Care Home: Swallowdale

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What the care home does well People live in a home which is clean, tidy, comfortably furnished and meets their needs.Each person has their own room and can choose how it is arranged.People can practise their skills such as cooking so that they can be more independent. Staff help them to do this.There is a wide range of leisure, work and social activities which people can choose to do and told us they enjoyed.They can choose where they go on holiday.They have regular meetings to talk about different things such as what they would like to do and what meals they are going to have.They told us they can talk about any problems or concerns they have and feel staff listen and act on them.People can see doctors, dentists and other people like this regularly to make sure they keep well.Staff are well trained.People told us they can visit or have visits from their family or friends when they want.The home is well managed and people told us they liked living there. What has improved since the last inspection? Requirements are things we say they must do if we find they are not meeting good standards. However, we did not make any during our last visit and have not for some years.Page 15 of 38Care Homes for Adults (18-65 years)There have been improvements made to the home. For example, the redecoration of the hall and refurbishment of the utility room.They have improved facilities for making sure peoples belongings such as medicines and money are kept safe.They now have wakeful staff on duty at night. Staff are well trained and people told us they were kind and friendly. What the care home could do better: The manager agreed to make sure care plans showed more clearly people`s wishes and feelings should they become unable to make decisions for themselves. Key inspection report Care homes for adults (18-65 years) Name: Address: Swallowdale 5 Bilsby Road Alford Lincs LN13 9EN The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sue Hayward Date: 1 1 0 1 2 0 1 0 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 38 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 © (2010) 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 38 Information about the care home Name of care home: Address: Swallowdale 5 Bilsby Road Alford Lincs LN13 9EN 01507462708 01754890538 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) : Linkage Community Trust care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: Date of last inspection 2 2 0 1 2 0 0 7 A bit about the care home Swallowdale is a large converted private house with gardens to the front and rear of the building. Care Homes for Adults (18-65 years) Page 4 of 38 Eight men and women over the age of eighteen live in the home. Everyone who lives in the home has their own bedroom. No one has to share a room. Everyone is given information telling them what they can expect if they live there. Care Homes for Adults (18-65 years) Page 5 of 38 Information and photographs are in the home showing the different things that happen. There are a range of social, leisure and work opportunities that people can choose to participate in. Some are operated by Linkage Community Trust and others in the local community. Care Homes for Adults (18-65 years) Page 6 of 38 The current cost per week for someone to live there ranges from £445.00 - £555.00 per week. A copy of this inspection report is available in the home or can be obtained from the manager. Care Homes for Adults (18-65 years) Page 7 of 38 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home Throughout this report the terms we and us refer to the Care Quality Commission (CQC). Before the visit, the manager had completed a questionnaire. This gave us some important information about how well they are meeting standards and how they plan to improve. We followed the care of two people and checked their records. Care Homes for Adults (18-65 years) Page 9 of 38 We spoke to five people who live at the home. Two people showed us their bedrooms. We spoke to two staff members who were on duty. Care Homes for Adults (18-65 years) Page 10 of 38 We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We talked in general to the manager and her manager about our findings at the end of the inspection. What the care home does well Care Homes for Adults (18-65 years) Page 11 of 38 People live in a home which is clean, tidy, comfortably furnished and meets their needs. Each person has their own room and can choose how it is arranged. People can practise their skills such as cooking so that they can be more independent. Staff help them to do this. Care Homes for Adults (18-65 years) Page 12 of 38 There is a wide range of leisure, work and social activities which people can choose to do and told us they enjoyed. They can choose where they go on holiday. They have regular meetings to talk about different things such as what they would like to do and what meals they are going to have. Care Homes for Adults (18-65 years) Page 13 of 38 They told us they can talk about any problems or concerns they have and feel staff listen and act on them. People can see doctors, dentists and other people like this regularly to make sure they keep well. Staff are well trained. Care Homes for Adults (18-65 years) Page 14 of 38 People told us they can visit or have visits from their family or friends when they want. The home is well managed and people told us they liked living there. What has got better from the last inspection Requirements are things we say they must do if we find they are not meeting good standards. However, we did not make any during our last visit and have not for some years. Page 15 of 38 Care Homes for Adults (18-65 years) There have been improvements made to the home. For example, the redecoration of the hall and refurbishment of the utility room. They have improved facilities for making sure peoples belongings such as medicines and money are kept safe. They now have wakeful staff on duty at night. Staff are well trained and people told us they were kind and friendly. Care Homes for Adults (18-65 years) Page 16 of 38 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 17 of 38 If you want to speak to the inspector please contact Sue Hayward Care Quality Commission (East Midlands) Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel. 03000 616161 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 18 of 38 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 19 of 38 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. Peoples needs are thoroughly assessed