Care Home: Sutton House

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What the care home does well People have the information they need about the home to help them make a choice as to whether or not they want to live there. Each person has a detailed, individual care plan. This shows staff how to support people to meet their needs and achieve their goals. People said they can make choices about what they do, where they go and what they eat and drink so they do the things they want. People said they often go out to the places they want to go to so they enjoy a meaningful lifestyle. People can keep in touch with their family and friends so they can maintain relationships that are important to them. A relative said, " The support my relative gets is excellent. The manager and his team have made my relative a very happy, young man." Staff support people to meet their health needs so helping them to keep well. A relative said, "In one word WONDERFUL no not one word but more, EXCELLENT, FABULOUS, SUPERB....................... " Staff have training in how to keep people safe from harm. There are good staff recruitment practices so that `suitable` people are employed to work with the people living there. The home is well decorated and furnished so it is homely and comfortable for people to live in. A relative said, " The home is beautiful, the standard is far the best we have seen." Each person has their own bedroom and en suite shower or bath room. People have a lot of their own things in their bedrooms and they are decorated in the way they choose. People said they like their bedroom and help to clean it. Staff have the training they need so they know how to help people communicate and how to meet their needs. A relative said, " The support my relative gets is excellent." The manager has many years of experience in managing homes for people who have a learning disability. They have the skills to do so to make sure the home is well run and benefits the people living there. A professional said, "In my 15 years experience I have never worked with such a wonderful manager and supportive director. The home is fantastic." Equipment in the home is often tested and kept in good order so that it is safe to use. What has improved since the last inspection? This was the first inspection of the home since it was registered in July 2009. What the care home could do better: All plans should be dated so it is clear when they need reviewing. This will ensure that they tell staff how to support the person to meet their current needs. Lists of belongings should be updated as people buy new things so it is clear what belongs to each person if things should go missing. All staff should be aware of the Deprivation of Liberty Safeguards so they know how this may affect the people living there. Key inspection report Care homes for adults (18-65 years) Name: Address: Sutton House 79 Sutton Road Birmingham W Midlands B23 5XA     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: Sarah Bennett     Date: 0 7 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Sutton House 79 Sutton Road Birmingham W Midlands B23 5XA 01213778900 01213778088 nigel.lyons@pharuscare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Pharos Care Limited Name of registered manager (if applicable) Mr Nigel Lyons Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Maximum number that can be accommodated is: 5 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: Code LD (5) Date of last inspection Brief description of the care home The home is on a main road in a residential area of Erdington, Birmingham. It is close to bus routes and a train station, so the city centre is accessible. It is close to shops, pubs, restaurants and a leisure centre. The accommodation consists of a detached, spacious property that is accessed via the road and has a large car park at the front. The premises have been renovated and refurbished to a high standard and is very homely. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 Brief description of the care home The home has five single bedrooms, one on the ground floor and four on first floor. The rooms have an en suite toilet, hand basin and shower or bath facilities. There is a separate communal bathroom, so that people have a choice of having a bath or shower. A separate ground floor toilet is available. Shared space includes a large kitchen, large living room and separate dining room that can also be used for activities. There is a laundry room on the ground floor with a washing machine and tumble dryer. There is a very large back garden with lawned and raised patio areas. There is a ramp with hand rails to the garden, so it is accessible to people with mobility difficulties. Care Homes for Adults (18-65 years) Page 5 of 30 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This inspection was carried out by one inspector over one day, the home did not know we were going to visit. This was the first key inspection of the home as it was registered in July 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 30 (AQAA) completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. There were two people living at the home. We case tracked the care received by both people. This involved establishing individuals experience of living in the care home by meeting and talking with them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at parts of the home and a sample of care, staff and health and safety records. The people living there, one of their relatives, a care professional, the manager and staff on duty were spoken with. