being carried out by health professionals. The AQAA says that carers receive appropriate medication training including basic knowledge of how Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: medicines are used & how to recognise & deal with problems. Written consent from all residents is received by the home for members of staff to re-order, store & administer medication prescribed by health professionals. There was evidence in the care files to show that the people had completed the medication consent form. The people spoken to told us that they were happy with their medication and felt happy. Two staff gave out medication to ensure that no errors are made. Staff records and staff spoken to confirmed that they had all received the medication training. Medication administration records (MAR) showed that the staff were signing the MAR sheet when giving out medication. Information read in one persons file showed that they had made the decision to stay at the home and not to be taken to a nursing home for their final days. It was said that they wanted to die in their own home. The home had accessed the specialist health professionals when caring for the person in the home. Care Homes for Adults (18-65 years) Page 19 of 32 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. Concerns raised are listened to and acted upon by management to ensure the peoples needs are met. Evidence: The home had a complaints procedure and this had not been updated since 2006. The manager informed us after the inspection that the complaints procedure had been updated with the relevant information. The AQAA says that We act immediately on any concerns. Residents speak on a one to one basis with members of staff or come directly to the manager who is easily accessible as she has contact with residents on a regular basis. All the people in the home were able to communicate verbally and those spoken to told us that they knew how to make a complaint to the manager or a member of staff if they were not happy. The manager told us that they had not received any complaints and had not made any safe guarding referrals to social services. The staff in the home had received training on safeguarding of vulnerable adults training. The staff spoken to informed us that they had completed the safe guarding of vulnerable adults procedures training. They had good understanding of this and understood the peoples behaviours to know if they were unhappy or not feeling well. Care Homes for Adults (18-65 years) Page 20 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent investments has greatly improved the appearance of the home and therefore creating a more comfortable environment for the people living at the home. Evidence: The home is situated in a residential area within easy walking distance to the shops and the local communal services. The home has eight single rooms and two of these rooms have en-suite facilities and there are also two double rooms. There are two lounges, a dining area, two communal bathrooms, a shower room, 3 separate toilets and a laundry room. There is a garden with patio area with tables and chairs. A tour of the home showed that the standard of house keeping is good with staff cleaning and tidying the peoples rooms and taking care of their laundry. The radiator in one bedroom and in the kitchen was very hot. . The hot water in some rooms was very hot. We were told by the manager that this was being sorted out today by the plumber. One bathroom door did not open properly. The staff toilet had no hot water and the tap was broken. The room needed painting. The hot water tap in the laundry room was not working, the room needed decorating. The hand rail on the main stairs to the dining room and lounge was loose. The small lounge was being decorated and a Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: television was being put in this room. The main lounge down stairs had new chairs, a television, some furniture and the flooring was replaced. Two Bedrooms were decorated and completely refurnished and two Bedrooms were decorated and carpeted. A corridor carpet was replaced in one area of the home. The hole in the laundry room had been repaired. Radon and asbestos testing had been undertaken and a fly screen to the kitchen window was purchased. The fire alarm went off at the time of the inspection and staff had to climb on to a chair to open a window. We were told that the ventilation was not good in the kitchen. We were told that this was being sorted by the manager. We were told that the lift was not used any longer because it was old and needed replacing. The home was recently inspected by the Environmental Health Officer (EHO) and requirements and recommendations were made for the home to undertake to improve health and safety in the home. We were told by the manager that these requirements had been met and evidence was produced by the home at the inspection. The AQAA says that our plans for improvement in the next 12 months is to have a Canopy for smokers outside area; and Decorate & re-furnish 2 bedrooms & laundry room, Decorate & new carpet in hallway & stairs. We were told that a no smoking policy for the house had been discussed with the people to ensure all the peoples needs were met. The people spoken to were in agreement of smoking outside the home and did not smoke in the home. The manager was in the process of getting a smoking canopy for the garden. Care Homes for Adults (18-65 years) Page 22 of 32 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. staff are provided training to ensure that they have the skills to meet the needs of the people. Evidence: The staff recruitment files were looked at in detail evidence showed that the home was obtaining all the relevant information required to safe guard the people in the home. The AQAA says We have 13 members of care staff. Of which 2 have achieved NVQ Level 3 & 7 have NVQ level 2. The manager informed us that all new staff would be doing NVQ training when they start employment. All new staff had started doing the skills for care induction training. The manager had booked refresher mental health training for all staff on the 1st of February 2010. Records showed that the home has a low turnover of staff and do not use agency staff. The staff tell us that they work well together as a team. It was said that they know the people very well and enjoy working at the home. It was also said that training was good and the manager was supportive. Records showed that not all the staff were receiving regular supervision with the manager. However we were informed that the manager was attending supervision Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: training and all staff would be receiving one to one monitoring by the manager after the training. The Manager did however speak to staff on a day to day basis about the people and what was happening in the home. . The AQAA says how we have improved in the last 12 