and they are provided with good information before admission so that they can feel confident their needs will be met. Evidence: Both records checked on this occasion showed that there is a thorough assessment procedure in operation, and people who use the service, their relatives and other professionals are fully consulted and involved. Records showed that people are individually risk assessed. Assessments are well documented and contain a range of detailed information such as the personal history, health and medical needs of people. All this information is used to develop detailed care plans. People the service supports told us they are involved in this process and knew what information is contained in their personal files. We saw that people had been given information telling them about the service and this information is readily available to people who live in the home and visitors. We saw it is available in different formats such as digital video disc (DVD) and symbols for people who have differing communication needs. People told us they received enough information about the service and a comment from a relative indicated that they were kept well informed. Staff told us that they received accurate information about peoples needs and we observed they had a good knowledge of them. People the service Care Homes for Adults (18-65 years) Page 20 of 38 Evidence: supports told us they had a choice about whether or not they lived at Swallowdale and were of the opinion they received the support they needed and liked living there. From discussions with the manager not all staff have had training about the Mental Capacity Act 2005 and peoples rights to make choices and decisions. A representative from the organisation confirmed that arrangements are being made to make sure further training is available to staff. It was clear from comments and records we saw that people who live in the home are consulted about significant decisions although the manager did agree to make sure that individual care plans reflected more clearly that peoples capacity to make decisions had been considered and showed their wishes should they be unable to do so themselves. Care Homes for Adults (18-65 years) Page 21 of 38 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual needs and wishes are well met and their independence is promoted so that they have choice and control over their daily lives. Evidence: We checked the care plans of two people who said we could. They both contained detailed information about their needs such as their leisure interests, daily living needs, medication, financial management and vocational needs. All people we spoke to were aware of the records that are held about them and two showed us their care plans. They were detailed and included information such as their individual likes and dislikes, any specific cultural, religious or dietary needs they may have as well as their goals and wishes for the future. Staff have a good knowledge of the needs of the people who live in the home. People told us they made their own decisions about what they do each day, and what activities they participate in. Where needed, we saw there were records in place showing assessments had been Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: carried out to identify any risks and how to minimise them so that people could be as independent as possible. For example, if they were responsible for administering their own medication. We saw that care plans are reviewed regularly and that people who use the service are part of this. People we spoke to were well aware of the information their records contained. People told us they were supported to make their own decisions. For example, they go on holidays of their choosing and take part in vocational and leisure activities of their choice. The organisation has told us that they have an advocate from a voluntary organisation who sits on a committee consisting of people who use a range of their services. We also saw that peoples personal records included information about advocacy services and how to contact them. Care Homes for Adults (18-65 years) Page 23 of 38 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 enjoy the wide range of social, leisure and vocational opportunities which they choose to participate in within the home and community. People like the meals, which are well balanced and promote healthy eating. Evidence: We saw care records contained information to show peoples food preferences and dislikes and of any special dietary needs they have. We saw that people are consulted about the choice of meals. Everyone we spoke to said they liked the food and we saw they had opportunities to help prepare meals. Records are kept of the meals provided and we saw that they were well balanced and healthy. On the day of the visit the evening meal was being prepared by people who live in the home and one confirmed that it was her choice. We saw that fresh produce is used and fresh fruit was available for people to help themselves if they wished. The kitchen area was clean and tidy. There have been no visits to the service by an Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: environmental health officer since 6th July 2005. People told us about the range of social, leisure and vocational activities they have the opportunity to participate in. We saw that individual records are kept of the activities and interests people pursue and included visits to and from relatives, visits to pubs, shopping trips, craft classes, discos and cinema trips. Comments from the people we spoke to confirm these activities and their involvement in the local community. They also told us they can choose where they go on holiday, for example some people visited Eastbourne, some Spain and some Great Yarmouth last year. People who live in the home told us that they have regular meetings were they can discuss matters such as their choices and preferences of meals and leisure and social activities. A comment we received from a relative was that the service provides our relative with a fulfilled way of life with so many activities. Care Homes for Adults (18-65 years) Page 25 of 38 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 are happy with the health and personal care provided, which meets their current needs and promotes their independence. Evidence: People who use the service told us they looked after their own medicines and we saw that they had satisfactory storage facilities to enable them to keep them securely. The organisation has told us they have policies and procedures