Care Home: Sycamores

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What the care home does well Staff said: "This is as near a normal home as possible. "I enjoy working here and hope that it never closes." "There is good communication between clients and staff as well as the manager." "The home gives good care and support for the service users and staff that work in it." "It promotes independence and respects their choices." Staff also said that they get good support from the manager/proprietor and that she is always available if needed. One person living at Sycamores said, "staff cook well." Others said that they liked living there. There is a fairly stable staff team and therefore people are supported by staff that they know and who know them well. People can and do choose what they want to do and where they go. There is a very relaxed atmosphere and staff and users of the service appear to get on well. Care plans and risk assessments are reviewed each month and therefore staff have current information to enable them to appropriately and safely meet peoples` needs. What has improved since the last inspection? There has been some improvements to the environment. Since the last inspection the upstairs toilet, lounge, hall and stairs and two bedrooms have been redecorated. The bathroom, dining room and two bedrooms had their flooring/carpets replaced. Also some changes were made to the bathroom floor to make it level. New garden furniture has been purchased purchased. The requirement from the previous inspection have been addressed in that the bathroom and toilet flooring were replaced. The medication folder now contains photographs of each person using the service and there is a list of staff that are able to administer medication along with a sample of their initials. Both of these are good practice as they lessen the risk of error and provide accountability in that it is clear who has administered medication and when. What the care home could do better: A new medication storage cupboard with a controlled drugs facility is needed and medication should not be stored in the kitchen. This is to comply with regulations and best practice and to ensure that medication is stored under suitable and secure conditions. Although the bathroom flooring was replaced last year it is now in need of replacement again. This will be more hygienic and also improve the environment for the people living at Sycamores. Key inspection report Care homes for adults (18-65 years) Name: Address: Sycamores 33 Dymoke Road Hornchurch Essex RM11 1AA     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: Jackie Date     Date: 0 2 1 0 2 0 0 9 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: Sycamores 33 Dymoke Road Hornchurch Essex RM11 1AA 01708726933 01708707370 jinder.prior@ntlworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Harjinder Kaur Prior,Mr Michael Joseph Prior care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who 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 Date of last inspection Brief description of the care home Sycamores is in a residential area of Hornchurch and is within walking distance of Romford market town. The home offers 24hour care for 5 adults with learning disabilities. The home accommodates males only. All accommodation is in single bedrooms and one bedroom has an en-suite facility. 2 bedrooms are on the ground floor and 3 are on the first floor. The home is not suitable for anyone who uses a wheelchair as the corridors are narrow and there is no passenger lift to the first floor. People are supported in community based activities by the staff team. The scale of charges per week range from 830 pounds to 1220 pounds per week. The manager/proprietor provided this information at the time of the visit. Information Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 Brief description of the care home about the service provided is contained in the service users guide 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 last inspection of this service started on 2nd November 2007. This inspection was unannounced and started at 10:00am. It took place over five hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that people receive, and were also observed carrying out their duties. People using the service were asked to give their views on the service and their experience of living in the home. All of the shared areas and three bedrooms were seen. Staff, care and other records were checked. Feedback questionnaires were sent to people who use the service, staff and other professionals. Completed questionnaires were received from one healthcare professional and four staff. As staff also work at another service operated by the manager/proprietor some feedback obtained at the recent inspection of that service was also used. Keyworkers supported all of the people living at Sycamores to complete Care Homes for Adults (18-65 years) Page 6 of 30 feedback forms. In addition we had the opportunity to talk to four of the men using the service and to a member of staff. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in September 2009. Information provided in this document also formed part of the overall inspection. The inspector would like to thank the people living at Sycamores and the staff for their input during the inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: A new medication storage cupboard with a controlled drugs facility is needed and medication should not be stored in the kitchen. This is to comply with regulations and best practice and to ensure that medication is stored under suitable and secure conditions. Although the bathroom flooring was replaced last year it is now in need of replacement again. This will be more hygienic and also improve the environment for the people living at Sycamores. Care Homes for Adults (18-65 years) Page 8 of 30 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. Assessments completed by the home and information and reports received from health and social care professionals mean that staff have the necessary information available to enable them to determine whether or not the home can meet a persons needs. People and their representatives have a written contract/statement of terms and conditions and will therefore be aware of what they are entitled to. Evidence: Standards 1, 2, 3, 4 & 5 were tested. There is a statement of a purpose and service user guide. These are updated when needed and are available at the home. This gives people information that helps them to decide if they want to move into Sycamores. There have not been any new admissions to the service since 2004. However the home has an admission policy and the AQAA (Annual Quality Assurance Assessment) states that the person would be invited to visit the home, meet other people living there, stay for a meal and eventually stay overnight. This would enable them to get to know the people who already live there and to see what it is like living at Sycamores. