Care Home: Stirling Close 8

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What the care home does well The interaction between staff and people who lived at the home was respectful and professional. A staff member who was spoken with during the inspection had a good knowledge about the individual support that people were provided with.People were supported to make choices about how they lived their lives.People were provided with opportunities to participate in activities which interested them.The home was clean and well maintained, which provided people with a pleasant place to live in. Each person had their own bedroom, which reflected their choices and individuality.The health professional survey asked what the service did well and it stated `everything`. What has improved since the last inspection? A recommendation from the last key inspection was that the `use by` dates for PRN (as required) medication be reviewed. At this inspection there was no PRN medication stored at the home. What the care home could do better: The complaints procedure needed to be updated to show the current contact details of CQC (Care Quality Commission), should people wish to contact us. Key inspection report Care homes for adults (18-65 years) Name: Address: Stirling Close 8 8 Stirling Close Oulton Lowestoft Suffolk NR32 4RA 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: Julie Small Date: 1 6 0 9 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 31 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 31 Information about the care home Name of care home: Address: Stirling Close 8 8 Stirling Close Oulton Lowestoft Suffolk NR32 4RA 01502587652 F/P01502587652 colin.g.hallam@tesco.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Colin Graham Hallam care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection 1 1 0 6 2 0 0 7 A bit about the care home 8 Stirling Close provides care for three younger adults with a learning disability. Set in a residential area in Oulton, near Lowestoft, the home is within walking distance of the local shops, public house and health centre. Local shops include a Chinese take-away, hairdresser, newsagent and clothing shop. The bus stop at the end of the road has a regular service into Lowestoft, where people can take advantage of a range of Care Homes for Adults (18-65 years) Page 4 of 31 activities. These include swimming pool, cinema, beaches, theatre, restaurants, shops and train station. The layout of the semi-detached twostorey property is of an ordinary, family home. There are no special adaptations, other than handrails in the bathroom. All peoples bedrooms are single, one with an en-suite bathroom. Sleeping in staff are provided with their own bedroom and en-suite shower room. There is a small-enclosed garden at the rear of the home, and off road parking for visitors at the front of the premises. Fees vary depending on how much the local authority pay to fund a placement. At the last key inspection the rates payable to the home from each of the local authorities are as follows: Norfolk County Council - £356.00 per week Suffolk County Council - £341.00 per week Haringey County Council - £323.68 per week Care Homes for Adults (18-65 years) Page 5 of 31 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 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home The unannounced inspection took place Wednesday 16th September 2009 from 16:20 to 19:10. The inspection was a key inspection, which focused on the core standards relating to adults and was undertaken by regulatory inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. During the inspection health and safety records, the staff rota and the menu were viewed. The care records of two people that lived at the home were tracked, which included care plans and medication records. Further records viewed are detailed in the main body of this report. Observation of work practice was undertaken and one staff member and two people who lived at the home were spoken with. Care Homes for Adults (18-65 years) Page 7 of 31 Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home and it was returned to us. We received one health professional survey, which had been completed by a relative of a person who lived at the home. What the care home does well The interaction between staff and people who lived at the home was respectful and professional. A staff member who was spoken with during the inspection had a good knowledge about the individual support that people were provided with. People were supported to make choices about how they lived their lives. Care Homes for Adults (18-65 years) Page 8 of 31 People were provided with opportunities to participate in activities which interested them. The home was clean and well maintained, which provided people with a pleasant place to live in. Each person had their own bedroom, which reflected their choices and individuality. The health professional survey asked what the service did well and it stated everything. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 9 of 31 A recommendation from the last key inspection was that the use by dates for PRN (as required) medication be reviewed. At this inspection there was no PRN medication stored at the home. What the care home could do better The complaints procedure needed to be updated to show the current contact details of CQC (Care Quality Commission), should people wish to contact us. Care Homes for Adults (18-65 years) Page 10 of 31 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 Julie Small Care Quality Commission CQC East Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 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 11 of 31 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 12 of 31 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 who use this service can expect to have their needs assessed and met. Evidence: There had