informing staff how to administer medication safely and staff confirmed as did training records this is included in their training programme. We saw there were well maintained records kept to show when medication had been given. They have a contract with a pharmacist who visits the service periodically and offers advice and guidance on the systems in place. We saw the most recent report of a visit made on the 17th November 2009. There were no issues arising from this. Care records we checked contained detailed information about peoples medical and health needs. They contained health action plans, medical care plans and information from other health professionals such as a speech and language therapist and a psychologist. We also saw records to show risk assessments are carried out about Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: individuals health related matters such as the risk of choking, behaviour management or falling and what to do to minimise these risks occurring. Records showed that health and personal care needs are regularly reviewed monthly and any changes necessary are documented. People we spoke to who live at Swallowdale told us they could visit the doctor when they wished and they had a choice of seeing them in private or with staff. We saw from the records we checked that people’s health is promoted and monitored in a variety of ways. For example, people attend well person clinics annually, their weight is monitored regularly and the organisation employs various health professionals who provide services to people when needed. They have also notified us appropriately of any matters affecting people’s health and well being and how they have responded to this. For example, when people have attended or be admitted to hospital for any reason. People who live in the home were satisfied with the care provided and their comments were it met theirs and their relative’s expectations. Care Homes for Adults (18-65 years) Page 27 of 38 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. Satisfactory processes are in place, which help to make sure people feel safe, know how and feel comfortable to raise concerns. Evidence: People told us they knew what to do if they had a problem or were unhappy and would feel comfortable to talk to staff about any concerns. All the people who responded to our survey said that they thought staff listened and acted on what they said. Relatives and carers who also completed surveys said they too, knew how to make a complaint and the service responded promptly if they had raised any. We saw that people who live in the home are given information about how to raise a complaint and a copy of this information was seen on each persons file checked. The manager told us it is available in different forms such as symbols or disc for people who communicate more easily this way. People told us they have house meetings and can raise any matters at these. We have not received any complaints neither have any safeguarding adults issues been raised with us since the last key inspection. We checked the records they keep of any complaints raised and saw there have been three in the past year and one, which the manager confirmed is still being looked into. Records are kept which detail the action taken to resolve any issues. However, we saw a concern had been raised and there was no information to show that there had been contact with the local authority to ascertain whether it needed referral under their procedures or not. The manager and company representative agreed action would be taken and since then we have received information to show this matter has been addressed. Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: Staff displayed a good knowledge of the forms of abuse that may occur and knew of their role to report such matters and who to report to. Records showed safe guarding of vulnerable adults is included as part of the organisations staff training programme and they have relevant procedures in place about this. People told us they felt safe living at Swallowdale. Care Homes for Adults (18-65 years) Page 29 of 38 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. The home is well maintained and provides comfortable, clean, well-personalised and safe accommodation for the people who live there. Evidence: We saw two rooms of people who gave us permission to do so. They were clean tidy and comfortably furnished and people told us that they are able to arrange their rooms how they wish and choose their own furniture and personal effects. Other communal areas we saw were also clean, tidy and homely with no obvious safety issues. These included the lounges, dining and kitchen area, bathrooms, toilets and the laundry room. We saw that there is antiseptic hand wash gel available for everyone to use and notices up reminding visitors to the home to do so. We saw peoples rooms are well personalised with items of their choosing. They have secure facilities in their rooms which they can use if they wish and their own room keys. The garden and external areas of the home are also well maintained and tidy. Since the last inspection staff said people who use the service had been involved with the maintenance of the garden and had entered a competition run by the organisation and attained second place. The manager said people had enjoyed growing and eating their own produce. People told us they liked living at Swallowdale. Those who had completed surveys told us Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: the home is always clean and tidy. Their comments during the visit showed that they are involved in domestic tasks, which increases their skilld and prepares them to live independently if this is what they wish to do. Their relatives also made positive comments about the living environment for example, Provides a high standard of accommodation and Excellent living conditions. We saw records to show that risk assessment of the safety of the environment had been reviewed in May 2009. People told us they are able to do their own laundry and staff support them where needed. There is a separate laundry room with domestic style appliances. Staff told us that they had training about infection control and equipment is available for them to use to maintain good hygiene standards. We saw people who use the service are free to come and go throughout the home as they please. People told us they felt safe in the home. Care Homes for Adults (18-65 years) Page 31 of 38 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 live in the home are protected by a thorough