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: People have the information they need about the home to help them make a choice as to whether or not they want to live there. Each person has a detailed, individual care plan. This shows staff how to support people to meet their needs and achieve their goals. People said they can make choices about what they do, where they go and what they eat and drink so they do the things they want. People said they often go out to the places they want to go to so they enjoy a meaningful lifestyle. People can keep in touch with their family and friends so they can maintain relationships that are important to them. A relative said, The support my relative gets is excellent. The manager and his team have made my relative a very happy, young man. Staff support people to meet their health needs so helping them to keep well. A relative said, In one word WONDERFUL no not one word but more, EXCELLENT, FABULOUS, SUPERB....................... Staff have training in how to keep people safe from harm. There are good staff recruitment practices so that suitable people are employed to work with the people living there. The home is well decorated and furnished so it is homely and comfortable for people to live in. A relative said, The home is beautiful, the standard is far the best we have seen. Each person has their own bedroom and en suite shower or bath room. People have a lot of their own things in their bedrooms and they are decorated in the way they choose. People said they like their bedroom and help to clean it. Staff have the training they need so they know how to help people communicate and how to meet their needs. A relative said, The support my relative gets is excellent. The manager has many years of experience in managing homes for people who have a learning disability. They have the skills to do so to make sure the home is well run and benefits the people living there. A professional said, In my 15 years experience I have never worked with such a wonderful manager and supportive director. The home is fantastic. Equipment in the home is often tested and kept in good order so that it is safe to use. Care Homes for Adults (18-65 years) Page 8 of 30 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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 have the information they need to make a choice about whether or not they want to live there. Assessments ensure that people can be confident that their needs can be met there. Evidence: The service users guide included a photograph of the home and pictures and was written in a way that was easier for people to understand. It included the relevant information that people would need to make a choice about living there. The statement of purpose included all the relevant and required information about the home to help people know whether or not their needs could be met there. There were two people living there so there were three vacancies. The manager said that they have had referrals and were completing assessments to ensure that the individuals needs could be met at the home. The manager said that they had not accepted a referral for one person, as they would not be compatible with another person living there. It is good that this is considered so that people live with people they can get on with. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Records showed that before each person moved into the home an assessment of their needs was completed to ensure their needs could be met. Professionals spoken to said that the manager visited the person several times before they moved in at the home they used to live at. This helped to get to know them and ensure that they could meet their needs. The person and their family also visited the home to help them make a choice as to whether or not they wanted to live there. Care Homes for Adults (18-65 years) Page 12 of 30 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 the information they need so they know how to support people to meet their needs and make choices about their daily lives. Evidence: The records of both of the people living there were looked at. These included an individual care plan that showed staff how to support the person to meet their needs and do the things they wanted to do. Plans were detailed and centred on the individual and their likes and dislikes. Plans stated how the person needed to be supported now but also what their long term goals were. This showed staff how supporting the person in the right way now would help them to achieve their long term goals. One persons plan about their religious and cultural needs had not been completed. However, the persons room and daily records indicated that the current staff knew what support the person needed to ensure these needs were respected. The other persons plan had been completed and showed staff how it was important to respect the persons cultural background and what they needed to do for this. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Care plans included how staff are to support the person with their communication so they can make their needs known. One persons plan indicated that they communicated using Makaton (a form of sign language). Staff said that they had not attended a training course on this but the manager knew several signs and had taught staff these. Records sampled showed and it was observed that staff knew how to communicate with this person. Each person has a key worker who completes a monthly report on what the person has done, if their needs have changed and what they have achieved during the month. The manager said that these are used to update care plans so they reflect the individuals current needs. A meeting with the people living there was held in December. Minutes of these showed that people talked about the home, its furniture and decoration and what they wanted to do at Christmas. The manager said and records showed that people are often consulted about what they do. Staff said and records showed that people met with staff on Sundays to talk about their menus and activities for the week. Staff said that if people changed their mind about these during the week this was respected. Records showed and it was observed that this happened. Plans included how the person was to be supported to take risks in their daily lives. These ensured that the person could be as independent as possible but any unnecessary risks to their health and safety are reduced. Care Homes for Adults (18-65 years) Page 14 of 30 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. The people living there experience a meaningful lifestyle so ensuring their health and well being. Evidence: Records showed that people take part in a range of activities that they enjoy at home and within the community. People go shopping, to a local snooker club, to the cinema, bowling, swimming, to restaurants, pubs, walks, library and go cycling. People have games