Care Home: St Peters (Flat 24)

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What the care home does well People live in a clean, comfortable and homely environment so they are comfortable and safe in their surroundingsPeople are supported by staff who are trained and get good support to do their job and meet peoples needs.People are supported to do things they enjoy, go on day trips and holidays so they live fulfilled lifestyles.People all have a care plan that is kept up to date and tells staff how their needs should be met.People are supported to eat a variety of foods to help them keep healthy.Safety checks are completed so the Home is safe for people to live in. What has improved since the last inspection? Staffing levels have improved a little and a deputy manager has been employed so there will be more opportunity for people to go out and do things they enjoy.Parts of the home have been painted so it is more comfortable and welcoming for people.A new television has been provided in the lounge so people can enjoy watching the television programmes they like. What the care home could do better: Decisions people make or are made in their best interests should be recorded and the reason why.The physical lay out of the Home does not ensure that people`s privacy and dignity needs are well met. Key inspection report Care homes for adults (18-65 years) Name: Address: St Peters (Flat 24) College Road Saltley Birmingham West Midlands B8 3TF 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: Donna Ahern Date: 2 0 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 33 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 33 Information about the care home Name of care home: Address: St Peters (Flat 24) College Road Saltley Birmingham West Midlands B8 3TF 01213274613 F/P01213274613 yvonne.thomas@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dawn Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 3 Date of last inspection 2 2 1 0 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Flat 24 St Peters is registered for three adults who have learning disabilities. Mencap are the Registered Providers. There is level access into the property. The home has two bedrooms and a lounge. There is a kitchen/dining room and bathroom with W.C. The home does not have a private garden area; there are communal grounds that are shared with other properties. Each of the people living at the Home had a copy of the service user guide and details of fees start from three hundred up to eight hundred pounds per week. Care Homes for Adults (18-65 years) Page 5 of 33 There is a range of information available on display in the hallway for visitors to read including a copy of the last inspection report, complaints and safeguarding information and a copy of the Homes improvement plan. Care Homes for Adults (18-65 years) Page 6 of 33 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 Care Homes for Adults (18-65 years) Page 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home One inspector visited the Home to carry out the inspection. We visited the Home over one day. The Home did not know we were going to visit. Before we visited we asked the Home to send us information about the Home, this is called a annual quality assurance assessment (AQAA). Three people live at St Peters and we met with all of them. We looked at Peoples care plans, daily records and health care records. This is called case tracking. Care Homes for Adults (18-65 years) Page 8 of 33 We also looked at parts of the Home to make sure it was clean and safe for people. We looked at health and safety records and staff records to make sure the Home was being well run for the people living there. We sent three surveys to people who live at the Home and six to staff. Three were returned from people living there and two from staff. The surveys ask people about their views of the Home, comments we received are included in the report. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 33 People live in a clean, comfortable and homely environment so they are comfortable and safe in their surroundings People are supported by staff who are trained and get good support to do their job and meet peoples needs. People are supported to do things they enjoy, go on day trips and holidays so they live fulfilled lifestyles. People all have a care plan that is kept up to date and tells staff how their needs should be met. Care Homes for Adults (18-65 years) Page 10 of 33 People are supported to eat a variety of foods to help them keep healthy. Safety checks are completed so the Home is safe for people to live in. What has got better from the last inspection Staffing levels have improved a little and a deputy manager has been employed so there will be more opportunity for people to go out and do things they enjoy. Care Homes for Adults (18-65 years) Page 11 of 33 Parts of the home have been painted so it is more comfortable and welcoming for people. A new television has been provided in the lounge so people can enjoy watching the television programmes they like. What the care home could do better Decisions people make or are made in their best interests should be recorded and the reason why. Care Homes for Adults (18-65 years) Page 12 of 33 The physical lay out of the Home does not ensure that peoples privacy and dignity needs are well met. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Donna Ahern 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT 01216005300 Care Homes for Adults (18-65 years) Page 13 of 33 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 set out 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 14 of 33 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 15 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people and their relatives would have the information they need to know so they can make a informed choice about whether they want to live at the Home. Evidence: We saw the certificate of registration on display in the hallway. Three people were living there at the time of the visit. People have lived at the Home for many years so it was not possible to assess the pre admission process. We saw that a detailed pre admission procedure is in place and if followed should ensure that full assessments are completed prior to admission. The service user guide and statement of purpose tell people what they can expect from the home and had been written in a style that is easier for the people living there to understand. Care Homes for Adults (18-65 years) Page 16 of 33 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. Staff have most of the information they need and a good understanding of how to offer care and support to each person, which should ensure