been no new admissions in the home since the last key inspection. The people that lived at the home had done so since 2001. Previous key inspection reports identified that peoples needs were assessed before they moved into the home. The care records of two people were viewed and it was noted that each held detailed care plans which identified how peoples assessed needs and preferences were met. The AQAA stated potential clients are referred and initially assessed for suitability for this home. This is followed by visits and short stays where feedback is given by all parties (potential client, their family or representatives, home staff and clients within the home). If all parties agree then an initial three month stay followed by a final assessment again taking into account the views of all parties and there have been no vacancies since the home opened but there is an admission procedure stating the above and this would be followed. Page 13 of 31 Care Homes for Adults (18-65 years) 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. People who use this service can expect to have their assessed needs and preferences set out in an individual care plan and to be supported to make decisions about their lives. Evidence: The care records of two people that lived at the home were viewed. Each held a detailed care plan which showed how the their assessed needs and preferences were met. The care plans included areas such as their care that they could attend to independently, their mobility, personal care needs, health, nutrition, finances and the support that they required and preferred with their appearance, for example if they needed prompting to ensure that they dressed appropriately for occasions and weather. The care plans were signed by the people to show that they had been consulted with and agreed with their care plans. The care plans were updated regularly, which identified where their needs and preferences had changed. A staff member was spoken with and they showed a good knowledge of the individual support each person needed and preferred. The AQAA stated each resident has their own care plan showing needs and choices generally for the residents, needs are assessed by Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: ongoing observation or as expressed by the individual, care plans are reviewed twice yearly or as required. The care that people were provided with was regularly reviewed in annual review meetings undertaken by their placing authorities. The care review minutes were viewed and it was noted that the people, their family or representatives and staff that worked at the home were involved in the meetings, which showed that people were consulted with about the support that they were provided with. Peoples care records that were viewed included detailed risk assessments which identified methods of minimising the risks in their daily living. The risk assessments included areas such as finances, traveling on public transport, working in the kitchen and mobility. The daily records of two people that lived at the home were viewed and each showed the support that people had been provided with on a daily basis, the staff observations of their well being and the choices that people had made, such as what activities they wished to participate in and the contacts that they maintained. Two people that lived at the home were spoken with and they told us that they chose what they wanted to do in their lives and that the staff listened to them. They told us about their key worker that worked at the home and that they helped them. A person told us that they managed their own personal finances and that the staff assisted them with their budgeting. We observed a staff member supporting people to count the balance their spending money, record the balance and ensure that their monies were stored securely. The spending money records of two people were viewed and each held a detailed record of all their transactions and receipts, which showed that peoples finances were appropriately safeguarded. During the inspection we observed several incidents of people making choices about their lives. People chose what they wanted to eat for their evening meal, staff worked with people in preparing the menu for the following week, a staff member supported people to make a shopping list of items that they needed to buy and they chose their evening activity. People were further consulted with about the support that they were provided with in regular house meetings. The minutes of a recent meeting were viewed and they showed how people had made choices about the activities that they wished to participate in. A staff member was spoken with and they clearly explained why and how peoples choices were listened to and acted upon, which showed a clear commitment to ensuring that people were consulted with in all areas of their care and lives. Peoples care plans that were viewed identified how people made and communicated decisions and how they should be listened to. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The health professional survey said that people were always supported to live the lives that they chose and that peoples privacy and dignity was always respected. The AQAA stated choices are encouraged by inclusion e.g. choosing of menus, at residents meetings and reviews and generally as an ongoing process of every day choices.... Care Homes for Adults (18-65 years) Page 16 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be provided with the opportunity to participate in activities which are of interest to them, to be treated with respect and to be provided with a balanced diet. Evidence: The AQAA stated residents are supported to live an individual lifestyle and encouraged to take part in activities within and outside the home, with inclusion in meal preparation and domestic duties, going out socially to clubs, pub