consoles and a variety of games that they enjoy. One person has their own laptop and they are supported to send emails to their friends and family. The manager said that they hope to purchase voice recognition software so the person can be more independent in doing this. Both people enjoy music and in developing this interest have improved their well being. There are musical instruments in the home. One person has said that they want to learn to play the piano and they hope to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: buy a digital piano. One person had recently started a college course in cookery and were supported by staff to go to this. They said they enjoyed this and were hoping to use public transport to get to the course. The home provides a vehicle that people contribute towards the cost of. Several of the staff can drive this so they can support people to go out into the community. People are also supported to use public transport if they are able to do this. The people living there moved in last summer. In September last year one person was supported to go abroad on holiday by staff. A relative of the person also went with them so helping them to maintain relationships that are important to them. Records showed and staff said that the person had enjoyed this. A professional spoken to said that the holiday had been very positive for the person and it was a credit to the staff that they supported this person, who they did not know very well, to go abroad. People are supported to maintain contact with their family and friends. Both people spent time with their family over Christmas and New Year. The manager said that staff worked hard to ensure that people were prepared for this so that they had a good experience and enjoyed their time. People also keep in contact through emails, phone calls and going out for meals with their family and friends. Records sampled showed that people are supported to do household tasks so helping them to be more independent. Support plans showed staff how to encourage people to be as independent as possible in their daily lives. People said and it was observed that they helped to clean their rooms and made snacks and drinks. A relative said, He is helping with washing up and vacuuming so helping his life to be more fulfilled. Records showed that people had a varied diet that included fruit and vegetables and reflected their dietary needs and cultural background. People choose their menus each week and have an alternative of what is for the main meal. Records showed that staff are working with individuals to change their eating habits to ensure their health and well being. Records showed and people said that they help to buy their food with staff from supermarkets and local shops. People are involved in preparing their meals and drinks. The kitchen is very spacious so enabling staff to support people safely, as due to their behaviours they become agitated when in the kitchen. Care Homes for Adults (18-65 years) Page 16 of 30 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 health and personal care needs of the people living there are met so ensuring their well being. Evidence: Care plans showed staff how to support people with their personal care and how to encourage them to do things for themselves. People were dressed in individaul styles that reflected their age, gender and the activities they were doing. Care plans stated what support people needed to move around so that the risks to them and staff supporting them are reduced. Mobility care plans stated what support people would need to use transport. These detailed the support needed to reduce risks to peoples safety and health. Records sampled showed that peoples weight is regularly monitored. This is good as a significant loss or gain of weight, when it is not planned, can be an indicator of an underlying health need. Records showed that staff encourage people to lose weight through changing their diet and exercise so helping to meet their health needs. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Records included an individual health action plan. This is a personal plan about the health needs of the person and what support they need to access health care services. Plans included pictures making them easier for the person to understand and be involved in. They were not dated, so it was not clear when they were written or needed reviewing to ensure they reflect the persons current needs. The people living there can sometimes behave in a way that others may find challenging and may affect their own health and well being. Staff record clearly individuals behaviour and what may have led to it so that support plans can be updated to show staff how to help people to manage they way they behave. Health professionals are involved in developing behaviour support plans with the person and staff at the home. Records showed that where appropriate health professionals are involved in individuals care to ensure their health needs are met. The system for recording peoples health ensures that their needs are monitored so that specialist advice and support can be given where needed. Medication is stored in a separate room, which was warmer than it should be to store some medicines in. We highlighted this when the home was registered. The manager has taken steps to ensure that where needed medication is stored at the correct temperature so the efficacy of it is not affected. A locked fridge has been provided so that all medication that needs to be stored below a certain temperature can be. Staff record the temperature of the fridge to ensure that medication is stored appropriately. Staff who give medication to the people living there have received training and been assessed as competent to do so. Staff had signed peoples Medication Administration Records (MARS) appropriately. MARS cross referenced with the amount of medication kept in the home, indicating that medication is given as prescribed. Weekly audits of medication are completed to ensure that errors are reduced. Where people are prescribed PRN (as required) medication a written protocol was in place. This stated when, why and how much of the medication should be given to the person so that it is used appropriately ensuring their