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: In addition the manager would obtain the necessary information from the person, their care manager and their families. She would also carry out her own assessment and talk to other people living in the home. Therefore sufficient information would be gathered to enable the staff team to identify the persons needs and to determine whether or not the service could meet those needs. Each person has a contract completed by the placing authorities and they are available at the home. Therefore people have details about the service that they are entitled to. 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. Peoples care plans and risk assessments contain sufficient information to enable staff to meet peoples needs. People are encouraged and supported to be involved in decisions about what they do and what happens in the home. Their opinions are listened to and valued. Evidence: Standards 6, 7, 8, & 9 were tested. Each person has a plan which gives details of how they need/like to be supported. Three care plans were examined during the visit and the information contained in them was detailed and relevant. Areas covered included personal care, skills, mobility, behaviour, sleeping patterns, dietary needs and finance. They also indicate strengths and priorities and what individuals like and dislike. For example one person likes football and watching television, another likes to help with household tasks. Care plans are reviewed monthly by the staff team. Care plans seen were up to date and demonstrated that staff know people well. Each person had signed their care plan. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: There was sufficient information available for staff to work with the person and to meet their individual needs. Daily recordings are made about what each person has done and support that they have been given. Therefore there is information about each individual, which can be used as part of the review process and to identify ongoing and changing needs. There are up-to-date risk assessments covering the necessary areas. These are relative to each individual, the activities that they do and their own specific behaviours. People had signed the risk assessments. This means that risk can be reduced and that peoples needs can be met as safely as possible. The men living at Sycamores can and do say what they like and dont like and make decisions about what they do and what happens in their lives. It has previously been identified by the manager/proprietor that they do not like formal meetings and this can make them quite anxious. However she does sit with people regularly to get their views and keeps notes that these discussions. These records show that people are consulted about a variety of things including the menu, activities and what celebrations they would like. Also during the course of the visit people were asking about things and discussing options. Staff said the people are always allowed to choose and are asked to suggest things. 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. People have opportunities for personal development and are supported to be as independent as possible. They are encouraged to engage in appropriate leisure activities within the local community. People are supported to keep in contact with their friends and relatives and visitors are made welcome at the home. People are given meals that they like and that meet their needs and preferences. Evidence: Standards 11, 12, 13, 14, 15, 16 & 17 were tested. None of the people living at Sycamores use any formal day services, although they have in the past. They have also attended college in the past. Activities take place and Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: people attend a local Church on a Sunday. Local clubs are used which take place on Monday, Wednesday and Saturday. People also go to places of interest and like to go out for meals. They especially like going out for birthday celebrations and were talking about what they would do for one of the proprietors birthdays. They use local facilities. The proprietor also runs another home close by and most staff work across both homes. People living at Sycamores often go to the other home to socialise or do things with the people living there. On the day of the visit some people had visited the other home during the morning and one person decided to stay there for lunch and to spend time with his friend there. People usually have an annual holiday and this has often been abroad. However peoples needs have changed and after talking to people it was decided that individual needs would be better met by accessing short breaks and giving more choices. People also decided not to travel too far away from home. As a result of this they have had day trips to Clacton and Southend and weekend breaks in Norfolk and the New Forest. A few years ago people started to talk about having a dog. It was a big commitment and not everyone was a dog lover. So as a compromise the manager/proprietor suggested that she got a dog which lived with her but they would help care for it. People visited various rescue places and helped to choose the dog. The dog has been a regular visitor to the home and people help care for him and take him out for walks. The dog has been poorly recently and has had some operations and is having hydrotherapy. People take it in turns to go along with the manager to this. One person said that he liked taking Spartan to the park for a walk and that they took him to the dog pool. Each person participates in household chores in varying degrees and help with the cooking and shopping. They are all able to make their own tea or coffee and staff give minimal supervision for this and this as observed on the day of the visit. Care plans indicate ways in which people are encouraged to be independent. For example one