recruitment procedure and a well-trained, knowledgeable and supportive staff team. Evidence: We saw the records of two staff including someone who had been employed within the past year. We saw that the recruitment process included application forms being completed, obtaining proof of identity, criminal records bureau (CRB), protection of vulnerable adults (POVA) and reference checks for each person. Notes are kept of interviews and they told us they have policies and procedures about equal opportunities and employment. Both of the staff on duty confirmed this to be the process. Staff comments confirmed there is an induction process which includes training about a range of matters, reading the organisations policies and procedures and shadowing staff already working in the home. Training records showed a range of training some which is updated on a regular basis and some which is more specific to meet the needs of people who live in the home is provided for staff. They have told us all but one staff has attained or is working towards obtaining a nationally recognised vocational qualification in care (NVQ) at various levels. Staff said they felt well supported and valued. For example, it was commented, this is the best job Ive ever done, we look at people as individuals. Staff comments and Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: records confirmed they have regular individual supervision sessions and annual appraisals of their work. There have been changes to the staffing arrangements since the last key inspection. There is now a wakeful member of staff on duty at night. There is an on-call system in operation for additional staff to be called in if needed. During the day there is one staff member present. For people who need individual support from staff, this is provided additionally as needed. In the evenings and at weekends there are two staff on duty. The manager works additionally to the staff rota. No comments were made to indicate people who live in the home had any problems with staff who work in the home. They all said they have key workers and knew who they were. Records we checked showed that they had been able to choose, which staff member took on this role. They said they liked the staff and felt comfortable to talk to them. We observed staff were polite and courteous and supported people promptly and appropriately during our visit. For example, when preparing the evening meal. We also saw records are kept to show when people express their gratitude and complimented staff and the service. All the surveys we received from people who live in the home said staff treated them well. Care Homes for Adults (18-65 years) Page 33 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a well managed service which promotes the health, welfare and safety of the people who live in it and actively seeks their views to contribute to its development. Evidence: There has been no change to the management arrangements of the home. The manager has a lot of experience working with adults with learning disabilities. She has a management certificate and is an NVQ assessor. She is also responsible for managing another home in Alford and divides her time flexibly between the two services. Records we checked showed that the manager participates in regular training to keep her knowledge and skills up to date. People who use the service told us they knew who was in charge and felt able to tell staff or the manager if they had a problem. They thought action would be taken to resolve any issues and they would be listened to. All the surveys we received indicated this as well. We were told and records confirmed there are various ways in which people can make their views known. For example, at house meetings or at peoples individual review meetings. People who live in the home said they knew they could contact us too. Care Homes for Adults (18-65 years) Page 34 of 38 Evidence: Staff comments confirmed there are general staff meetings and team meetings held. They said they felt valued and supported in their role. A staff member made the comment you can contact the manager anytime and there is always a manager on call. She also commented this is the best job Ive ever done. She confirmed that the organisation uses surveys with staff as well as people who live in the home and their relatives to obtain their views about its quality. There are a range of systems in place to monitor the quality of the service including the Pointers committee, which is run by and for people who use the organisations services. Representatives from various services can sit on this committee if they choose to. There are also regular monthly visits from a senior manager who assesses and monitors areas such as staffing, complaints, social and community issues and building and maintenance issues. Records are in place to show these are carried out monthly. They have told us they have a range of organisational policies and procedures in place to promote the safety and welfare of people who use the service. Some are on display such as the procedure to be followed in the event of a fire occurring. Records we checked showed that regular checks of the fire alarm system are carried out, as are fire drills and checks of the emergency lighting system. We saw that there are risk assessments in place relating to fire safety and the environment and these had been reviewed within the past year. Records and comments from staff showed that the organisations training programme includes health and safety matters such as first aid, moving and handling and dealing with challenging behaviour. They have also confirmed that regular checks are carried out to make sure that equipment is in good working order, for example the emergency lighting was last serviced in June 2009, portable electrical appliances in February 2009 and the central heating system in January 2009. People told us they liked living at the home and felt safe. Relatives and carers comments we received included the service manages change well and in response to what the service could do better, very little, we just hope it continues as is has since it opened. Care Homes for Adults (18-65 years) Page 35 of 38 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 36 of 38 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 37 of 38 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) 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. Care Homes for Adults (18-65 years) Page 38 of 38 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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