peoples needs are met in a way they prefer. Evidence: We looked at two care plans. Care plans explain what each person needs are and the care and support they require to make sure these needs are met. We found that the files looked at gave information about how staff should support the person in order to meet their individual needs in relation to personal care, communication health care and social activities, likes and dislikes. It was positive that pictures and photographs were included throughout the care plan so that they were meaningful and personal to the individual. Information was written in a way that reflected personalised care. This should ensure that people receive support in a way that they prefer. We saw very limited information recorded about how peoples cultural and religious needs are met which may mean that these needs are not fully met. We spoke to two members of staff who support each of the people we also observed Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: people being supported by staff. The staff demonstrated knowledge of peoples individual needs which was consistent with the information on peoples file. This indicates that staff know how to provide care and support to people so their needs are understood and met. We saw risk assessments for fire safety, bathing and showering, mobility, road safety and mobility. These detail the support people need to be safe whilst still being enabled to be independent. One of the peoples needs had changed and this has resulted in an increase in falls.Staff we spoke to knew what they must do to keep people safe and protect them from the risk of harm. Although the risk assessment for the persons mobility had been up dated it did not reflect that the falls had happened or that any safeguards in place to support the person had been reviewed which could put the person at risk of further harm. We saw staff supporting people to make choices about what they wanted to drink and have for a snack before the evening meal. We looked at daily records and key worker reports. They do not always reflect peoples response to care and how choices are made and if they are made in the best interest of the individual. Consideration should be given to how the key worker meetings can be improved so that decisions people make or are supported to make are clearly recorded. A communication board is on display in the dining room which is really positive and should enhance peoples communication and help them make every day decisions. Pictures and photographs are used to give people visual information about meals they have chosen and the staff on duty each day. Some of the pictures in use had become a bit worn or it was not very clear what they represented. We saw that the board had not been completed in full on the day of our visit which could result in limiting opportunities for people to communicate. Care Homes for Adults (18-65 years) Page 18 of 33 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 experience a meaningful lifestyle that promotes their independence and is reflective of individual needs. Evidence: We looked at care plans and daily records to establish that people are leading meaningful lifestyles and taking part in activities that they enjoy. We also spoke to two staff members and observed care and support on the day. Care plans detail what people like to do. All three people attend a day centre four days a week. Sampling of the records indicated that people go out to the shops, for walks, to the barbers, to places of interest and go out for occasional meals. The home is mainly a lone working service so activities must be planned in advance so that additional staff is on duty to support people. We have raised this is previous inspection reports and some improvements have been made with additional staffing available on certain days. The recent appointment of a deputy manager should also provide some additional staff support so people can go out more on either planned or spontaneous activities. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: We saw from reading records, looking at photographs and talking to people that they have been supported to go on several day trips including Lichfield musical festival, Canal boat trip, Drayton Manor park, Twycross Zoo, Southport annual flower show, West Midlands Safari park and Soilhull Theatre for a musical. It was positive that people had just started a leisure log in a visual and pictorial format and this should help identify what people have done, what they have enjoyed and should help with future planning of activites. People were observed in day-to-day tasks such a putting their washing in the machine, taking cups and plates to the kitchen, washing up and wiping the tables and generally helping out around the home. We saw staff prompting and encouraging people to do this which promotes peoples independence. People seemed relaxed and freely accessed all areas of the home choosing to go to their own bedroom, the kitchen or sitting in the communal lounge. One of the people showed me their bedroom. The limitations of the current environment remain as we reported in previous inspections reports. The environment does not provide opportunities for two people to have a single bedroom for privacy. There is evidence through observing and reading records that this causes difficulties for both people due to their preference for different sleeping routines and the use of the bedroom for private space. In one of the surveys returned to us one of the people told us I would be much happier if I do not have to share a room, I would like one for myself. We were told that one of the people is exploring the possibility of moving to another home and relevant assessments are being completed so that any moves or decisions made are in the best interest of the individual. People are supported to maintain contact with relatives and friends and staff spoken with demonstrated that they recognise the importance of personal relationships. We saw a range of tinned, frozen and supplies of fresh food were available. Menus looked at identified a variety of meals to meet any taste, for example traditional roast meals and spicy dishes. Staff said menus are planned with peoples involvement. We saw care plans had information about peoples likes and dislikes. Mencap has recently produced a booklet called right bite to help people with meal planning. We saw records of tests in place for food and storage safety checks, which means food is stored and prepared in a hygienic and safe manner. Care Homes for Adults (18-65 years) Page 20 of 33 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. There are effective systems in place to meet peoples personal and health care