well being. Records showed that peoples medication is regularly reviewed and changed where needed to ensure individuals health needs are met. One persons medication that reduces their anxiety and agitation had recently been reduced. They were prescribed a high dose when they moved into the home. The manager was keen to work with health professionals to reduce this persons medication, as a high dose could impact Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: on the persons well being. The ethos of the home is that peoples behaviour is not controlled by medication alone, but by working with the individual and supporting them to lead a fulfilling lifestyle. Care Homes for Adults (18-65 years) Page 19 of 30 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. Arrangements ensure that the views of the people living there are listened to and they are safeguarded from harm. Evidence: The complaints procedure was included in the service users guide and available in the home. It included pictures so that it is easier for people to know how to complain if they have concerns about the home. We have not received any complaints about the home and they have not received any since the home opened in July 2009. The manager said that they need to get better at recording compliments, as they have received some but have not recorded them. This helps to show how the service is performing and the quality of it. Staff receive training in a recognised form of physical intervention that focusses on diverting peoples attention and only using physical intervention as a last resort. The manager is an accredited trainer in this and provides training to staff. A professional said that the person they work with often needed staff to restrain them physically at the home where they lived before. However, this has not been necessary at this home as staff have supported the person well and helped them to manage their behaviour. Staff were observed to work with individuals in a way that distracted their attention to more positive things when they became anxious. Records showed that Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: staff recorded how well distractions worked and what the person liked or disliked. This helps staff to be able to support individuals in the way they like and reduce their anxieties. Behaviour support plans detailed how staff were to do this. Both of the people living there have funding for 1:1 staffing. Rotas sampled showed that this was always provided and three staff were on duty when we visited, so an extra member of staff was available. An inventory of belongings had been completed when a person moved in. For one person this had been updated as the person had bought new things but had not for the other person. This should be updated regularly to ensure that staff know what belongs to each person, so if things should go missing there is a clear record of these. Peoples money is held securely in the home and the staff who have access to this is limited however, people can have access to their money at all times during the waking day. The manager or staff are not the appointee for the people living there. Records showed that staff ensure that people regualrly receive the money they are entitled to. Records of money held in the home matched the amount kept for them. Receipts are kept of all expenditure. These and records showed that people spend their money on personal items, not on things that should be provided by the home. People do contribute towards the cost of the vehicle. It is stated in the service users guide that a charge is made for this, so that people know this before they move in. Agreements are in place that state that the person agrees to paying this and how much. Staff tarining records sampled showed that staff receive training in safeguarding the people living there from harm. The manager has received training in the Deprivation of Libverty Safeguards and demonstrated a good working knowledge of this. Staff should also be aware of this legislation and how it may affect the people living there. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and safe environment that meets their individual needs. Evidence: The home is spacious, clean, well decorated and furnished making it homely and comfortable for people to live in. A relative said, The home is beautiful, the standard is far the best we have seen (and weve seen quite a few!). The Staff have so much pride in Sutton House and this reflects upon the people who live there. Staff said that if repairs are needed, these are dealt with promptly so the home can continue to be well maintained and comfortable. Communal rooms include a lounge, dining room and kitchen, all of which are on the ground floor. They plan to build a conservatory at the rear of the home to provide another communal area so that people can have a choice of rooms to spend time in. The back garden is large so building a conservatory will not impact on the outdoor space available. There is a ramp with handrails leading to the garden so it is accessible for people with mobility difficulties. The bedrooms of both of the people living there were seen with their agreement. These were very personalised, well furnished and decorated and reflected the Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: individuals tastes and interests. People living there and a relative said and records showed that people are supported to clean and tidy their bedrooms and look after their belongings so promoting their self esteem. One bedroom is on the ground floor so is suitable for people who have mobility difficulties. People have an en suite bath or shower room. These were personalised and kept clean and hygienic. One person had a bath but prefers to often use the shower. A communal shower is provided next door to their bedroom and they use this when they want to. A separate laundry room is provided so that people do not have to take soiled laundry through areas where food is prepared, eaten or stored so reducing the risk of cross infection. The laundry room and all parts of the home were clean and free from offensive odours, making it pleasant for people to live in. Care Homes for Adults (18-65 years) Page 23 of 30 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. The