Care Home: The Beeches

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What the care home does well The environment supports communication in that there is lots of information displayed about who is on duty, what activities are on offer. This means that people can find out about things for themselves rather than having to rely on staff. Staff work with health professionals to ensure that people have the support they need to remain healthy and well. People can access the garden so can get fresh air when they want to. Service users are involved in keeping the garden tidy and growing flowers and vegetables. The staff team and management are stable and some staff are longstanding. This means that they know service users well. What has improved since the last inspection? The three requirements made at the last inspection have been met. The audit and monitoring of practice including medication practice has improved. This means that any errors can be picked up early and acted on, protecting service users. The manager is now registered with us so he has passed the fit person process. Staff have had training in areas related to peoples needs like Person Centred Planning. The frequency of one to one meetings for staff has increased. This means staff have more opportunity to talk about work and get the support they may need. The induction has been updated to include up to date information about learning disabilities. What the care home could do better: We found that for some people the new Person Centred Plans are still at an early stage. Work should continue to ensure that everyone has a plan that details how staff are to support their needs and hopes and dreams for the future. The manager may wish to review plans to ensure that all of the information in the files is still relevant. The manager may wish to review the amount and purpose of daily records completed by staff so they have more time with service users. To protect peoples dignity and privacy the manager should ensure that sensitive information about service users is held in line with the Data Protection Act. Anyone subject to physical intervention should have clear dated guidelines showing their consent, agreement and involvement, to protect them and staff. So the home is a nice safe place to live, some work is needed to the rear of the building. Key inspection report Care homes for adults (18-65 years) Name: Address: The Beeches 35 Ethelbert Road Canterbury Kent CT1 3NF     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: Kim Rogers     Date: 1 2 0 9 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 29 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 29 Information about the care home Name of care home: Address: The Beeches 35 Ethelbert Road Canterbury Kent CT1 3NF 01227769654 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): canterbury.thebeeches@virgin.net Mr David John Barzotelli Name of registered manager (if applicable) Mr Christopher Paul Dives Type of registration: Number of places registered: care home 18 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: 18 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home The Beeches is a care home, which has been registered to provide personal care, support and accommodation to 18 people with learning disabilities. People at this home should all be over 18 years of age. The home is located in a residential part of Canterbury, not far from the city centre and close to public transport. There is parking space for up to eight vehicles at the front of the house and also some on road parking, though this is subject to restrictions. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 18 1 3 0 2 2 0 0 9 Brief description of the care home The home consists of a large detached building with an extension to the rear. All bedrooms are single. At the rear of the house is a garden area, with seating, greenhouse and shed, which is well maintained and accessible. The owner is Mr David John Barzotelli, who also owns another home in the area. Mr Christopher Dives is the registered manager. The basic fee payable is about £633.93 per week. Any extra care (e.g. for personal care, toileting, feeding, speech programmes or extra / specialist community integration) is charged for on top of the basic fee. Transport costs and day centre sessions are also extra charges payable. For more information about the fees and services please contact the provider. Care Homes for Adults (18-65 years) Page 5 of 29 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: This was an unannounced Key inspection of the service. This means that we assessed the Key Minimum Standards. The last Key inspection of this service was 13/02/09. Copies of this report are available from the Provider or can be viewed on our website. We spoke to people who use the service. We spoke to staff and sampled various records. We made observations. We looked at the last Annual Quality Assurance Assessment or AQAA. The manager completed this and it gives good information about how the home has improved and how they intend to improve further. Following the last inspection the manager sent us an improvement plan detailing how they intend to improve and meet the three requirements that we made on 13/02/09. We found that these three requirements have been met. Care Homes for Adults (18-65 years) Page 6 of 29 We looked at any notifications from the home about accidents and incidents. We sent surveys to people who use the service and other stakeholders. People told us what they think about the Beeches. We received 6 surveys back from service users and 5 from staff. All made positive comments about the service including, Staff said, I feel the home treats all service users as individuals and meets their needs well. Sometimes could have more staff on duty. Staff do so much paperwork when time could be spent with service users The Beeches is a happy home, staff appear to enjoy working here. I feel the Beeches offers support care and understanding to everyones needs It is a very homely place Has a lovely comfortable homely feel Good fun atmosphere and provides for everyones needs. Service users said, We get to help around the home. The staff are nice It is a clean home I like the staff, the food, my bedroom and day trips All the staff help me. It is a nice comfortable home. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: We found that for some people the new Person Centred Plans are still at an early stage. Work should continue to ensure that everyone has a plan that details how staff are to support their needs and hopes and dreams for the future. The manager may wish to review plans to ensure that all of the information in the files is still relevant. The manager may wish to review the amount and purpose of daily records completed by staff so they have more time with service users. To protect peoples dignity and privacy the manager should ensure that sensitive information about service users is held in line with the Data Protection Act. Anyone subject to physical intervention should have clear dated guidelines showing their consent, agreement and involvement, to protect them and staff. So the home is a nice safe place to live, some work is needed to the rear of the building. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 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 29 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 their needs assessed before they move in. There is some information about the home to help people decide about moving in. Evidence: We found that there is some information about the home giving details of the service provided. This is produced in text and is displayed in the home. We found some information is produced in a way that is more meaningful with pictures and photographs. This means that people have some user friendly information about the home. Before a person moves in the home obtains an assessment from care management and carries out their own assessment. This is done so that the manager can make sure the home can meet the persons needs. At the last inspection the manager agreed to make sure that peoples personal goals and aspirations are assessed as well as their needs. This means the manager can make sure peoples aspirations as well as their needs can be supported. We found that no one has moved in since the last inspection. We found at the last inspection that people are offered trial stays and visits before they decide to move in. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: We received six surveys from service users. Service users said that they were asked about moving in and that they had the information they needed to make a decision about moving in. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their needs will be recorded and supported. Potential risks are assessed and managed and people have support to make choices and decisions. Evidence: We found that each person has a service user plan. This details the persons needs and what staff need to do to meet those needs. This means that people get the support they need in the way they prefer. In two plans sampled we found some old information, some dating back to 1999 that may no longer be relevant. This means that files are heavy and bulky and may have old information that staff do not need on a day to day basis. The manager may wish to review this and archive some information. We found that a start has been made on developing individual person centred plans (PCP). The manager has developed a planning tool that key workers are completing with each person. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The person centred plans find out about the persons personal goals and aspirations for the future. This is work in progress, as we found at the last inspection. For the two people sampled this is at a very early stage as a lot of the pages are blank. For one person two goals for the future had been identified and recorded but there was no plan in place yet to who staff are to support these goals and who is to do what by when. Staff said they have watched a training video about person centred planning and are working with individual service users to complete the new plans. We found that most information is held securely but some sensitive information about service users is not recorded and stored in line with the Data protection Act. Staff use a file showing the schedule for the day that includes a bath rota showing service users names. This means that people confidentiality and privacy is not protected and the manager needs to review how this information is recorded and held. We received five surveys back from staff. Staff said they have a lot of paperwork to do that takes them away from spending time with service users. We found that staff complete lots of different records on a daily and a monthly basis. For example a review sheet is completed monthly about whether some one wants two chairs in their bedroom or not. Staff also complete a separate monthly record of chats with staff to see if the person is happy at the home. There is a separate dependency chart to complete monthly. It may be possible to combine this to reduce the time staff spend on paperwork. The manager may wish to review this so that staff are recording what is relevant and necessary and not recording things twice giving staff more time to spend supporting service users. The new plans include information about how people communicate. This is clear and detailed to ensure that people have the support they need to make choices and decisions. We found that the environment supports communication in that information is displayed in a meaningful way. For example people can see what activities are on offer, what is for dinner and who is on duty. We found that menu board showing meal choices was not on the wall on the day of the visit but behind a cabinet. This means that people could not see what was on offer that day so had to rely on staff telling them. We found that potential risks to people are identified and assessed. Action is recorded that staff must take to reduce risks. We found that risk assessments are reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 14 of 29 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 support to access a range of activities and life long learning opportunities. People have support to keep in touch with family and friends. Food is wholesome and nutritious and people have support to be involved in planning and preparing meals. Evidence: We found that people have the opportunity to take part in a range of activities including furthering their education. Some people attend college and local day services. Some people are attending courses on how to develop and increase their life skills. One person said they enjoyed recent courses on cooking and horticulture at college. Staff said service users have enjoyed recent organised trips out. Staff can use a vehicle to support people to access the community. Staff said they also support people to use public transport or to walk down into Canterbury town centre. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We found that each person has an activity planner so people know what they are doing and when. Activity choices are displayed on a board in the lounge to help people choose what they would like to do. Staff facilitate activities held in house. We saw one person having support to complete a jigsaw puzzle, one person was helping in the kitchen and others were watching football on television. We found that hobbies are supported, for example, one person enjoys gardening and growing flowers so has a green house and vegetable plot to use. Some people have support to attend church. There are also visiting churches and entertainers invited into the home. People told us about their holidays that they said they enjoyed. Some people have had holidays with their family. Nine service users were away for the weekend together during our visit. We found that people have the support they need to keep in touch with family and friends. Families are invited to review meetings if service users wish to have them there. There are two telephones for service users use. Contact details of family and friends and the support people need to keep in touch are recorded in service user plans. We found that people are involved in planning and preparing meals at the home. Although most of the food is purchased on line and delivered to the home, people go to the local shops for small items. This means that people get to experience the sights and sounds of shops and supermarkets. One person told us they help staff with the cooking. On the day of the visit a service user was in the kitchen helping the cook. We found that service users can make drinks when they want them. Special diets are supported and weight and nutrition is monitored to ensure people stay well and healthy. The six surveys we received from service users said that people can choose how they spend their days and evenings. Care Homes for Adults (18-65 years) Page 16 of 29 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 know their personal and health needs will be supported. Medication practice is safe protecting service users. Evidence: We found that peoples personal care needs are recorded in their individual plans. This means that people are supported with personal care in the way they prefer. Although there are no en suite bedrooms, toilets and bathrooms are sited close by. This means that people can have a bath or shower when they want to. We found that health needs are recorded with action by staff to meet those needs also recorded. We found that there is a record of health appointments and outcomes. The home has worked closely with health professionals to ensure that people have the support they need with their health. The manager has introduced health action plans that staff are in the process of completing with individuals. This means that service users will have the support they need to take more responsibility and control over their health. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: We found that records of monitoring of health needs are kept. This means that staff can recognise any changes at an early stage. We looked at medication storage and found this to be safe. There is a central medication cupboard and service users usually come to this cupboard for their medication or their medication is taken to them. The monitored dosage system is used. Mostly staff control medication. Staff said that service users are constantly assessed to see if they can take any more control of their medication with the right support. We found that medication records are in order. The acting team leader said that the audit of medication practice has improved since the last inspection. She said that the staff in charge checks the records daily and reports any discrepancy to the manager. She said the manager checks the records regularly to make sure any errors are picked up and acted on. The improvement plan from the manager says the audit of medication practice has improved and there has been more staff training to ensure that staff have the skills they need to administer medication safely. Care Homes for Adults (18-65 years) Page 18 of 29 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. Peoples complaints are listened to and acted on. People are safeguarded from harm and abuse. Some guidelines to support problem behaviors need review. Evidence: We found that there is a complaints procedure. This is displayed in the home and given to all new residents. The manager has developed a more meaningful procedure with pictures and photos. This means that the procedure is more accessible for everyone. There is some information available to people about local advocacy services should they need them. Staff told us how the know that people are not happy about something. They said they look for clues in peoples body language and gestures. Neither the home nor the Commission have received any complaints about the service since the last inspection. The home has a policy and procedures to follow to ensure that people are safeguarded from harm and abuse. We found that staff have training in how to safeguard vulnerable adults. When asked staff could say what abuse is and how they would respond to it that is, whom they would report to. Six service users returned surveys to us. All six surveys said that people know who to talk to if they had a complaint. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We found some guidelines to support problem behavior in a service user plan sampled. The guidelines said to take the persons wrists and hold them gently but firmly until the person calms down. This is a restrictive physical intervention. These guidelines are not dated or signed by who was involved in writing them. There is no record that the person concerned agrees with or consents to this restrictive physical intervention. When asked the person said if staff held their wrists it would probably make it worse. Staff said they have not had to do this for some time. To ensure that service users and staff are protected, the manager should review the any behavior support guidelines and if physical intervention is still necessary it should be assessed and documented with the persons consent, agreement and involvement, in line with the Minimum Standard and good practice guidance. Care Homes for Adults (18-65 years) Page 20 of 29 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 generally clean and well maintained. Evidence: We found that the home is clean and that service users have support to take part in household chores and in tending the garden. This means that people are included and involved in the day to day running of the home. We found that two parts of the home did not very smell fresh (the area at the bottom of the stairs and by the office) and the manager may want to look into this. This seems to be isolated to the day of the visit as all six surveys from service users said the home is always clean and smells fresh. All bedrooms are single although none have en suite facilities. Toilets and bathrooms are sited near to bedrooms. Some bathrooms have been updated and a wet room has been created to offer people the choice of a shower. There are large communal areas that people can relax in. We found that seating consists of single chairs with no multiple seats like a sofa. This means people do not have the opportunity to sit close to each other and the manager may wish to review this. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: People can access the garden from the house. The garden has seating, patio area, vegetable plot and green house. The size of the garden has been reduced as an area of the garden has been sectioned off due to some building work. People said they enjoy spending time in the garden. We found that the home is generally well maintained although some parts of the rear of the house are in need of attention. For example there is flaking paint on the fascia boards to the rear, first floor of the house. A rear first floor window has flaking paint and some tiles to the rear are missing and broken. The manager may wish to include this work in the development plan for the home. Care Homes for Adults (18-65 years) Page 22 of 29 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. There are enough trained staff to meet peoples needs. Recruitment checks are robust protecting service users. Evidence: We found that there are enough staff to meet peoples needs. We found that staffing can be flexible so that extra staff can be called on when necessary. Staff said that the rota is planned around the needs of the service users. For example, to accommodate outings, activities and appointments. The home employs support workers, domestic staff and a cook. There are waking and sleeping staff on duty at night. There is a manager and deputy manager. The staff team is stable with some longstanding staff so staff know service users well. All staff are permanent staff and have job descriptions and contracts. This means that service users have continuity of care and support. Names of people on duty are displayed so service users know who will be supporting them. One person told us, the staff are brilliant here. Staff said they have the opportunity to attend regular staff meetings and have one to one meetings with a line manager. This means that they have the opportunity for Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: discussions with colleagues and time for coaching and mentoring. We spoke to a new staff member who said they had an interview and got to meet service users before they started work at the home. They said that recruitment checks were carried out and that they had an induction. Other staff confirmed this in the surveys we received. Staff said they had Criminal Records Bureau checks and that they have the training and support they need. The induction has been improved since the last inspection to include up to date information about learning disabilities. The improvement plan from the manager says that staff are now trained in Person Centred Planning and the acting team leader confirmed she had done this training. Care Homes for Adults (18-65 years) Page 24 of 29 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. The home is well managed. People who use the service have the opportunity to air their views and opinions about the home. People know that their health and safety is protected. Evidence: The same manager is in post as at the last inspection. The manager is now registered with us. This means that he has passed the fit person process so people know he is fit to manage the service. The manager is working towards the qualification required by the Minimum Standards. The manager has the support of a deputy manager and team leaders. Staff said positive things about the manager in the five surveys we received and face to face to the inspector. The three requirements made at the last inspection have been met. We found that service users views are sought at service user meetings. Some changes have been made based on service users views including organising and offering more outings. Staff said people have enjoyed recent outings. Surveys are sent out to Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: stakeholders like family and staff. People give their views and the manager produces a report and action plan for improvement. This is shared with stakeholders so they can see how the home intends to improve. Results from the recent quality assurance audit shows that staff, service users and relatives are happy with the service provided. There is an annual development plan showing how they intend to improve the service. The audit and monitoring of medication practice has improved since the last inspection. We found that the home was given a four star rating on 24/03/09 by the environmental health officer. The last AQAA shows that health and safety checks are carried out on the premises and equipment. This protects service users. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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