needs. Evidence: Care plans that we looked at had good detail about how to meet peoples personal care needs. There was information about how much support people required from staff and also detailed how people should be encouraged to do as much for themselves in order to maintain their independence. We saw that people were dressed in age appropriate clothing and people were well groomed, this indicates that people are supported to maintain a good self-image. We met all of the people who live in the home and saw that staff were prompt to offer personal care or support as needed. We saw that each person has a Health Action Plan in place these should ensure that individual health care needs are monitored and support needed provided. We saw that changes in needs had been made to people care plans so staff knew how to meet peoples health care needs. We saw that referrals had been made to different professionals so that specific health care needs are met. One of the people had a speech and language therapy assessment Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: and guidelines were in place for staff to follow so the person is supported to be safe at meal times. The manager told us that she is seeking further clarification to ensure the guidelines in place fully meet the persons needs. We looked at the log of health care appointments and saw medical appointments and interventions are recorded so peoples well being can be monitored. My hospital books have been completed in an easy read format. In the event of a hospital stay the books would give nursing staff the information they would need to know about an individual so they receive care in a way they prefer. The shared bedroom and single bathroom does cause difficulties and does not fully promote the privacy and dignity of people. However as previously mentioned the reviewing of peoples need process that is now underway and should eventually lead to improved outcomes for people. Medication is stored in a locked cabinet in the office. The cupboard was found to be clean, tidy and well ordered. The medication administration records had been signed for indicating medication had been given as required. Copies of prescriptions are retained so that staff can check the right medication has been received from the chemist. There were no controlled drugs. None of the people self-administered their medication. Peoples consent to medication had been obtained and recorded on their care plan. There is information on peoples care records detailing what the medication is for and possible side effects, which are informative for, staff so they know what to look for. The manager confirmed that staff are assessed annually and receive external training on the safe administration of medication. This should ensure they continue to have the skills and knowledge to administer medication safely to people. Care Homes for Adults (18-65 years) Page 22 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to listen to and respond to complaints about the service. Arrangements are in place so people should be protected from harm. Evidence: The complaints procedure is available in an easy read format so it is more meaningful for the people who live at St Peters. However people living at the Home would require considerable support to raise a complaint or concern. We received no complaints about this Home and no complaints have been made directly to the service since our last visit. Staff we spoke to demonstrated a general understanding of their duty to safeguard people and how to report concerns on to senior managers. A local protocol for reporting concerns was on display in the office so people would be able to contact the right department. We looked at training records to determine that training in safeguarding vulnerable adults had been provided. Safeguarding procedures and a whistle blowing policy was available for staff to refer to. The AQAA informed us that Mencaps new induction for staff focuses heavily on protection and safeguarding. Systems are in place for the recording of accidents and incidents to the commission. Records seen matched what had been reported to us. We saw inventories of peoples belongings on their case files. These need some updating, as records looked at had not been completed for over a year. This should ensure that peoples personal items are accounted for and protected. Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: We saw that systems are in place for the recording of peoples personal money and risk assessment inform staff about how to support people and ensure their money is handled safley. Care Homes for Adults (18-65 years) Page 24 of 33 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. People live in a clean, safe and comfortable home, which promotes their well-being but does not meet the needs of all the people living there. Evidence: Flat 24 St Peters is a ground floor flat. We have highlighted in previous reports that the home does not meet the needs of all the people living there. The shared bedroom and one bathroom causes difficulties for the people living there. Some progress has been made since our last visit. We were informed that Birmingham Social Care and Health department have started to reassess peoples needs. The bathroom is domestic in layout with limited space for people to move about. There is a shower over the bath and a toilet and wash hand basin. There is no separate toilet facility toilet which does cause difficulty for the people living there, if someone is having a shower or bath and another person needs to use the toilet. There is a spacious kitchen dining room and a separate lounge. Most of the communal areas have been decorated in the last twelve months so it is clean and comfortable for people. The washing machine is located in the kitchen with guidelines in place so it is only used when food preparation is not taking place which promotes good hygiene and infection control practice. The kitchen was clean and well equipped with adequate space to store fresh, frozen, dried and tinned food. Records showed that fridge and freezer Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: temperatures had been regularly recorded to make sure food is stored safely. Staff told us that people had been supported to personalise their bedrooms. The bedroom we looked at had lots of personal items. There is no garden directly linked to the home, however there is a large well-maintained grass area to the side of the Home for communal use and a small front garden which the men have been supported to make a bedding area and have planted some flowers. They also have their own garden chairs which they use to sit outside when the weather is fine. We saw photographs of