people living there are supported by a stable and well trained staff team who can meet their individual needs. Evidence: The AQAA stated that seven out of the thirteen staff have achieved National Vocational Qualification (NVQ) level 2 or 3 in Care. This ensures that staff have the skills and qualifications to meet the needs of the people living there. Staff and the manager said that some staff are starting NVQ training at college this month. This will ensure that more staff have this training and knowledge. The AQAA stated that they do not use agency staff but have a small, consistent team of bank workers to fill empty shifts when staff are on holiday. The manager said that there is a low rate of sickness. The home has been fully staffed since it opened so the staff have got to know the people living there well and provide consistent support to them. Rotas showed that people had the staffing that they were funded for. Both people are funded to have 1:1 staffing and at times this staffing level was exceeded. At night there is one waking night staff and one staff who does a sleep in shift so is on call on the premises. The manager said as more people move in, more support will be needed Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: at night so there will be two waking night staff and no sleep in staff. Minutes of staff meetings showed that these are held regularly and staff have an opportunity to discuss issues relating to how they support the people living there and the running of the home. A relative said, We cannot enthuse about Sutton Road and Pharus Care enough. More Adult Care Providers should take a leaf out of the home and its carers. The support my relative gets is excellent. The manager and his team have made our relative a very happy, young man. The records of three of the staff that work there were looked at. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau (CRB) check had been received. This ensures that suitable people are employed to work with the people living there. Staff training records showed that staff receive the training they need to enable them to support the people living there. The AQAA stated and records showed that new staff receive a full induction and the training they need when they first start working there. Staff said that they felt well supported in their role and enjoyed working at the home. Staff records sampled showed that two of the three staff had received two formal, recorded supervision sessions since working at the home from July 2009. The other member of staff had not yet had any formal supervision but had only recently been recruited. It is recommended that staff have at least six, formal supervision sessions each year to ensure they are supported in their role and their training and development needs are identified. The manager said this can be difficult to achieve and often informal supervision is held. Staff also have opportunity in staff meetings to be supported and said that they felt supported and enjoy their work. Care Homes for Adults (18-65 years) Page 25 of 30 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 arrangements ensure that the health, safety and welfare of the people living there is promoted and protected so ensuring their well being. Evidence: The manager is registered with us. He is a qualified learning disbaility nurse and has achieved the Registered Managers Award, so that he has the skills and knowledge to manage the home. The manager has several years experience of managing homes for people who have a learning disability and behaviours that may challenge others. The manager is supported by the area manager who provides him with formal supervision. The manager said that he is well supported in his role. A professional said, In fifteen years experience I have never worked with such a wonderful manager and supportive director. Staff said that they felt supported by the manager and the company that they work for. A representative of the provider visits monthly to audit the home and writes a report of this visit. Reports seen were detailed and included the views of the people living Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: there and staff. The manager is given a list of actions to take following these visits to improve the service and these actions are monitored to ensure they are completed. The AQAA stated and records sampled showed that all equipment in the home is regularly serviced and tested to ensure it is safe to use and well maintained. Staff test the water temperatures weekly to make sure they are within the recommended limits to reduce the risk of people being scalded. Records sampled showed that they were within the recommended limits. Fire records showed that staff do a weekly fire safety audit that involves testing the fire equipment to make sure it is safe and would alert people if there was a fire. A fire drill has taken place since people have moved into the home to ensure that they and staff would know what to do if there was a fire. Records showed that this went well and people knew what to do. The fire risk assessment was detailed and stated what action was needed to ensure that the risks of there being a fire are reduced as much as possible. Records showed that appropriate action had been taken to reduce these risks. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 6 19 All care plans should be completed to ensure that staff know how to support individuals. Health action plans should be dated so it is clear when a review is needed to ensure it reflects the persons current needs. Compliments received should be recorded to show how the service is performing and the quality of it. All staff should be aware of the Deprivation of Liberty Safeguards and how this legislation may affect the people living there. Inventories of belongings should be updated regularly to ensure that staff know what belongs to each person, so if things should go missing there is a clear record of these. Staff should have at least six, formal supervision sessions each year to ensure they are supported in their role and their training and development needs are identified. 3 4 22 23 5 23 6 36 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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