persons plan says that he likes to help with household tasks, another says that he is helpful around the house and will clean the bath/shower after use. Staff supervise as and when necessary. People are encouraged to be as independent as possible. There was a very relaxed atmosphere at the home and people were observed to spend time sitting, chatting and having a cup of tea with staff. Links with families and friends are encouraged and there are no restrictions placed on visiting times. Families are invited to review meetings. One person has relatives in Cornwall and to assist him to visit them the manager/proprietor takes him to Bristol and the family meet him there. This cuts down on the travel time and distance and makes it easier for the family. Meals and meal times are generally arranged around the daily activities that are taking place. All of the people living at Sycamores are able to indicate what they Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: would like to eat. The main meal is in the evening and there is a four week rotating menu that was agreed with the people that live there. At lunchtime people chose what they had to eat and did not all have the same thing. One person had a lie in and had breakfast late so did not have his lunch with the others. Another person had his lunch at the other home. People said that they like to go out to eat especially to the Liberty Bell in Romford. Nobody has any specific dietary requirements in relation to their religious or cultural needs. Care Homes for Adults (18-65 years) Page 17 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. People who use this service receive personal care that meets their needs and preferences. There are supported to receive the health care that they need. People are supported to receive their prescribed medication safely. Evidence: Standards 18, 19, 20 & 21 were tested. The people living at Sycamores require differing amounts of support with their personal care and details of the help that they need and how they prefer to be supported are in their individual plans. However in the main people require only supervision and encouragement with personal hygiene. Care plans also show ways in which people are supported to be as independent as possible in this area. For example, can bath himself, has a bath everyday and needs assistance to wash his back and his hair, can electric shave himself. People receive personal care that meets their needs and preferences. Each person is registered with a local GP and specialist help is received when needed. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: This includes input from the psychiatrist. They also have an annual health check. Staff support each person to all of their medical appointments. Peoples files have details of health care issues and show that they have regular access to health care professionals. Records are kept of medical appointments and these show that people have checks from the optician, dentist and when needed the chiropodist. Therefore people are supported to receive the health care that they need. None of those living at Sycamores are able to self medicate and medication is administered by staff that have been trained and deemed capable to do this. The proprietor said all staff have medication instruction and training and that the pharmacist visits every three months to ensure everything is okay. Records show that staff had all received medication training during September. Examination of the MAR (Medication Administration Record) found that this had been appropriately completed with the necessary codes at the bottom of the sheet. For accountability the medication file contains the names of the staff that are able to administer medication along with their signed initials. There was a folder that contained details of what medication was for and medication information leaflets. The manager has put photographs of each person on the medication records in line with good practice. Medication is stored in a lockable cabinet attached to the wall in the kitchen area. To comply with regulations and best practice medication must be stored in a purpose made metal cupboard that is fixed to the wall in a suitable area unable to be viewed from outside, out of direct sunlight, and away from heat/humidity. Care homes are also now required to have a controlled drugs cupboard. The manager has discussed death and dying with people and their families and has recorded the outcomes in each persons care plan. All staff members have been made aware of this. 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. People living at Sycamores are safeguarded by the working practices and support of the staff team. Evidence: Standards 22 & 23 were tested. The home has policies and procedures for dealing with complaints and this is displayed in the home. The proprietor/manager is at the home regularly and has lots of informal discussions with the people living there. The people living at Sycamores have all been there for some time and therefore the manager knows them well and from observations during the visit it was apparent that they are comfortable talking to her. Families have been given her mobile telephone number so that they can contact her directly if they wish. Staff are also asked if they have any concerns or difficulties. There were not any recorded complaints. The Commission has not received any concerns or complaints since the last inspection. The proprietor/manager is appointee for four people and the other looks after his own finances with some support. Monies are kept in separate tins and only the manager has access to these. Records are kept and receipts are on file. A random selection of peoples finances was checked and cash amounts held agreed with records. Systems are in place to safeguard peoples finances. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Staff have received protection of vulnerable adults and challenging behaviour training. They are aware of what constitutes possible abuse and of the action that needs to be taken. The section on staffing later in this report gives information that confirms that there is an appropriate recruitment procedure and this also helps to safeguard people living in the home. 