etc. Assisting with shopping, visiting relatives or being visited by relatives and going out with friends. The care plans of two people that lived at the home were viewed and they identified the day services, such as work, that they regularly attended and the choices that they had made with regards to their day services. A person that was spoken with told us about their work and what they did at work, which they enjoyed. They told us that they used public transport to travel to their work place. The person and a staff member explained the activities that they had undertaken to ensure that they were safe and confident in Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: using public transport independently. A person showed us their bedroom and it was noted that they had several certificates of achievement of life skills courses that they had attended. Peoples care plans that were viewed identified peoples preferred activities and interests and their daily records showed where they had participated in activities. The minutes from a recent house meeting were viewed and they showed that people were consulted with about the activities that they participated in. Two people that were spoken with told us about how they chose what they wanted to do, which included buying magazines, attending a social club every Tuesday and Thursday, going shopping in Lowestoft, holidays, playing with a play station games console, watching soap operas on the television, going to the beach, going to the pub and going out with their befriender. During the inspection people were observed to make a list of shopping that they needed, such as toiletries, plan a shopping trip with a staff member, a person chose to take a bath, preparing to watch their chosen soap operas, doing a word search puzzle and colouring pictures with coloured pens. We complimented people on how clean their home was and they told us that they helped to keep their home clean, such as dusting, vacuuming the carpets, cleaning the bath and washing up. This was confirmed in peoples daily records that were viewed. People told us that they liked the staff and it was noted that the interaction between staff and people that lived at the home was friendly, respectful and professional. Peoples care plans identified how peoples privacy should be respected and they identified methods of respecting peoples dignity, such as supporting them to undertake their routine personal care and support with choosing their clothing. People that were spoken with told us about how they maintained contacts with their family and friends, which was confirmed in the care plans and daily records that were viewed. During the inspection people were observed to choose their evening meal, which they told us that they enjoyed. People helped themselves to drinks when they wanted them. A person told us what their favourite food was. Two people and a staff member were observed to plan the menu for the week after the inspection. The menu was viewed and it was noted that people were provided with a balanced, varied and nutritious diet. It was noted that there were fresh fruit and vegetables provided each day and every Friday people had a choice of a take away meal. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their health care needs met and to be protected by the homes medication procedures. Evidence: The care plans of two people were viewed and each detailed the support that people required and preferred to meet their personal care needs and the area of their care that they could attend to independently. The plans identified the support that people required with maintaining their chosen style with regards to their hair care and clothing. Peoples daily records that were viewed showed the choices that they made, such as the time that they went to bed and when they undertook their personal care routines. During the inspection we observed a person tell a staff member that they were going to have a bath before their television programmes started, which showed that they made choices about their personal care. The AQAA stated generally residents maintain their own personal care with generally only reminders required or guidance when standards slip. Assistance is normally for the things like hair washing or drying.... The medical records of two people were viewed and each detailed the support that people Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: routinely received from health care professionals and the outcomes for all appointments that they had attended, which included with the doctor, dentist, optician and mental health care professionals. Peoples care plans were updated where the outcomes of health care appointments had required temporary or permanent changes to the support that people required. The health professional survey said that peoples health care needs were always met and that the service always sought advice and acted upon it to manage and improve peoples health care needs. The AQAA stated all residents supported to visit health professionals as required. The homes medication procedures were viewed and detailed the methods for the safe handling, storage and administration of medication. A recommendation of the previous key inspection was that the use by dates for PRN (as required) medication be monitored to ensure that the medication was safe to use. At the time of the inspection there were no prescribed PRN medication. Peoples care records that were viewed included a detailed medication profile, which identified their prescribed medication, why the medication had been prescribed and the possible side effects of the medication. The MAR (medication administration records) of two people were viewed and it was noted that all medication was accounted for. A staff member explained the procedures for the administration of medication and how the MAR charts should be completed and they showed us a book, in which any issues regarding medication was recorded. They had a good understanding of their role and responsibilities regarding the safe handling and administration of medication. They told us that they had been provided with medication training and that they were due to attend a refresher course October 2009. The medication was stored in MDS (monitored dosage system) blister packs in a secure cupboard in the kitchen. The AQAA stated support is given on medication administration and Boots system is used and drugs kept in locked cupboard. Information on drugs and side effects kept on file to give information. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to have their complaints listened to and acted upon and to be protected from abuse. Evidence: A staff member was spoken with and they told us that they had been provided with safeguarding training, which was regularly updated. They had a good understanding of their role and responsibilities in reporting and recording concerns of abuse. They told us about how the homes safeguarding procedures clearly identified the actions that they should take. The AQAA told us that there had been no safeguarding alerts made in the last twelve months and stated all staff given POVA (protection of vulnerable adults) training as soon as possible after starting employment and updated. All clients are aware of who to talk to if they have concerns and also given opportunities to raise concerns in residents meetings. The homes complaints procedure was viewed and it clearly explained the methods of making a complaint and the actions that would be taken upon the receipt of a complaint. The procedure included several contact addresses of organisations, should people wish to contact them, which included the local authority and CSCI (Commission for Social Care Inspection), which needed to be updated to show the contact details of CQC (Care Quality Commission). Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: The AQAA stated complaints procedure in place and relatives aware of it, also in picture format in the residents guide. The complaints book was viewed and there were no complaints since the last key inspection, which was confirmed by the AQAA. Care Homes for Adults (18-65 years) Page 22 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be provided with a safe, clean and comfortable home to live in. Evidence: The home was clean, well maintained, homely and provided attractive decor and furnishings throughout. It was noted that there were no unpleasant odours in the home. We complimented two people on how clean their home was and they told us that they helped to ensure that their own home was clean and tidy, which included hoovering the carpets, dusting and washing up. Two peoples daily records that were viewed identified when they had contributed to the housekeeping of their home, which included keeping their bedroom and communal areas clean and tidy. The AQAA stated the home is always kept clean and tidy by both staff and clients. The home provided communal areas which included a lounge, which held comfortable seating, a television, digital television box, DVD player and stereo. The carpet and curtains were clean and well maintained. The dining room held a dresser, chairs and a table, on which people ate their evening meal and did an in house activity in the evening of the inspection. The kitchen was clean, well maintained and provided the appropriate facilities for the use of three people. There was a small enclosed garden to the rear of the home, which people could sit in when the weather permitted. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: The AQAA stated gardens are well maintained. Decoration and furniture replacement is on an ongoing basis as required. The home provided sufficient toilets and bathrooms for the use of three people and staff members. There was a staff sleep in room, which provided an en suite shower and toilet facility. A bathroom on the first floor provided a bath, shower, hand wash basin and toilet and a ground floor bedroom provided an en suite bathroom. A person who lived at the home showed us their bedroom, which was clean, comfortable and well maintained. It was noted that their bedroom reflected their choices and individuality, there were items of personal memorabilia in their bedroom, which included photographs, souvenirs and training certificates. The person told us that they had chosen their curtains and bedding and that they liked their bedroom. The AQAA stated all bedrooms are personalised to the clients taste where they can keep their own things. A staff member was spoken with and they had a good understanding of their role and responsibilities regarding infection control. They were observed to use good infection control procedures, which included wearing protective clothing and washing their hands when working with food. The AQAA told us that they had an action plan to deliver best practice in prevention and control of infection and that all staff had been provided with infection control training. Care Homes for Adults (18-65 years) Page 24 of 31 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 who use this service can expect to be supported by staff are are trained and qualified to meet their needs and to be protected by the homes recruitment procedures. Evidence: Since the last key inspection one staff member had left and there had been no new staff recruited. At the last key inspection this standard was met and therefore the recruitment records were not viewed during this inspection. At the last key inspection the recruitment records for a staff member were viewed and the report stated since the last inspection one member of staff had left, and another recruited. To monitor that the home was following safe recruitment procedures, the new member of staffs personnel file was looked at. It held a completed application form, and