months is by having staff training on Adult Abuse Awareness & POVA, Basic Food Hygiene, Handling & Administration of Medicines, Managing Challenging Behaviour, Emergency First Aid, Health & Safety for Carers, COSHH, Fire Training, Risk Assessment for Carers. The AQAA says Our plans for improvement in the next 12 months: is to have 2 Carers to commence NVQ Level 2 & 2 Carers to commence level 3, Mental Health Training, Infection Control Training, Equality & Diversity Training, Care Planning Training, Improve staff recruitment procedure to be more robust, Manager to do Supervision training, More staff meetings to improve communication. Care Homes for Adults (18-65 years) Page 24 of 32 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. Management has improved the systems to ensure that the health and safety needs of the people are met. Evidence: The registered Manager who is also one of the proprietors of the home has been working at this home for 23 years. The manager has NVQ level 3 in care. The manager stated that they will not be undertaking NVQ level 4 in management. However it was said that the registered manager form the other sister home who already has NVQ level 4 in management will be running the two homes in the near future. The manager said when this happens, they will become the deputy manager of the home. We were told that the manager from the sister home was going to write to the commission to explain how these new management arrangements were going to operate for the two homes. The manager says that they work well with the staff and they have daily contact with the people living in the home. This was observed on the day of the inspection. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: The staff and the people say that they like the manager and if they had any problems they would speak to the manager. One staff said the manager is very good and they listen to us. Most of the people said that if we have any concerns we talk to the manager. The home had undertaken a service users survey since the last inspection. The information read was very positive about living at the home. We are told that the home gets Thank you letters & feedback from families & residents It was said that they had good working relationship with the G.P surgery and Mental Health professionals and the families of the people. The accident and incident book showed that these are recorded satisfactory. The Fire Officer had visited the home on the 25th of February 09 and this was satisfactory. A risk assessment for the home was also completed. The home was undertaking monthly emergency light testing. Weekly fire drill was being undertaken on a monthly basis. This was discussed with the manager and it was said that they were not aware that this had to be done on a weekly basis but agreed that this would take place on a weekly basis. The manager informed us that a plumber was visiting the home on the day of the inspection to sort the hot water and radiator temperatures to ensure the people are kept safe in the home. The manager also informed us that they had not carried out regular fire drill practices but it was said that this would happen every three months. The names of the people involved and time taken was not recorded. The fire escape doors had no signs. The manager said that they would sort this out. Care Homes for Adults (18-65 years) Page 26 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 The people must be involved 17/06/2009 in drawing up their care plans and when they are being reviewed This is to ensure that the people are aware how their goals and aspirations will be met 2 16 12 Personal information about the person must not be recorded on the kitchen board This does not maintain the persons dignity and privacy 17/05/2009 3 24 23 All areas of the home must be kept in a good state of repair and reasonably decorated. This is to ensure people live in a homely enviroment 30/09/2009 4 24 23 (2)(b) (d) All areas of the home must be kept in a good state of repair and reasonably decorated. 30/06/2007 5 33 18 The staffing rota must be 30/05/2009 reviewed to ensure that there are adequate numbers of staff on duty. This is to ensure that the Care Homes for Adults (18-65 years) Page 27 of 32 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 needs of the people are met and they are not put at a risk. 6 35 18 Staff must be provided with the training as stated in the report. This is so they have the skills to look after the people that they care for. 7 39 24 The AQAA must be completed by management when asked for by CSCI. This is so that we are aware of how the home is managing the needs of the people and information that we need is obtained for monitoring purpose. 8 39 24 There must be systems in 18/06/2009 place including the seeking of the views of the people that live in the home, that management then act upon and subsequently change the delivery of care. This is so that the people influence the running of the home. 9 42 13 The tap in one of the bathrooms must be repaired and the water temperatures must be monitored and maintained and be set This is to ensure the people are kept safe from any risks. 10 42 13 The fire doors must be kept 30/04/2009 Page 28 of 32 30/06/2009 30/04/2009 30/05/2009 Care Homes for Adults (18-65 years) 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 closed at all times unless there are fireguards put on. This is to ensure that the people are protected from any risks to their health and safety. 11 42 13 The no smoking areas in the house must be kept odour free from the odours of tobacco smoke. This is to ensure that the people and staff are protected from passive smoking. 12 42 13 A risk assessment must be 20/05/2009 undertaken for a radiator that is next to a persons bed This is to ensure that the person is kept safe from any risks. 30/04/2009 Care Homes for Adults (18-65 years) Page 29 of 32 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 6 15 Care plans must be updated when a persons needs change. This is to provide staff with the information needed to satisfactory meet the peoples needs. 20/05/2010 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 2 8 24 Ensure risk assessments are updated when a persons needs change to meet their needs. Ensure that the hot water taps in the home are all working to meet the peoples needs and maintain their health and safety. Ensure that the hand rail on the main stairs to the dining room and lounge is fixed properly to keep the people safe. Ensure a risk assessment is undertaken on the two radiators identified at the inspection. This is to ensure the people are kept safe. Ensure staff receive regular supervison to monitor how they Page 30 of 32 3 4 24 24 5 36 Care Homes for Adults (18-65 years) 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 are meeting the needs of the people. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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