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 and comfortable home that is suitable for their needs Evidence: Standards 24, 25, 26, 27, 28, 29 & 30 were tested. Sycamores is a home for 5 adults with learning disabilities situated in Hornchurch, Essex. It is an end of terrace house with a large enclosed garden to the rear. There is a large through lounge, a kitchen/dining area, a bathroom and two bedrooms on the ground floor. Upstairs there are 3 further bedrooms, a toilet and a laundry room. The house is situated near to local bus routes and is conveniently situated for access to Romford town centre where there are shops, cinemas and other amenities. Bedrooms are suitable for the needs of the people using them. The rooms were very individual and contained peoples personal possessions and photographs. People can have keys to their rooms and some choose to do this. Since the last inspection the upstairs toilet, lounge, hall and stairs and two bedrooms have been redecorated. The bathroom, dining room and two bedrooms had their flooring/carpets replaced. Also some changes were made to the bathroom floor to make it level. The flooring was then replaced. However the new flooring is now Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: already in poor condition and needs to be replaced again. None of the people require any specialist adaptations and the home would not be suitable for people with mobility difficulties. There is a part-time handyman and he undertakes odd jobs and general maintenance of the house and garden. Therefore the building is appropriately maintained and safe. At the time of the visit the home appeared to be clean and was free from offensive odours. 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. People are supported and protected by recruitment practices of the service. Staffing levels are sufficient and staff receive the necessary training to meet peoples needs. People are supported by a staff team who know them well and who are committed to providing a good service to them. Evidence: Standards 31, 32, 33, 34, 35 & 36 were tested. There are two staff on duty during the daytime shifts and one waking staff on duty at night. In case of emergency staff can get support from the manager/proprietor or from the sister home. Feedback from the people living at Sycamores was that the staff were nice. People appeared to be very relaxed in the company of the staff and spent time chatting to them. Staff said if there are any problems they can always get support easily. From discussions with staff and from examining the rota the staffing arrangements are appropriate to meet the needs of the people living there. There is a fairly regular staff team and some staff have been at the home since it opened. Therefore people are supported by a regular staff team that know them well. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The home has an appropriate recruitment and selection policy and procedure. Several of the staff employed are now long standing and offer continuity of care. The files of two newer members of staff were checked. The files contained application forms, references, health declarations, interview questions, confirmation of identification and when appropriate confirmation of leave to remain in this country. There was also evidence of the necessary POVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau)checks. Therefore people are protected by the services recruitment procedure. Staff on duty said that they had received training since they started work in the home and records seen confirmed this. This training has included food hygiene, health and safety, moving and handling, challenging behaviour, infection control, protection of vulnerable adults, emergency first aid and refresher medication administration. The newest member of staff is to due to start NVQ level 2 in January 2010. Six other staff have already achieved NVQ level 2 and another is in the process of doing this. One member of staff is studying for NVQ level 3 and another has already completed this. Therefore staff receive the training that they need to provide a good service to the people living there. 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. People living at Sycamores benefit from a service that is well managed and where their opinions are sought and valued. They live in a safe home. Evidence: Standards 37, 38, 39 & 42 were tested. The manager/proprietor has completed NVQ level 4 and is suitably qualified. She has extensive experience of running service for people with learning disabilities. She is registered to manage both of the homes that she is proprietor to and spends her time between the two services. The staff are aware of the lines of accountability within the home and were clear about their roles and responsibilities for the day. Feedback from staff was that there were good relationships between the people living at Sycamores, staff and the manager. Staff also said that they get good support from the manager and that she is always available when needed. The manager monitors the quality of the service provided. She has devised quality assurance forms and gives them to people when they visit but she has not had any Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: returned. However it was evident that she regularly seeks the views of the men and that she has discussions with relatives. In addition she carries out spot checks at the home both during the day and at night. The necessary health & safety checks are carried out regularly and records are kept of these checks. For example fire call points and hot water temperatures are tested weekly and fridge and freezer temperatures are checked daily. Appropriate servicing is carried out on the fire system and fire equipment and fire drills had been held in February and June 2009. Appropriate service and checks are also carried out on equipment and services. For example gas safety and portable appliance testing. A safe environment is provided. 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 1 20 13 Medication must be stored in 31/12/2009 a purpose made metal cupboard that is fixed to the wall in a suitable area unable to be viewed from outside, out of direct sunlight, and away from heat/humidity. There must also be a controlled drugs cupboard. To comply with regulations and best practice and to ensure that medication is stored under suitable and secure conditions. 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 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. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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