the men working and sitting in the garden. Care Homes for Adults (18-65 years) Page 26 of 33 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. People are supported by a staff team who receive the training and support they need to do their job well and meet peoples needs. Evidence: We watched the way that people interacted with staff on duty, which indicated that good relationships exist between people living there and the staff supporting them. We looked at the staffing rota for the week of the visit and the previous week. These showed that there is usually one staff member on duty during the day. A few times per week an extra staff member is on duty so that people can go food shopping or take part in planned activities. The manager works mainly 9-5 and provides hands on care when required. We spoke to two staff during this visit who demonstrated that they had a good understanding of peoples individual needs. We spoke to staff about the training they had received and they said that they had completed training in mandatory areas including safeguarding, medication, health and safety, first aid and fire. We looked at the staff training records which confirmed mandatory training had taken place and in addition training specific to meeting peoples needs had also taken place. Training was also scheduled to take place soon on dysphasia, Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: epilepsy and makaton. This should ensure that staff continue to have the up to date knowledge and skills required to meet peoples individual needs. We looked at staff recruitment records for the two most recently employed people. One staff member had transferred from within the organisation and we were advised that additional checks had not been made. Previous references and CRB details from when they were first employed were available. We saw that Criminal Records Bureau checks (CRB) for all staff have been checked in a recent audit carried out by the service manager. Application and references for the new starter were on their file which should ensure that people are protected from the risk of having unsuitable staff work in the Home with them. Staff told us that they receive regular supervision with the manager. This was confirmed by looking at records and ensures staff have the opportunity to reflect on their practice and consider their individual training needs. Regular staff meetings take place, which provide an opportunity for staff to discuss good practice and development issues. The minutes of meetings seen were very detailed and informative. Staff who completed and returned the surveys to us indicated that they get the support they need to do their job and there is usually enough staff on duty. They told us The home takes pride in assisting people to lead an independent life and Staff are a good team. The AQAA informed us that 5 of the 6 staff have achieved a National Vocational Qualification in care. This should contribute towards ensuring that the staff team have effective knowledge of social care. Care Homes for Adults (18-65 years) Page 28 of 33 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. Arrangements in place ensure the health, safety and well being of the people living there. Evidence: The manager has several years experience of working with people who have a learning disability. She has been the manager at St Peters since August 2008 and was recently registered with CQC. She is also the registered manager for Flat 1 St Peters, which is, located in the same complex a short distance away. The manager assisted us with the inspection process. She was open and welcoming and demonstrated a commitment to continue to improve standards for people. The recommendations we made in the last inspection report had been met which demonstrated a commitment to comply with the regulations. It is positive that some progress has been made towards addressing the reassessment of peoples needs and the suitability of St Peters. There are quality assurance systems in place including an auditing system. The Homes senior manager carries out monthly visit to the home to monitor and report on standards. Reports are available of these visits. Reports seen were very detailed and should ensure Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: that the provider takes responsibility for monitoring the Home. A continuous improvement plan is displayed in the office for people to see. This provides a focus for improving standards across all areas of the Home. People who live in the Home have completed surveys. The manager told us the format for these will be improved so that they are more meaningful to people. We saw that systems are in place for the recording of accidents and incidents to the commission. Records seen matched what had been reported to us. Staff spoken with and records looked at confirmed that staff have completed training on health and safety, fire, first aid, manual handling and basic food hygiene so a safe environment is provided for people. We looked at some health and safety records including Fire records, gas appliances safety certificates and water temperatures checks. All are checked and serviced regularly. An independent safety consultant had reviewed the work place fire risk assessment and identified work that needed to be done to provide a safe environment. The manager told us that all recommendations had been met and an action plan to demonstate this would be completed. The systems we seen for monitoring health and safety including weekly and monthly audits are generally thorough and should ensure peoples health and safety are promoted. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  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 Care Homes for Adults (18-65 years) Page 31 of 33 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 Description 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 Description 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 1 2 3 4 5 6 6 7 7 9 16 24 Peoples cultural and religious needs and how these are met should be detailed in their care plan. The decisions people make or are made in their best interest and the reason why, should be clearly documented. People should be given the communication assisstance to make decisions about their own lives. Risk assessments should reflect any changes in need and should ensure that safeguards in place remain adequate. Steps should be taken so that peoples privacy is not impacted on. The negative impact of the environment should be minimised so peoples privacy and dignity is promoted. Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or 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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