where gaps in their employment history had been identified, staff had clarified the reason why. The file held two written references, interview feedback sheet, medical questionnaire, paperwork to validate their identity, and Criminal Bureau Records (CRB) clearance notification. The manager confirmed that until a member of staffs CRB clearance has been received (and deemed acceptable) they are not left to work on their own, instead they will shadow a permanent staff. Discussions with a new member of staff, confirmed that they had worked 2 to 3 weeks shadowing until their clearance came through. This was seen as positive, and ensured they received a good induction, and were able to get to know the residents. The AQAA stated thorough recruitment process followed, new staff cant work alone until Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: shadowing process shows they are competent. A staff member was spoken with and they told us that the manager and two care staff supported the people that lived at the home on a rota basis. They said that the vacant post had been advertised. A staff member worked at the home when people were present, for example before and after their day services and a staff member undertook sleep in duties to ensure that people were provided with support if needed throughout the night. The staffing rota was viewed and confirmed what the staff member had told us. A staff member told us that they had been provided with a TOPSS (now Skills for Care) induction course and that they completed an induction workbook. They told us that they had been provided with training such as manual handling, safeguarding, first aid, food hygiene and medication. They said that they were provided with annual updates on their training and that they had attended training updates on health and safety and first aid this year and that they were booked to attended safeguarding and medication the month after the induction. The staff member said that they felt that the training that they were provided with was good and gave them the knowledge that they required to meet peoples needs. The home had met the target of 50 of care staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 in care. The AQAA said that all staff that worked at the home had achieved their awards, which was confirmed by a staff member who was spoken with. The health professional survey said that the care staff had the right skills and experience to support peoples social and health care needs. The AQAA stated it is policy that all staff must have or undertake, as soon as possible, NVQ to level 2 minimum and be willing to undertake other training as required. Care Homes for Adults (18-65 years) Page 26 of 31 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. People can expect to be provided with a service which is run in their best interests and to have their health, safety and welfare promoted and protected. Evidence: The home was run by a manager who had been successful in the CSCI (Commission for Social Care Inspection) registered manager application process. The manager was on leave at the time of the inspection. The previous key inspection report stated the home is owned and managed by Mr Colin Hallam, who is also Registered Manager and co-owner of a small registered home 15 miles away in Norfolk. Although the manager divides his time between the two homes, they are able to provide sufficient managerial cover to both homes. There were no concerns raised during this and previous inspections, from residents, relatives, or staff, over the management of the home. Mr Hallam said that he had completed his Registered Managers Awards (RMA), and was currently concentrating on finishing his NVQ 4 in Care. The AQAA stated the home is run by myself and support from my wife. We keep ourselves up to date with all aspects of the home by active involvement, checking of records, talking to and involvement with clients and staff. All home checks are counter Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: checked by ourselves and training kept up to date. We ensure we are always aware of what is happening in the home. A staff member was spoken with and confirmed that the manager and co-owner attended the home on a daily basis and they were complimentary about their approach. People were provided with the opportunity to express their views about the service that they were provided with in regular satisfaction questionnaires, house meetings and their care review meetings. People that were spoken with said that the staff listened to what they said and that they were happy with the service that they were provided with. The health, safety and welfare of people that lived at the home was promoted and protected. A staff member told us that they had been provided with health and safety, safeguarding, medication, food hygiene and first aid training. Staff were further provided with information about how they should safeguard people in the homes health and safety procedures and the environmental risk assessments, which were viewed. The risk assessments identified how the assessed risks were minimised in areas such as fire, infection control and working in the kitchen. The fire safety records were viewed and it was noted that regular checks and fire drills were undertaken, which ensured that people were safeguarded in case of a fire. The health and safety records that were viewed showed that water, refrigerator and freezer temperatures and electrical appliances were regularly checked. Accident records were viewed and showed that they were routinely completed and that the actions were taken to ensure that people were appropriately supported when accidents had occurred. The AQAA told us that they had written COSHH (Control of Substances Hazardous to Health) assessments. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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